Transgender and nonbinary young adults of color experience intersecting gender and racial discrimination in sexual healthcare settings and develop identity-affirming protective strategies to navigate these barriers.
Key Findings
Results
Participants experienced gender-based discrimination in sexual healthcare settings, representing a significant barrier to care.
Sample consisted of 20 transgender and nonbinary young adults of color (TNYAC) ages 20-30 years residing across the United States
Interviews were conducted via Zoom from September 2021 to January 2022
Gender discrimination was identified as a distinct theme through thematic analysis guided by intersectionality theory
Researchers used double-coding of transcripts to ensure analytical rigor
Results
Participants experienced racial stereotyping in sexual healthcare settings as a form of discrimination.
Racial stereotyping was identified as a distinct theme separate from gender discrimination
Participants held diverse racial/ethnic identities including Black, Latine, Asian-American and Pacific Islander, and multiracial
Racial stereotyping was described as occurring through both interpersonal and systemic interactions
These experiences were analyzed as part of intersecting systems of racial and gender oppression
Results
Participants experienced racial segregation within sexual healthcare settings.
Racial segregation was identified as a third distinct theme in sexual healthcare experiences
Like other forms of discrimination, racial segregation was characterized as occurring through both interpersonal and systemic interactions
This finding reflects systemic, not just individual-level, barriers to care for TNYAC
Results
Participants reported that their sexual healthcare experiences were shaped by the intersection of both racial and gender oppression simultaneously, not just one form of discrimination at a time.
Intersectionality theory guided the analytical framework of the study
Participants explicitly noted how intersecting systems of racial and gender oppression shaped their experiences, not each system in isolation
This intersectional experience was identified as a distinct theme beyond the individual themes of gender discrimination or racial discrimination alone
Results
Transgender and nonbinary young adults of color developed identity-affirming protective strategies to navigate discrimination in sexual healthcare.
Protective strategies included independent information seeking outside of clinical encounters
Another protective strategy was choosing providers with shared gender and/or racial identities
These strategies were described as reflecting the resilience of TNYAC in navigating discriminatory systems
The use of such strategies also underscored the need for equitable and inclusive healthcare services
Discussion
Healthcare system-level interventions were identified as potential solutions to address multiple forms of discrimination experienced by TNYAC.
Cultural humility training for healthcare providers was identified as a recommended intervention
Co-located services were also recommended to improve care access and quality
These recommendations were framed as responses to participants experiencing 'multiple forms of oppression'
The study called for 'equitable and inclusive healthcare services' as a systemic need
What This Means
This research suggests that transgender and nonbinary young adults of color face a compounded set of challenges when seeking sexual healthcare. Through in-depth interviews with 20 participants from diverse racial and ethnic backgrounds across the United States, researchers found that these individuals encountered discrimination based on both their gender identity and their race — including racial stereotyping and racial segregation within healthcare settings. Importantly, participants described how these two forms of discrimination did not operate separately but combined in ways that made their healthcare experiences uniquely difficult, a concept known as intersectionality.
This research also suggests that, in response to these barriers, participants developed their own coping strategies. These included seeking out health information on their own rather than relying on providers, and deliberately choosing healthcare providers who shared their racial or gender identity. While these strategies reflect the resourcefulness and resilience of the people interviewed, they also point to a significant gap in healthcare systems that places the burden of navigating discrimination on patients themselves.
The study highlights that improving sexual healthcare for transgender and nonbinary people of color requires addressing discrimination at the system level, not just through individual provider awareness. The researchers suggest interventions such as cultural humility training for healthcare workers and co-located services — meaning combining different types of care in one place — as ways to reduce barriers. This matters because unmet sexual healthcare needs can have serious consequences for health, and marginalized groups already face disproportionate health disparities.
Mazon C, Badillo C, Polanco Walters F, Hughto J, Nelson K, Gordon A. (2025). Experiences of Gender and Racial/Ethnic Discrimination in Sexual Healthcare Among Transgender and Nonbinary Young Adults of Color.. Perspectives on sexual and reproductive health. https://doi.org/10.1111/psrh.70017