The Relationship between Gender Identity, Transphobia, and Provider Trust among Sexual and Gender Minority Individuals in Rural Appalachia

Authors

• Mohammed Sheikh Eldin Jibriel, Lehigh UniversityFollow
• Rachel W. Faller, University of North Carolina at GreensboroFollow
• Amanda E. Tanner, University of North Carolina GreensboroFollow
• Tamar Goldenberg, University of North Carolina at GreensboroFollow
• Jeanette M. Stafford, Wake Forest UniversityFollow
• Ana D. Sucaldito, University of North Carolina at GreensboroFollow
• Lilli Mann-Jackson, Wake Forest School of MedicineFollow
• Jorge Alonzo, Wake Forest School of MedicineFollow
• Manuel Garcia, Wake Forest School of MedicineFollow
• John W. ChaffinFollow
• Lucero Refugio Aviles, Wake Forest University School of MedicineFollow
• David M. Kline, Wake Forest School of MedicineFollow
• Laurie P. Russell, Wake Forest School of MedicineFollow
• Tucker McGuire, University of North Carolina at GreensboroFollow
• Peggy H. WeilFollow
• Antonio Del Toro, Western North Carolina AIDS ProjectFollow
• Aimee M. Wilkin, Wake Forest UniversityFollow
• Scott D. Rhodes, Wake Forest UniversityFollow

Abstract

This analysis examines the relationship between gender identity, transphobia, and provider trust among diverse sexual and gender minority (SGM) individuals living in rural Appalachia, a region with profound health disparities. We analyzed baseline data from the Appalachian Access Project, collected between April and September 2022, from 141 participants using mixed model linear regression. Nonbinary individuals exhibited lower provider trust compared to cis-male counterparts. Additionally, an interaction effect between transphobia and gender identity was observed, with higher transphobia associated with significantly lower provider trust among nonbinary individuals. Findings highlight the importance of addressing transphobia and promoting affirming and culturally congruent healthcare practices to improve health experiences and outcomes for SGM individuals. Further research should explore strategies to support the unique healthcare needs of SGM populations, with particular attention to the needs of nonbinary individuals.

Creative Commons License

This work is licensed under a Creative Commons Attribution-Noncommercial 4.0 License

Recommended Citation

Sheikh Eldin Jibriel, Mohammed; Faller, Rachel W.; Tanner, Amanda E.; Goldenberg, Tamar; Stafford, Jeanette M.; Sucaldito, Ana D.; Mann-Jackson, Lilli; Alonzo, Jorge; Garcia, Manuel; Chaffin, John W.; Refugio Aviles, Lucero; Kline, David M.; Russell, Laurie P.; McGuire, Tucker; Weil, Peggy H.; Del Toro, Antonio; Wilkin, Aimee M.; and Rhodes, Scott D. (2026) "The Relationship between Gender Identity, Transphobia, and Provider Trust among Sexual and Gender Minority Individuals in Rural Appalachia," Health Behavior Research: Vol. 9: No. 1.