From Mistrust to Mutual Aid: How Transmasculine People Navigate Health Information in the Face of Exclusion

Background and Purpose:
Transmasculine individuals assigned female at birth (TM/AFAB) encounter persistent structural barriers to affirming and evidence-based healthcare, including provider bias, gatekeeping, and institutional erasure. In response, many turn to peer networks and digital platforms to access and appraise health information. This study investigates how transmasculine people navigate health information-seeking, evaluate credibility and relevance, and develop strategies to mitigate medical mistrust. The aim is to inform health equity interventions and policies that support inclusive, community-driven health communication.

Methods:
This qualitative study employed semi-structured interviews (n=30) and focus groups (n=12) with transmasculine participants in a large urban East Coast city. Data collection was informed by the Gender Affirmation Framework and Critical Health Literacy (CHL), emphasizing the role of identity-based trust and community-generated knowledge. Reflexive thematic analysis was used to examine patterns in how participants sourced, vetted, and shared health information, particularly in the context of exclusion from formal medical systems.

Results:
Participants described digital platforms—especially Reddit—as trusted spaces for trans-specific health dialogue. These platforms offered access to peer-reviewed lived experience, allowing participants to cross-check information and share context-specific guidance. Social networks served as essential filters in the absence of trans-competent and identity-concordant providers, with participants relying on community expertise to assess the accuracy and applicability of health content. To navigate clinical environments, participants employed "shape-shifting" strategies, including strategic self-presentation, performative pathology, and identification of “clinical co-conspirators” to access needed care. These findings highlight both the ingenuity and emotional labor involved in seeking safe, affirming healthcare.

Conclusions and Implications:
Peer networks and social media function as vital infrastructure for transmasculine individuals in the face of systemic health exclusion. For social work research, this underscores the need to expand definitions of health literacy to include decentralized, community-informed processes. Practitioners and policymakers must recognize the role of informal networks in meeting critical health needs and invest in trans-led, culturally responsive health education initiatives. Social work is uniquely positioned to advance these goals through interdisciplinary collaboration, policy advocacy, and the development of participatory interventions that center transmasculine voices. Strengthening these informal systems while transforming formal institutions is essential to promoting health equity and trust for gender-diverse communities.