Both transgender and nonbinary individuals, as well as their allies were surveyed in order to assess the top health concerns in Southern states. Of those surveyed, the three top issues were: transition-related care, access and availability of transition-related care and the education of providers about the transgender community and issues within the community. These issues are consistent with issues reported nationally among the transgender community and their allies. It is recommended that future research, education and health initiatives focus on these issues in order to address them.

There is inconsistent support regarding the teaching of transgender care and issues within medical school. As a result of this, patients who are transgender are negatively impacted and more likely to face health inequities. Of those medical schools that incorporated teachings about the transgender community into their curriculum, there was improvement in the attitudes, knowledge and skills necessary to care for this patient population.

This study was conducted in order to assess whether or not having a transgender inclusive PCP or delaying care due to fear of discrimination contributed to poorer health outcomes.It was found that there is a connection between delayed care due to fear of discrimination and poorer health outcomes. Whether or not having a transgender inclusive PCP influences health outcomes is still uncertain; further research needs to be conducted.

Two surveys were sent to resident and faculty physicians at a WVU Hospitals in West Virginia in order to assess their attitudes about treating transgender patients. West Virginia is primary a rural state. Of those surveyed, a little over 3/4 assumed their patients were not transgender while almost 1/2 said they would need additional education on the transgender community in order to provide the appropriate care. In addition, male providers had a higher negative perception of the transgender community. Further studies are suggested in order to fully evaluate the needs of the transgender community.

In Massachusetts, there is a law that prevents discrimination based on gender identity for employment, housing, credit, public education and hate crimes. However, this law does not prevent discrimination in public places such as hospitals, doctor's offices, transportation, retail stores, etc. A survey was conducted to assess the amount of discrimination experienced in which setting over the last 12 months, and how that impacted overall health. 24 percent reported discrimination in healthcare over the last 12 months and the result was an increased risk for adverse emotional and physical health, as well as the postponement of care when patient's were sick. In order to combat health inequaties in the transgender community, Massachusetts needs to pass legislation that prevents discrimination in public settings.

Interview were conducted among 25 transgender women between the ages of 18-39 in Oregon. The goal of these interviews was to assess barriers to receiving gender-affirming services. Compared to other states, the women felt that Oregon was more accepting and "trans-friendly." This motivated them to move across the country in order to receive the care they needed. Though there was a health plan available that covered hormone therapy, financial and social discrimination limited access to the health system. It is recommended that there be people that can assist people in the transgender community with navigating access to transgender-friendly healthcare services.

22 transgener military veterans were surveyed through a combination of telephone interviews and questionnaires. It was found that while the VA was working to make services more accessible to the transgender veterans, there was a gap in the administration of care, training of the staff and the availability of specific services to meet the needs of those in the transgender veteran community. It was recommended that the VA continue to evaluate and work on how their staff are trained to interact and administer care to transgender patients.

Recommended services for transgender youth include: puberty blockers, hormones, masculinizing chest surgery and counseling. A review of available insurance plans was conducted to see what coverage was available for these services. None of the plans provided coverage for all four recommendations, 49 percent had one transgender-specific exclusion. The median for the research assistant to review each insurance plan was 50 minutes. It is suggested that insurance companies be educated on the medical needs of transgender youth so that the services they need are covered and plans are accessible.

66 transgender individuals took part in a large LGBTQ needs assessment study. The study revealed that transgender individuals psychosocial needs barriers, personal needs barriers and lack of community safety were a predictor of poor self-perceptions. Recommendations to improve health disparities included more health resources, greater access to care and community perceptions, especially in the Southern United States.

Due to the lack of healthcare coverage for many individuals in the transgender community, crowdfunding is a very popular way of trying to bridge the gap. 391 crowdfunding campaigns were created between 2012-2016 for gender-affirming care. Majority of these did not meet their funding goal. Studies found that transgender men who had their friends share their campaign on FB raised a greater percentage of their goal amount compared to transgender women who raised more money overall. This is not recommended as a viable option for funding money to cover out-of-pocket expenses for gender affirming care.