F1. Oral Session: Care Under Pressure: People, Policy, and Planetary Health
F1.01 - Oral Session: Providers Under Pressure: Measuring Trans-affirming Providers’ Experiences (TAPE) in the Context of Evolving Healthcare Policies
Area of Responsibility: Area IV: Evaluation and Research Keywords: Health Research@@@LGBTQ+@@@Policies, Subcompetencies: 5.1.1 Examine the determinants of health and their underlying causes (e.g., poverty, trauma, and population-based discrimination) related to identifie, 5.2.6 Identify organizational policies and procedures and federal, state, and local laws that pertain to the advocacy efforts. Research or Practice: Research
At the end of this session, participants will be able to:
Identify how structural determinants such as population-based discrimination and hostile legislative environments contribute to provider burnout and workforce instability in gender-affirming and transition-related care.
Assess how state policies shape the provision of gender-affirming and transition-related care, and apply this knowledge to develop advocacy strategies that protect providers and sustain equitable access to care.
Leverage their awareness of the harmful outcomes associated with hostile legislative environments to develop effective, non-partisan narratives to influence legislators.
Brief Abstract Summary: Gain insight into how anti-trans legislation is reshaping the landscape of gender-affirming and transition-related care (GATRC) in the United States. Drawing on findings from the Measuring TAPE (Trans-Affirming Providers’ Experiences) Study, this session shares preliminary data from 125 medical and mental health providers to examine how hostile policy environments contribute to stress, burnout, and workforce instability. Learn how providers are adapting their practices in response to legal threats and how these changes affect access to care. Discover protective factors, such as affirming professional networks and sanctuary state policies, that promote resilience and reduce burnout. Participants will explore actionable strategies for integrating provider experiences into advocacy campaigns and policy design, strengthening efforts to sustain equitable access to GATRC and support the health workforce amid escalating legislative attacks.
Detailed abstract description: Gender-affirming and transition-related care (GATRC) is evidence-based, medically necessary treatment that improves the health and well-being of transgender and gender diverse (TGD) individuals. Across the United States, a wave of legislation has sought to restrict or criminalize the provision of this care, particularly for minors, threatening providers with professional sanctions, loss of licensure, or imprisonment. While the harmful effects of these policies on patients have been increasingly documented, less is known about effects on providers. Led by a collaborative team of queer and trans researchers, the Measuring TAPE (Trans-Affirming Providers’ Experiences) Study aims to address this gap by examining how hostile policy environments shape the professional and personal experiences of GATRC providers.
This presentation shares preliminary findings from a mixed-methods study of 125 medical and mental health providers across the United States conducted between September 2024 and March 2025. The Copenhagen Burnout Inventory was used to assess burnout, a key indicator of patient safety, work satisfaction, and career intentions. Survey results reveal a direct relationship between provider burnout and practicing in states with higher levels of anti-trans legislation. Providers described adaptations to the shifting policy landscape, such as removing online information about their practice, seeking legal counsel, delaying care, and considering relocation. Transgender providers were disproportionately affected, exhibiting higher personal and client burnout, lower social support in some domains, and greater exposure to systemic inequities.
The study also examined protective factors, including individual and LGBTQ community-based resilience, social support, and experiences of marginalization. Findings reveal complex interactions between these covariates and provider burnout, highlighting opportunities for interventions at multiple levels, from institutional supports and peer networks to state-level policy protections.
Attendees will examine how social support, resilience, and inequities shape the relationship between legislation and provider well-being, and how these dynamics affect patient care and public health. The session will link these findings to broader advocacy and policy efforts, emphasizing the harmful impact of anti-trans legislation on GATRC delivery specifically and healthcare systems broadly. Participants will discuss actionable strategies for integrating provider experiences into advocacy campaigns, legislative analysis, and policy design. By centering the voices of those on the front lines and highlighting research led by queer and trans scholars, this session will encourage attendees to consider how health education professionals can advance policies that protect both providers and the communities they serve.
