{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,26]],"date-time":"2026-10-26T06:08:45Z","timestamp":1792994925703,"version":"4.5.0"},"reference-count":47,"publisher":"MDPI AG","issue":"23","license":[{"start":{"date-parts":[[2021,12,2]],"date-time":"2021-12-02T00:00:00Z","timestamp":1638403200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100009455","name":"West Virginia University","doi-asserted-by":"publisher","award":["Schneider Langlois School of Social Work Fund"],"award-info":[{"award-number":["Schneider Langlois School of Social Work Fund"]}],"id":[{"id":"10.13039\/100009455","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100009455","name":"West Virginia University","doi-asserted-by":"publisher","award":["Faculty Senate Community Engagement Grant"],"award-info":[{"award-number":["Faculty Senate Community Engagement Grant"]}],"id":[{"id":"10.13039\/100009455","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJERPH"],"abstract":"<jats:p>Research indicates that rural transgender and gender diverse (TGD) populations have a greater need for health services when compared with their urban counterparts, face unique barriers to accessing services, and have health disparities that are less researched than urban TGD populations. Therefore, the primary aim of this mixed-methods study (n = 24) was to increase research on the health care needs of TGD people in a rural Appalachian American context. This study was guided by a community-engaged model utilizing a community advisory board of TGD people and supportive parents of TGD children. Quantitative results indicate that travel burden is high, affirming provider availability is low, and the impacts on the health and mental health of TGD people in this sample are notable. Qualitative results provide recommendations for providers and health care systems to better serve this population. Integrated mixed-methods results further illustrate ways that rural TGD people and families adapt to the services available to them, sometimes at significant economic and emotional costs. This study contributes to the small but growing body of literature on the unique needs of rural TGD populations, including both adults and minors with supportive parents, by offering insights into strategies to address known disparities.<\/jats:p>","DOI":"10.3390\/ijerph182312700","type":"journal-article","created":{"date-parts":[[2021,12,2]],"date-time":"2021-12-02T21:19:08Z","timestamp":1638479948000},"page":"12700","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":34,"title":["Trans*Forming Access and Care in Rural Areas: A Community-Engaged Approach"],"prefix":"10.3390","volume":"18","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0536-8990","authenticated-orcid":false,"given":"Megan E.","family":"Gandy","sequence":"first","affiliation":[{"name":"School of Social Work, West Virginia University, 29 Beechurst Ave, Morgantown, WV 26505, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kacie M.","family":"Kidd","sequence":"additional","affiliation":[{"name":"Division of Adolescent Medicine, Department of Pediatrics, Medical Director, Gender & Sexual Development Clinic, WVU Medicine Children\u2019s, West Virginia University School of Medicine, 1 Medical Center Drive, Morgantown, WV 26506, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"James","family":"Weiss","sequence":"additional","affiliation":[{"name":"School of Social Work, West Virginia University, 29 Beechurst Ave, Morgantown, WV 26505, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Judith","family":"Leitch","sequence":"additional","affiliation":[{"name":"Department of Social Work, University of North Carolina at Greensboro, 1400 Spring Garden Street, Greensboro, NC 27412, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xavier","family":"Hersom","sequence":"additional","affiliation":[{"name":"Transforming Healthcare Community Advisory Board Member, School of Social Work, West Virginia University, 29 Beechurst Ave, Morgantown, WV 26505, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2021,12,2]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"222","DOI":"10.1016\/j.socscimed.2015.11.010","article-title":"Transgender stigma and health: A critical review of stigma determinants, mechanisms, and interventions","volume":"147","author":"Hughto","year":"2015","journal-title":"Soc. 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