Degree Name

DrPH (Doctor of Public Health)


Public Health

Date of Award


Committee Chair or Co-Chairs

Deborah Slawson

Committee Members

Joel Hillhouse, Stacey Williams, Katie Baker


Background: Transgender or nonbinary (TNB) individuals in the United States experience higher rates of sexual and reproductive health disparities when compared to their cisgender counterparts, along with lower access to care. TNB people in the south experience higher rates of disparities. Societal, interpersonal, and individual barriers contribute to these disparities in the TNB population. However, there is a paucity of research examining the sexual and reproductive health experiences of TNB people living in Central Appalachia.

Methods: An interpretive phenomenological analysis (IPA) research design was used to collect and analyze semi-structured interviews with TNB individuals living in central Appalachia regarding their sexual and reproductive health experiences. Transcribed interviews were analyzed repeatedly by the primary investigator and the study equity committee to identify emergent themes which focused on understanding an individual’s lived experiences through interpretation.

Results: Twenty participants from eastern Tennessee and western North Carolina from four Appalachian states within three Appalachian sub-regions participated in this study. Four themes were identified: a) perceptions and/or experiences receiving SRH healthcare shaped the individual’s self-agency regarding accessing and receiving SRH care, along with influencing their sense of self regarding their gender; b) heteronormative expectations within the medical field influenced interactions with providers and the care system; c) community is integral to SRH experiences, and d) policy and laws impact willingness and ability to access SRH care.

Discussion: TNB individuals living in central Appalachia experience individual, interpersonal, community, and social factors that impact their sexual and reproductive healthcare experiences. By addressing these factors based on recommendations from participants, public health leaders, policy makers, and providers can improve sexual and reproductive healthcare experiences of TNB people living in central Appalachia.

Document Type

Dissertation - embargo


Copyright by the authors.

Available for download on Saturday, June 15, 2024