Evidence map›Paper›PMID 41132106›Full record

ArticleSexual and reproductive health matters2025

A qualitative study on healthcare providers' biases towards transgender and gender diverse people accessing contraceptive care.

Yasaman Zia, Connie Folse, Adrien Lawyer, Felix Zeid, Alejandra Alvarez, Erica Somerson, Kathryn Albergate Davis, Dane Menkin, Mitzi Hawkins, Jen Hastings and 1 more

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Sexual and reproductive health matters, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors.

Yasaman ZiaAssistant Professional Researcher, Department of Obstetrics, Gynecology, and Reproductive Sciences, University of California San Francisco, San Francisco, CA, USA; Researcher, Bixby Center for Global Reproductive Health,University of California San Francisco, San Francisco, CA, USA.ORCID 0000-0001-6049-3706
Connie FolseHealth Educator, Department of Obstetrics, Gynecology, and Reproductive Sciences, University of California San Francisco, San Francisco, CA, USA; Senior Manager Curriculum & Training, Bixby Center for Global Reproductive Health, University of California San Francisco, San Francisco, CA, USA.
Adrien LawyerCo-Director, Transgender Resource Center of New Mexico, Albuquerque, NM, USA.
Felix ZeidLead Health Education Coordinator, UNM Medical Group, University of New Mexico (UNM) Truman Health Services, Albuquerque, NM, USA.
Alejandra AlvarezData Manager/Analyst, Department of Obstetrics, Gynecology, and Reproductive Sciences, University of California San Francisco, San Francisco, CA, USA; Data Manager/Analyst, Bixby Center for Global Reproductive Health, University of California San Francisco, San Francisco, CA, USA.
Erica SomersonHealth Educator, Department of Obstetrics, Gynecology, and Reproductive Sciences, University of California San Francisco, San Francisco, CA, USA; Training & Technical Assistance Manager, Bixby Center for Global Reproductive Health, University of California San Francisco, San Francisco, CA, USA.
Kathryn Albergate DavisConsultant, Department of Obstetrics, Gynecology, and Reproductive Sciences, University of California San Francisco, San Francisco, CA, USA; Contraceptive Training Specialist, Bixby Center for Global Reproductive Health, University of California San Francisco, San Francisco, CA, USA.
Dane MenkinFamily Nurse Practitioner, Director of LGBTQ Services, Mainline Health, Philadelphia, PA, USA.
Mitzi HawkinsAssistant Professor, Department of Obstetrics, Gynecology, and Reproductive Sciences, University of California San Francisco, San Francisco, CA, USA.
Jen HastingsAssistant Clinical Professor, Department of Family and Community Medicine, University of California San Francisco, San Francisco, CA, USA.
Cynthia HarperProfessor, Department of Obstetrics, Gynecology, and Reproductive Sciences, University of California San Francisco, San Francisco, CA, USA; Investigator, Bixby Center for Global Reproductive Health, University of California San Francisco, San Francisco, CA, USA.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Bias in sexual and reproductive health care (SRH) undermines the quality and delivery of essential services. For transgender and gender diverse (TGD) patients, barriers to care may be acute when seeking gendered services, such as contraception. Few studies have assessed providers' perceptions of TGD patients in SRH. Our objective was to examine bias in contraceptive providers' attitudes towards and experiences with TGD patients. We conducted in-depth interviews, from August 2022 to August 2024, with 41 healthcare providers located throughout the US and attending CME-accredited trainings on contraceptive counselling. We utilised deductive thematic analysis to identify the domains of implicit and explicit bias specific to TGD patients. Many providers struggled to understand gender diversity and had difficulty using gender-inclusive frameworks in care delivery. Explicit biases were exemplified in the pervasiveness of gender binarism within the healthcare system and providers' lack of experience with TGD patients. Providers demonstrated implicit biases through their deficits in knowledge regarding TGD patients' medical needs and culturally insensitive approaches. They offered suggestions to mitigate bias, including institutional changes to make clinics more trans-inclusive and affirming. Biases and disparities specific to TGD patients are perpetuated through a lack of awareness and stigmatisation in healthcare settings. Our findings highlight areas to improve awareness of bias, dispel confusion with evidence on gender-inclusive care, and integrate structural changes within clinics to reduce the burdensome impacts of bias on TGD patients. Advocacy at both the provider and institutional levels is needed to offer quality contraceptive care for TGD patients.

Indexed as

Attitude of Health PersonnelContraceptionHealth PersonnelHealth Services AccessibilityTransgender PersonsAdultFemaleHumansInterviews as TopicMaleMiddle AgedQualitative ResearchUnited Statescontraceptiongender-affirminggender diverseprovider biastransgender health

Identifiers

PMID41132106
PMCPMC12624886

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.