# Understanding perceived access and receipt of gender-affirming treatments among transgender Veterans

> **NIH VA I01** · EDITH NOURSE  ROGERS MEMORIAL VETERANS HOSPITAL · 2024 · —

## Abstract

Background: Transgender people experience discord between their gender identity and birth sex, defined as
gender dysphoria. Gender-affirming treatments (GATs) are medically necessary treatments to reduce gender
dysphoria. However, among transgender Veterans (trans Vets) who desire GATs, not much is known about
barriers and facilitators to accessing and receiving GATs in VA and VA Community Care (CC). To ensure
effective and equitable GAT access for trans Vets, it is critical to understand: [1] GATs trans Vets receive and
where they receive them, [2] barriers, including social determinants of health (SDOH) barriers that are highly
prevalent among trans Vets, and facilitators associated with desired GAT receipt in VA and CC, [3] how
barriers and facilitators influence GAT access and desire, and [4] how to improve GAT access in VA and CC.
Significance: This study addresses the 2022 HSR&D priority areas of Access to Care, Health Equity/SDOH,
MISSION Act, and research gap of underserved LGBTQ+ Veterans. It is also a high priority for our operational
partners in VA LGBTQ+ Health Program, Pharmacy Benefits Management, Office of Integrated Veteran Care,
and Office of Mental Health and Suicide Prevention. Knowledge gained from this study will ensure that GAT
delivery in the VA is patient-centered and is responsive to the lived realities and needs of trans Vets.
Innovation and Impact: This study will be the first to characterize the GATs received in VA and/or CC to
understand how VA and CC are balanced in terms of delivering GATs. This study will also provide novel data
on trans Vet experiences related to GAT access in CC, which will be likely relevant to other underserved
Veterans accessing CC. Further, it will be innovative in providing data on services and resources used by trans
Vets to address barriers that influence GAT access. This will be key to developing patient-centered
implementation strategies to improve GAT access in VA and CC.
Specific Aims: We propose a sequential explanatory mixed method study whose aims are to:
Aim 1. Characterize the GATs received by trans Vets in VA and/or CC (VA/CC)
Aim 2. Identify barriers and facilitators associated with desired GAT receipt in VA and CC
Aim 3: Understand trans Vet experiences related to GAT access in VA and CC.
Methodology: Database Aim 1: We will expand our VA cohort of 9,608 trans Vets (IIR 17-238) from 2006-18
to the data available at the time of funding. We will add CC data to determine the types of GATs received by
trans Vets in VA and/or CC. Survey Aim 2: We will survey a national sample of trans Vets identified from Aim
1. Among trans Vets who desire GATs, we will determine SDOH barriers, other barriers, and facilitators
associated with desired GAT receipt. Among trans Vets who did not desire GATs, we will determine reasons
for not wanting GATs. Qualitative Aim 3: From Aim 2 participants, we will recruit a purposive sample of trans
Vets who received all desired GAT(s), who received some desire...

## Key facts

- **NIH application ID:** 10635461
- **Project number:** 1I01HX003719-01
- **Recipient organization:** EDITH NOURSE  ROGERS MEMORIAL VETERANS HOSPITAL
- **Principal Investigator:** Guneet Jasuja
- **Activity code:** I01 (R01, R21, SBIR, etc.)
- **Funding institute:** VA
- **Fiscal year:** 2024
- **Award amount:** —
- **Award type:** 1
- **Project period:** 2024-01-01 → 2027-12-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10635461

## Citation

> US National Institutes of Health, RePORTER application 10635461, Understanding perceived access and receipt of gender-affirming treatments among transgender Veterans (1I01HX003719-01). Retrieved via AI Analytics 2026-05-25 from https://api.ai-analytics.org/grant/nih/10635461. Licensed CC0.

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