Date of Award

January 2015

Document Type

Open Access Thesis

Degree Name

Master of Public Health (MPH)


School of Public Health

First Advisor

Alice M. Miller

Second Advisor

John Pachankis


Transgender populations face substantial barriers to healthcare access, exacerbated by a lack of inclusive research. The health needs of those who are gender nonbinary or genderqueer, identifying outside the binary of man and woman, are especially poorly understood. Using a primarily qualitative online survey, data on gender identity, health access, and healthcare experiences were collected from 81 gender nonbinary participants, and analyzed using a mixture of quantitative and qualitative methodologies. A number of interesting findings emerged, including that 90% of participants across age groups began identifying as gender nonbinary within the last 6 years, 77% reported interest in some aspect of medical transition, and 75% had avoided healthcare because of the cost. Connections between geography, health access, disclosure of gender identity and quality of healthcare experiences were explored, as well as suggestions provided by participants for ways to improve healthcare experiences for gender nonbinary patients. Results of this study indicate that gender nonbinary people often feel invisible and unwelcome in health settings, due in part to widespread assumptions of gender and sex’s inseparable and binary natures, and that this discomfort in health settings, as well as economic and geographical factors, may negatively impact nonbinary patients’ access to healthcare. Suggestions for improved care include increased education of providers on trans and gender nonbinary identities and health needs, inclusion of non-binary gender and pronoun options on intake forms and medical records, and de-emphasizing gender in healthcare.


This is an Open Access Thesis.