| Sumario: | Background: Transgender and gender-diverse (TGD) individuals, whose well-being relies on gender-affirming care, faced heightened barriers during the COVID-19 pandemic. Structural inequities intensified as non-emergent services were deprioritized. Objective: In this paper we examined changes and delays in healthcare access by TGD populations across the United States during the COVID-19 pandemic. Methods & Design: From September 2022 through March 2023, we administered an online survey to TGD adults in the United States. Participants responded to the question, "How did COVID-19 impact your experience accessing healthcare?" We used inductive coding and thematic analysis techniques to analyze the 87 responses. Results: Response themes were: (1) shift to telehealth, (2) availability and access and why those were limited, (3) affordability, (4) delays in gender-affirming care, and (5) delays in healthcare overall. Participants frequently discussed telehealth shifts and access limitations. Conclusion: TGD individuals face significant, structurally rooted healthcare barriers that COVID-19 intensified. Integrating gender-affirming care into comprehensive healthcare systems is essential for ensuring accessible care for TGD populations. Additionally, creating and reforming relevant policies with input from TGD individuals can help reduce healthcare access disparities going forward and in future crises.
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