{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,19]],"date-time":"2026-09-19T17:28:43Z","timestamp":1789838923171,"version":"4.0.1"},"reference-count":34,"publisher":"MDPI AG","issue":"17","license":[{"start":{"date-parts":[[2021,9,1]],"date-time":"2021-09-01T00:00:00Z","timestamp":1630454400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100007859","name":"University of Kansas","doi-asserted-by":"publisher","award":["N\/A"],"award-info":[{"award-number":["N\/A"]}],"id":[{"id":"10.13039\/100007859","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJERPH"],"abstract":"<jats:p>Transgender and gender diverse (TGD) youth experience health disparities due to stigma and victimization. Gender-affirming healthcare mitigates these challenges; yet, we have limited understanding of TGD youth\u2019s healthcare experiences in the U.S. Midwest and South. Using a multiple case study design, we aimed to develop an in-depth and cross-contextual understanding of TGD youth healthcare experiences in one Midwestern state. Families with a TGD child under 18 were recruited with the goal of cross-case diversity by child age, gender, race, and\/or region of the state; we obtained diversity in child age and region only. Four white families with TGD boys or non-binary youth (4\u201316) in rural, suburban, and small towns participated in interviews and observations for one year; public data were collected from each family\u2019s community. Thematic analysis was used within and across cases to develop both family-level understanding and identify themes across families. Findings include a summary of each family as it relates to their child\u2019s TGD healthcare experiences as well as the themes identified across cases: accessibility and affirming care. Although limited by a small sample with lack of gender and race diversity, this study contributes to our understanding of TGD youth healthcare in understudied regions.<\/jats:p>","DOI":"10.3390\/ijerph18179219","type":"journal-article","created":{"date-parts":[[2021,9,1]],"date-time":"2021-09-01T11:39:03Z","timestamp":1630496343000},"page":"9219","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":12,"title":["\u201cI Have Nowhere to Go\u201d: A Multiple-Case Study of Transgender and Gender Diverse Youth, Their Families, and Healthcare Experiences"],"prefix":"10.3390","volume":"18","author":[{"given":"Megan S.","family":"Paceley","sequence":"first","affiliation":[{"name":"School of Social Welfare, University of Kansas, 1545 Lilac Lane, Lawrence, KS 66045, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jennifer","family":"Ananda","sequence":"additional","affiliation":[{"name":"School of Social Welfare, University of Kansas, 1545 Lilac Lane, Lawrence, KS 66045, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3781-326X","authenticated-orcid":false,"given":"Margaret M. C.","family":"Thomas","sequence":"additional","affiliation":[{"name":"Luskin School of Public Affairs, University of California Los Angeles, 3250 Public Affairs Building, Los Angeles, CA 90095, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Isaac","family":"Sanders","sequence":"additional","affiliation":[{"name":"A Way Home Washington, 1200 12th Ave. S. Suite 710, Seattle, WA 98144, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Delaney","family":"Hiegert","sequence":"additional","affiliation":[{"name":"School of Law, University of Kansas, 1535 W 15th Street, Lawrence, KS 66045, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Taylor Davis","family":"Monley","sequence":"additional","affiliation":[{"name":"School of Social Welfare, University of Kansas, 1545 Lilac Lane, Lawrence, KS 66045, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2021,9,1]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"460","DOI":"10.1037\/a0029597","article-title":"A conceptual framework for clinical work with transgender and gender nonconforming clients: An adaptation of the minority stress model","volume":"4","author":"Hendricks","year":"2012","journal-title":"Prof. Psychol. Res. 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Bioethical Inq."}],"container-title":["International Journal of Environmental Research and Public Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1660-4601\/18\/17\/9219\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T06:54:07Z","timestamp":1760165647000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1660-4601\/18\/17\/9219"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,9,1]]},"references-count":34,"journal-issue":{"issue":"17","published-online":{"date-parts":[[2021,9]]}},"alternative-id":["ijerph18179219"],"URL":"https:\/\/doi.org\/10.3390\/ijerph18179219","relation":{},"ISSN":["1660-4601"],"issn-type":[{"value":"1660-4601","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,9,1]]}}}