Provider Trust in a Sample of Transgender Latinas in the US South.

Objective: Low provider trust may further undermine care engagement, particularly in the United States (US) South where access to gender-affirming services remains uneven. Despite its importance, determinants of provider trust among transgender Latinas are understudied. This study examined factors associated with provider trust among transgender Latinas living in the US South. Methods: Using baseline data from an intervention trial conducted in North and South Carolina, we conducted mixed-effects regression analyses to assess associations between provider trust and demographic, behavioral, healthcare utilization, psychosocial, and structural factors, including acculturation, social support, discrimination, internalized transphobia, ethnic group pride, and patient activation (confidence in managing one's overall health). Results: The sample included 144 Spanish-speaking transgender Latinas. Higher patient activation was positively associated with provider trust (p < .001), whereas higher internalized transphobia pride scores were negatively associated with trust (p = .001). Conclusions: Patient activation may be an important correlate of provider trust and represent a modifiable target for behavioral interventions. At the same time, higher transgender pride was associated with lower trust, underscoring the need for healthcare environments that affirm identity while addressing potential vigilance or skepticism shaped by lived experiences of stigma.