Transgender and nonbinary (TNB) adults face a multitude of challenges when attempting to access general health care. Issues include fear of discrimination and encounters with providers who are not familiar with treating the needs of this population. These challenges may result in the delay or denial of medically necessary care. This study explores nuanced experiences of gender identity and sexual orientation around accessing health care. Using a statewide sample of TNB individuals (N = 417), analyses include descriptive statistics and logistic regressions predicting delayed care due to fear of discrimination and having any medical intervention to understand the importance of transgender-inclusive care and other experiences across identities. Findings indicate differential experiences across gender identity, sexual orientation, and age. Access to a trans-inclusive primary care provider was one of the strongest indicators both for not delaying care due to fear of discrimination and having had a medical intervention. Providers should be provided with more nuanced training about being culturally responsive and aware of differences across sexual orientation within the TNB community. This will move toward ensuring not only increased access to needed care and medical interventions, but toward potentially lowering the rate of those who delay access to care due to fear of discrimination.

Forced sex is a major issue experienced by individuals of all ages, genders, and sexual orientations. Little is known about how LGBQ, transgender, and non-binary young people experience sexual violence. This study examines experiences of forced sex, exploring the intersection of sexual orientation and gender identity, as well as how other socio-demographic and mental health variables are related to differential risk of forced sex. Young people who experience sexual orientation and gender identity marginalization were at elevated risk for experiencing sexual violence. Forced sex was also associated with negative mental health outcomes and bullying victimization. More inclusive sexual violence prevention and support programing for young people and methodological improvements in the way we examine sexual orientation and gender identity in research are needed.