Exploring the Gaps: Healthcare Coverage and Access for Transgender and Gender-Diverse (TGD) Adults in Atlanta, GA

INTRODUCTION: This capstone project explores the experience of transgender and gender diverse (TGD) adults in Atlanta, GA with a focus on navigating healthcare coverage and accessing affirming, affordable care. This project is a summary report with themes from findings, policy implications, highlight of community partners providing/modeling quality care, and a call for future funding for TGD health-related research. NEED: TGD populations are disproportionately less likely to have adequate healthcare coverage, a reality worsened when living in a state without traditional Medicaid expansion. Compounding stressors amplify this gap in care, directly impacted by poor social determinants of health. Existing literature exploring the relationship between TGD health-related stressors and outcomes in the South is scarce. METHODS: Using qualitative methods and Ilan Meyer’s Minority Stress Model, this study analyzes how minority status and various stressors influence access to health services. Primary data were collected through virtual interviews with five TGD participants, supported by a literature review on TGD healthcare inequities in the U.S. South. FINDINGS: This study identified several barriers to healthcare access for TGD adults in Atlanta, Georgia. Key findings include widespread bureaucratic hurdles, such as insurance denials and provider gatekeeping; negative provider experiences stemming from a lack of cultural competency; and internalized stressors related to core beliefs about identity and care-seeking. Participants highlighted social determinants of health inequities around employment discrimination, social and community environments, lack of affirming mental health support, and limited health literacy. PUBLIC HEALTH IMPLICATION: Existing literature and project findings highlight a severe need for supportive infrastructure at the local, state, and federal levels. Public health institutions must focus on strengthening support by prioritizing funding for community-led interventions and prioritization of TGD input and voice.