First Advisor

Abby Mulcahy

Date of Award

Spring 6-2025

Document Type

Thesis

Degree Name

Bachelor of Science (B.S.) in Social Work and University Honors

Department

Social Work

Language

English

Subjects

healthcare access, transgender health, barriers to healthcare, gender-affirming care, geographical healthcare access, social work

DOI

10.15760/honors.1685

Abstract

Urban and rural healthcare differ significantly in the amount of facilities, providers and kinds of specialty care that are offered in each environment. The United States is split into urban and rural counties in any given region, and based on those population sizes, are the allocation of healthcare resources for residents. In rural areas in the U.S., transgender adults lack access to gender-affirming care and encounter a lack of gender-affirming care providers due to workforce shortages, discrimination, and a lack of cultural competency. To determine if these residents lacked access to care compared with their urban counterparts, I performed a narrative comparison of two counties in Oregon - Multnomah and Hood River - on six topics - the number of hospitals in each county, the number of physicians, the number of primary care physicians, the number of general surgeons, the number of OBGYN's, and the number of gender-affirming care providers. Data sources for this project include summary statistics from independent research completed at the Williams Institute of UCLA, Health Policy and Research, as well as various academic journals, articles and letters. Findings include that rural counties lack access to gender-affirming care providers for transgender adults and that rural counties have less gender-affirming care providers compared to urban counties. These differences are due to workforce shortages, a lack of specialty care providers in rural counties, and less infrastructural support for transgender adults in rural environments. In conclusion, transgender adults in the United States do not have reliable healthcare in rural counties.

Rights

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Persistent Identifier

https://archives.pdx.edu/ds/psu/43790

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