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RESEARCH ARTICLE (Open Access)

Understanding the health care needs of transgender and gender diverse people engaging with rural Australian sexual health centres: a qualitative interview study

Ava Del Tufo https://orcid.org/0000-0003-0300-5897 A * , Rosalind Foster A B , Bridget Haire A , Christy E. Newman https://orcid.org/0000-0002-5482-2822 C , Anthony K. J. Smith https://orcid.org/0000-0002-0005-9542 C , Margaret Crowley D , Donna Burn E and Anna McNulty B F
+ Author Affiliations
- Author Affiliations

A Kirby Institute, Wallace Wurth Building, Corner of High Street & Botany Street, UNSW Sydney, Sydney, NSW 2052, Australia.

B Sydney Sexual Health Centre, Level 3, Nightingale Wing, Sydney Eye Hospital, 8 Macquarie Street, Sydney, NSW 2000, Australia.

C Centre for Social Research in Health, UNSW Sydney, Sydney, NSW 2052, Australia.

D Dubbo Sexual Health Centre, 203 Brisbane Street, Dubbo, NSW 2830, Australia.

E Orange Sexual Health Centre, 96 Kite Street, Orange, NSW 2800, Australia.

F School of Population Health, UNSW, Samuels Building, F25, Samuel Terry Avenue, Kensington, NSW 2033, Australia.

* Correspondence to: z5215088@ad.unsw.edu.au

Handling Editor: Lisa McDaid

Sexual Health 20(4) 339-346 https://doi.org/10.1071/SH22159
Submitted: 23 September 2022  Accepted: 8 May 2023   Published: 5 June 2023

© 2023 The Author(s) (or their employer(s)). Published by CSIRO Publishing. This is an open access article distributed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License (CC BY-NC-ND)

Abstract

Background: Although there is a presumption that LGBTQ+ people living in rural Australia will have poorer health outcomes than those living in metropolitan areas, minimal research has focused specifically on the perspectives of transgender and gender diverse (henceforth referred to as ‘trans’) people living in these regions. The purpose of this study was to understand what health and wellbeing means to trans people in a regional or rural community and identify their health needs and experiences.

Methods: A total of 21 trans people were recruited through two regional sexual health centres (SHC) and interviewed between April and August 2021. Data were analysed via reflexive thematic analysis. This paper focuses on participants’ accounts of health and wellbeing regarding gender affirmation, the experience of rural living, respectful holistic care, safety in rural communities, isolation, loneliness, and employment.

Results: The experience of living rurally can have both positive and negative impacts on the experiences of trans people. Participants reported experiences of stigma and discrimination, reduced employment opportunities and limited social interactions, which led to feelings of isolation and loneliness; however, they also reported high quality of care, particularly with the specific SHCs which supported this research.

Conclusion: Living rurally can impact both positively and negatively on the health and wellbeing of trans peoples, and the experiences of living in this environment are diverse. Our findings challenge the perception that rural trans people experience only poor health outcomes and shows the difference that key health services such as SHCs can make in supporting trans health.

Keywords: Australia, gender affirming care, gender diversity, LGBTQ+ health and wellbeing, qualitative analysis, rural and regional health, sexual and reproductive health, transgender health.


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