TY - JOUR
T1 - The Impact of COVID-19 on Healthcare Access for Gender-Diverse Adults
T2 - A Qualitative Study
AU - Sahasrabudhe, Saniya
AU - Snyder, Jaylin
AU - Akré, Ellesse Roselee
N1 - Publisher Copyright:
© The Author(s) 2026. This article is distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 License (https://creativecommons.org/licenses/by-nc/4.0/) which permits non-commercial use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access pages (https://us.sagepub.com/en-us/nam/open-access-at-sage).
PY - 2026/1/1
Y1 - 2026/1/1
N2 - Background: Transgender and gender-diverse (TGD) individuals, whose well-being relies on gender-affirming care, faced heightened barriers during the COVID-19 pandemic. Structural inequities intensified as non-emergent services were deprioritized. Objective: In this paper we examined changes and delays in healthcare access by TGD populations across the United States during the COVID-19 pandemic. Methods & Design: From September 2022 through March 2023, we administered an online survey to TGD adults in the United States. Participants responded to the question, “How did COVID-19 impact your experience accessing healthcare?” We used inductive coding and thematic analysis techniques to analyze the 87 responses. Results: Response themes were: (1) shift to telehealth, (2) availability and access and why those were limited, (3) affordability, (4) delays in gender-affirming care, and (5) delays in healthcare overall. Participants frequently discussed telehealth shifts and access limitations. Conclusion: TGD individuals face significant, structurally rooted healthcare barriers that COVID-19 intensified. Integrating gender-affirming care into comprehensive healthcare systems is essential for ensuring accessible care for TGD populations. Additionally, creating and reforming relevant policies with input from TGD individuals can help reduce healthcare access disparities going forward and in future crises.
AB - Background: Transgender and gender-diverse (TGD) individuals, whose well-being relies on gender-affirming care, faced heightened barriers during the COVID-19 pandemic. Structural inequities intensified as non-emergent services were deprioritized. Objective: In this paper we examined changes and delays in healthcare access by TGD populations across the United States during the COVID-19 pandemic. Methods & Design: From September 2022 through March 2023, we administered an online survey to TGD adults in the United States. Participants responded to the question, “How did COVID-19 impact your experience accessing healthcare?” We used inductive coding and thematic analysis techniques to analyze the 87 responses. Results: Response themes were: (1) shift to telehealth, (2) availability and access and why those were limited, (3) affordability, (4) delays in gender-affirming care, and (5) delays in healthcare overall. Participants frequently discussed telehealth shifts and access limitations. Conclusion: TGD individuals face significant, structurally rooted healthcare barriers that COVID-19 intensified. Integrating gender-affirming care into comprehensive healthcare systems is essential for ensuring accessible care for TGD populations. Additionally, creating and reforming relevant policies with input from TGD individuals can help reduce healthcare access disparities going forward and in future crises.
KW - access to care
KW - COVID-19
KW - transgender and gender-diverse]
KW - [gender-affirming
UR - https://www.scopus.com/pages/publications/105044346852
UR - https://www.scopus.com/pages/publications/105044346852#tab=citedBy
U2 - 10.1177/11786329261464655
DO - 10.1177/11786329261464655
M3 - Article
C2 - 42433385
AN - SCOPUS:105044346852
SN - 1178-6329
VL - 19
JO - Health Services Insights
JF - Health Services Insights
ER -