UC Riverside

Members of the trans community experience disproportionate barriers to healthcare. These barriers are the result of difficulties in access, gatekeeping of gender affirming care, transphobia, and the lack of widespread provider competency in trans health and medicine (Polonijo et al. 2020; shuster 2021; Stryker 2017). Marginalization within medicine works in tandem with regional disparities in available care, discriminatory laws, policies, and institutional procedures to increase vulnerability and promote poor health outcomes for trans patients (J. L. Herman and O’Neill 2020; WPATH 2011; J. S. Herman et al. 2016). Anthropological work on trans communities and health has expanded in recent years (Plemons 2017, Valentine 2007), however, further research is needed to document community-driven approaches to managing persistent disparities as well as strategies to alleviate their negative effects. The purpose of this research is to examine how trans care, defined as both activist and clinical practice (Malatino 2020), is shaped by the inclusion of trans healthcare professionals in providing gender affirming care across Los Angeles and Riverside Counties in Southern California. As trans people who receive gender affirming care become professional healthcare providers (physicians, therapists, and healthcare system navigators) who serve trans patients, they navigate their experiences in accessing and receiving gender affirming care, their concern for their community, and their current position as authority within healthcare institutions that often perpetuate barriers to care (shuster 2021). Analysis of qualitative data based on one year of ethnographic fieldwork from 2020 to 2021 among networks of trans healthcare professionals reveals varied approaches in incorporating experience-informed care into serving trans patients. The level in which the aims of activism and advocacy on behalf of their community is infused with clinical care practice was traced through participant stories collected through fieldwork. Some trans healthcare professionals embraced a care model informed by activism while others resisted deviating from established clinical norms. The diversity in care modalities represented in this research constitutes queering care, a proposed framework from which to assess divergent perspectives, contradictory practices, liberatory action, and the reproduction of medical regulation all present within what constitutes trans healthcare practiced by trans people and for trans people.