Barriers to gender affirming healthcare for transgender and non-binary people with endometriosis

Cheryl Eder, Rizwana Roomaney
International journal of transgender health · 2025 · vol. 27(4) , pp. 1–11 · doi:10.1080/26895269.2025.2545578 · PMID:42517010 · PMC13403546 · W4413244421
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This paper examines the obstacles transgender and non-binary individuals face when seeking gender-affirming care for endometriosis.

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This qualitative study explored the experiences of eight transgender and non-binary individuals with endometriosis through semi-structured interviews analyzed using a phenomenological framework. The findings identified five key themes, highlighting significant barriers such as gender-unaffirming hormonal treatments, inadequate healthcare provider communication, and exclusionary medical environments. Participants reported feeling unheard and compelled to advocate for their own care, which perpetuated a sense of unhomelikeness while managing this chronic condition. This paper is centrally about endometriosis — specifically examining the unique barriers to gender-affirming treatment and healthcare access faced by transgender and non-binary patients.

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Abstract

BACKGROUND: Endometriosis is a chronic and painful gynaecological condition that is known to negatively affect people's quality of life. Much of endometriosis research has focussed on cisgender women with endometriosis, but endometriosis is known to affect transgender and non-binary people. There is limited research on the treatment of endometriosis for transgender and non-binary people. AIM: To explore transgender and non-binary people with endometriosis experience of gender affirming endometriosis treatment. METHODS: We conducted a follow-up study with eight transgender and non-binary participants with endometriosis. We collected data through an online semi-structured interview and we used Hermeneutic analysis to analyze the data. We applied Svenaeus' Phenomenology of Medicine as our theoretical framework. RESULTS: We reported our findings under five themes: (1) Gender affirming endometriosis healthcare, (2) Endometriosis hormonal treatments that are not gender affirming, (3) The impact of not being heard by HCPs, (4) Barriers in receiving gender affirming endometriosis healthcare, and (5) Medical appointments and examinations that are not gender affirming. DISCUSSION: Participants experienced a number of barriers in receiving gender affirming endometriosis healthcare perpetuating a sense of unhomelikeness. Barriers included HCPs limited communication, limited research on gender affirming endometriosis healthcare, patients needing to advocate for their own gender affirming healthcare and medical spaces that are not gender inclusive. HCPs have a critical role in supporting their transgender and non-binary patients with endometriosis in managing living with this chronic condition. We recommend that further research, training and awareness is needed that focusses on gender affirming endometriosis healthcare.
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Abstract

Background Endometriosis is a chronic and painful gynaecological condition that is known to negatively affect people’s quality of life. Much of endometriosis research has focussed on cisgender women with endometriosis, but endometriosis is known to affect transgender and non-binary people. There is limited research on the treatment of endometriosis for transgender and non-binary people. Aim To explore transgender and non-binary people with endometriosis experience of gender affirming endometriosis treatment.

Methods

We conducted a follow-up study with eight transgender and non-binary participants with endometriosis. We collected data through an online semi-structured interview and we used Hermeneutic analysis to analyze the data. We applied Svenaeus’ Phenomenology of Medicine as our theoretical framework.

Results

We reported our findings under five themes: (1) Gender affirming endometriosis healthcare, (2) Endometriosis hormonal treatments that are not gender affirming, (3) The impact of not being heard by HCPs, (4) Barriers in receiving gender affirming endometriosis healthcare, and (5) Medical appointments and examinations that are not gender affirming.

Discussion

Participants experienced a number of barriers in receiving gender affirming endometriosis healthcare perpetuating a sense of unhomelikeness. Barriers included HCPs limited communication, limited research on gender affirming endometriosis healthcare, patients needing to advocate for their own gender affirming healthcare and medical spaces that are not gender inclusive. HCPs have a critical role in supporting their transgender and non-binary patients with endometriosis in managing living with this chronic condition. We recommend that further research, training and awareness is needed that focusses on gender affirming endometriosis healthcare.

Acknowledgements

We acknowledge and thank our participants’ for their invaluable time and their life stories that they shared with us. Disclosure statement No potential conflict of interest was reported by the author(s).

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Condition tags

endometriosis

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