“How Does My Not Being Able to Fit Into a Box Affect My Care?”: The Risks and Rewards of Disclosing Non-Binary Gender to Health Care Providers

Abstract

Transgender people encounter many obstacles to receiving quality health care, including lack of access to gender transition-related care, health care providers’ unfamiliarity with how to provide appropriate care, and outright discrimination in clinical settings. These obstacles affect transgender people differently depending on factors including their race, class, age, and ability. While there is a great deal of research on some of these factors, there has been little consideration of the barriers to health care that specifically affect non-binary transgender people, who do not solely identify as men or women. This thesis explores the unique experiences of non-binary transgender people in health care settings through interviews and a focus group with transgender people exploring how they make decisions to disclose that they are transgender to their health care providers or to keep their identities private. This study finds that non-binary transgender people encounter unique obstacles in their interactions with health care providers due to the transnormative medical enforcement of the gender binary, but that there are also many rewards to choosing to disclose transgender identity to health care providers. Ultimately, health care is an institution that systematically perpetuates transphobia and the complex decisions that transgender people make around disclosing that they are transgender to their health care providers are always colored by the expectation of mistreatment.