"We need to be heard, respected, and supported" : the impact of sexual healthcare interactions and discrimination on the mental health of trans and gender diverse people

The history of trans and gender diverse (TGD)1 healthcare has been characterised by a lack of understanding and erasure around how individuals experience their gender and sexuality. TGD people often bear the brunt of stigma and discrimination based on their gender and expression, which has significant impacts on their lives and healthcare (Balik et al., 2020). In most societies around the world, TGD people face marginalisation from multiple, often intersecting, aspects of their daily life, including legal, economic, educational, employment, housing, medical, social, and cultural forms of discrimination (James et al., 2016). At the same time, the invisibility of TGD people within population-based data collection and research continues to preclude trans health and social issues from being considered and represented within policy and resource and service allocation (Callander et al., 2019). Specifically, TGD people often face significant barriers to adequate healthcare compared to cisgender (cis) counterparts (Shires & Jaffee, 2015). This is, in part, attributable to fear, stigma, transphobia, lack of trans inclusive and specific services, and healthcare workers being under-informed of the specific needs for trans and gender diverse patients, which subsequently leads to unmet health needs and discrimination within mainstream health services (Balik, et al., 2020; Poteat, German, & Kerrigan, 2013; Ussher, Allison, Perz, Power, & The Out with Cancer Study Team, 2022a).