- The third most commonly reported barrier was availability, which referred to a lack of access to services. 
- Lack of availability was due to the general lack of providers, as well as a specific lack of competent providers who were willing to provide care to transgender and gender non-conforming patients.

Arizona State University

Issues related to treatment providers and availability of care were reported as barriers to gender-affirming care.

Medical and Mental Health Field Barriers to Gender-Affirming

Puckett, J. A., Cleary, P., Rossman, K., Newcomb, M. E., & Mustanski, B. (2018). Barriers to Gender-Affirming Care for Transgender and Gender Nonconforming Individuals. Sexuality Research & Social Policy, 15(1), 48–59. https://doi.org/10.1007/s13178-017-0295-8

Barriers to Gender-Affirming Care for Transgender and Gender Nonconforming Individuals

Availability of Care

- Some issues related to the medical and mental health fields were reported as barriers to gender-affirming care. 
- Some persons encountered unfamiliarity from medical professionals, such as a lack of knowledge about transition-related care (e.g., appropriate dosage of hormones) or the diversity of transgender identities.
- Common experiences included being asked invasive questions that perpetuated beliefs in only two genders and left participants feeling invalidated.
- Several reported experiencing bias and stigma from mental health providers. This included participants feeling that their mental health was inappropriately used as a rationale to deny care, being denied mental health services as well as therapists “gatekeeping” and interfering with obtaining letters that are recommended under WPATH guidelines.


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