Enhancing Gender-Affirming Provider Communication to Increase Health Care Access and Utilization Among Transgender Men and Trans-Masculine Non-Binary Individuals

LGBT Health. 2020 Aug/Sep;7(6):292-304. doi: 10.1089/lgbt.2019.0294. Epub 2020 Jun 3.


Purpose: This study was designed to enhance health care providers' abilities to engage transgender men and trans-masculine non-binary individuals (TMNBI) in sexual and reproductive health care conversations by identifying preferences for provider communication and terminology related to sexual and reproductive anatomy and associated examinations. Methods: From May to July 2017, we conducted a cross-sectional online survey with a convenience sample of TMNBI (N = 1788) in the United States. We examined participants' provider communication experiences and preferences related to sexual and reproductive anatomy, and preferred terminology for sexual and reproductive anatomy and associated examinations. Communication experiences/preferences and preferred terminology were assessed by gender identity and gender-affirming medical interventions (hormones and/or surgery). Results: Most participants had regular access to health care (81.3%); of those, 83% received care from a provider knowledgeable in transgender health. Only 26.9% of participants reported that a provider had ever asked about preferred language for their genitalia/anatomy. The majority of the sample (77.7%) wanted a provider to ask directly for preferred language and 65% wanted a provider to use medical terminology, rather than slang when talking about their body. Participants provided varied responses for their preferred terminology related to sexual and reproductive anatomy and associated examinations. Conclusions: These data underscore the importance of medical providers asking for and then using TMNBI' preferred language during sexual and reproductive health conversations and examinations, rather than assuming that all TMNBI use the same language. Asking for and using TMNBI' preferred language may improve gender-affirming sexual and reproductive health care and increase patient engagement and retention among these individuals.

Keywords: gender-affirming health care; patient–provider communication; sexual and reproductive health; transgender men.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Adolescent
  • Adult
  • Communication*
  • Cross-Sectional Studies
  • Female
  • Health Personnel / psychology*
  • Health Services Accessibility / statistics & numerical data
  • Humans
  • Male
  • Middle Aged
  • Patient Acceptance of Health Care / statistics & numerical data
  • Physician-Patient Relations*
  • Transgender Persons / psychology*
  • Transgender Persons / statistics & numerical data
  • Transsexualism*
  • United States
  • Young Adult