Transgender people can encounter significant obstacles and barriers within healthcare systems that may hinder access to care or affect the quality of treatment they receive. These challenges vary widely, but together they can create environments that feel less supportive than they should be.
Author
- Stephanie Horsted
PhD Candidate, Pain management in the transgender community, Department of Research and Graduate Studies, Health Sciences University
A 2025 report found that, in the UK, 52% of transgender people surveyed had a negative healthcare experience . The effect of such experiences, which can be due to prejudice, discrimination or simply a lack of knowledge among healthcare staff, can be profound. It forces many to live with health problems without seeking medical attention .
One of the most common problems encountered by transgender people in healthcare is misgendering . This occurs when a health professional uses incorrect names or pronouns, for example referring to someone as "he" instead of "she," or using a former name - known as deadnaming - either through lack of knowledge or an unwillingness to acknowledge a patient's gender identity.
For many transgender people, being misgendered is a denial of who they are, even if it's not intended. Studies show that frequent misgendering can lead transgender and non-binary people to feel invisible, invalidated and emotionally distressed. This kind of miscommunication can leave patients feeling disrespected or dismissed, reinforcing existing inequalities in care .
The impact of misgendering trans people goes far beyond emotional discomfort. According to US charity the Trevor Project's 2024 national survey on LGBTQ+ youth mental health, transgender and nonbinary young people whose pronouns were respected all or most of the time had around half the suicide attempt rate of those whose pronouns were rarely or never respected.
This doesn't mean pronoun use alone prevents suicide, but that it signals something larger : affirmation, safety and belonging. Misgendering, by contrast, reinforces rejection and invisibility. The psychological strain of being misgendered, combined with the stress of untreated health issues, can make healthcare settings feel unsafe and discourage people from seeking support.
Research indicates that these experiences contribute to deeper mistrust of healthcare professionals and reduce engagement with medical services. Over time, that mistrust can make people reluctant to return for follow-up care, even when they are unwell. Evidence shows that transgender people who delay seeking healthcare because of anticipated discrimination experience poorer physical and mental health outcomes.
Exclusion from routine screening
Another widespread issue is the lack of inclusion in standard health screenings . Many medical protocols, from cervical smear tests to prostate exams, have been historically designed with cisgender patients in mind.
"Cisgender" refers to people whose gender identity matches the sex they were assigned at birth. This traditional focus has created serious gaps in preventive care for transgender people, particularly those who have transitioned or whose bodies do not align neatly with conventional gender categories.
Research shows that transgender people are significantly less likely to receive recommended cancer screenings than cisgender patients. A large US primary care study found that transgender people were screened at far lower rates for cervical (56% v 72%), breast (33% v 65%) and colorectal cancer (55% v 70%) than cisgender people.
Similarly, a systematic review reported that trans men were less likely to attend cervical and breast screening, while trans women had lower rates of prostate cancer screening than cisgender men.
These disparities are not simply a matter of personal choice. Administrative systems in many countries still match screening invitations to gender markers rather than anatomy . As a result, some patients are automatically called for irrelevant tests while others are excluded from ones they need.
This can delay early detection and leave treatable conditions undiagnosed. Experts note that such oversights reflect a healthcare model that still operates around a rigid gender binary rather than one based on a person's medical need and anatomy.
Even when screenings are offered, they can be uncomfortable or traumatic . Procedures such as pelvic or breast exams are often not designed with transgender bodies or experiences in mind.
For example, trans men may still have internal reproductive organs that are associated with the female anatomy, but experience heightened distress or gender dysphoria , a feeling of discomfort or anxiety caused by a mismatch between their gender identity and physical anatomy, during pelvic exams. Research shows that this can make routine care feel invasive or emotionally painful.
Trans women may find breast or prostate examinations distressing or triggering (they can provoke anxiety, fear or memories of past discrimination) if staff are unfamiliar with gender-affirming care , which emphasises respectful communication, consent and understanding of diverse anatomies. In settings where these practices are lacking, patients may fear being judged, misgendered or asked insensitive questions.
Equipment, clinic environments and communication styles are often based on cisgender assumptions , which presume that all patients' bodies and identities align with the sex they were assigned at birth.
This can heighten anxiety and discomfort, making medical visits feel unsafe. Consequently, many transgender people postpone preventive screenings , reinforcing a cycle in which missed appointments lead to later diagnoses and poorer health outcomes.
"Trans broken arm syndrome"
A particularly common phenomenon in transgender healthcare is known as "trans broken arm syndrome" . The term describes how healthcare professionals sometimes overlook or minimise a transgender person's immediate medical needs by focusing disproportionately on their gender identity or transition history, even when unrelated to the presenting issue.
For instance, a transgender person might attend an emergency department with a broken arm but find that clinicians focus on hormone therapy or surgical history rather than the injury, leading to misdiagnosis, delays in treatment or inappropriate care.
The cost of fear
The combined impact of misgendering, exclusion from essential screenings and "trans broken arm syndrome" often drives transgender people to avoid healthcare altogether. Many delay seeking medical help because they expect to be disrespected or mistreated.
The fear and anticipation of stigma can become so overwhelming that it outweighs the need for care, leading to worsening physical and mental health over time.
That so many transgender people continue to endure preventable suffering because they fear discrimination or practices that make them feel uncomfortable because of a lack of training reveals a persistent problem within healthcare systems. These disparities are not only the result of individual prejudice but also of structural inequities in medical education, screening protocols and institutional design.
Without a cultural shift towards inclusion and respect, transgender people will continue to face inequities in access to healthcare, with potentially serious consequences for their physical and mental wellbeing.
Stephanie Horsted does not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.
