Exploring Relationships between Mutual Aid and Accessing Healthcare Among Transgender and/or Nonbinary People

Background and Purpose: Research on transgender and/or nonbinary (TNB) health and healthcare has increased significantly in recent years. This research has shown that TNB people experience numerous systemic barriers when accessing healthcare, including but not limited to past discriminatory experiences, needing to educate providers and staff, and being denied treatment. As a result, TNB people are one of the most underserved populations in healthcare and are less likely to access routine and specialty care than cisgender people. While scholarship continues to examine TNB people’s healthcare experiences, little is known about TNB people who choose not to access the healthcare system and if/where they are meeting their healthcare needs.

One possibility is that TNB people are relying on mutual aid. Mutual aid is the act of caring for one another and meeting each other’s needs because the systems in place will not. Mutual aid has a long history among TNB communities ranging from Marsha P. Johnson and Sylvia Rivera’s STAR house to care networks created by Black TNB people during the HIV/AIDS epidemic. Although mutual aid has existed since humans have existed, mutual aid proliferated in response to the COVID-19 pandemic.

Methods: Using data from a statewide health survey of TNB individuals (N=263), we examined the relationships between healthcare access over the past 12 months, perceptions about patient privacy preservation, and mutual aid. Past-year healthcare access was measured by the dichotomous question “in the past 12 months, have you seen a medical doctor or health care provider?” Logistic regression was used to assess which factors were significantly associated with past year healthcare access.

Results: Two-thirds (66.8%) of participants reported visiting a medical doctor in the past year. Participants who had relied on TNB community members for general health information (β=-1.79, p=.019) or to meet healthcare needs (β= -1.91, p<.001) were significantly less likely to have visited a doctor in the past year than those who had not. Participants who reported having a disability (β=1.66, p=.008) or reported their sexual orientation as queer (β=1.73, p=.005) were also more likely to have visited a doctor in the past year.

Conclusions and Implications: The relationship between TNB formal healthcare access and relying on mutual aid has several interesting implications. This may indicate that some TNB people prefer seeking help via mutual aid over formalized healthcare systems, likely to avoid possible discriminatory healthcare experiences. Furthermore, the fact that some TNB people do not have their health needs met by healthcare systems does not mean these needs are unmet entirely. Rather, TNB people may turn to mutual aid, both demonstrating important resiliency in TNB communities as well as the imperative to improve formalized healthcare to appropriately TNB health needs. Future research should continue to examine the role of mutual aid in TNB health and healthcare as well as explore ways these systems can work together to meet the needs of TNB people.