Trans healthcare temporalities: The impacts of waiting for gender affirmation on trans identities, wellbeing, and futurity

Abstract

Background: Trans and gender diverse (hereafter, ‘trans’) people seeking medical gender affirmation often face prolonged waiting periods for diagnoses and treatment, adversely impacting their health and wellbeing. These delays can disrupt affirmation plans and exacerbate distress associated with incongruence between physical appearance and gender identity. Time is a critical factor in these experiences, yet healthcare systems may not account for the diverse temporalities of trans lives. Methods: This study explores the temporal dimensions of trans people’s experiences of gender affirming healthcare in Tasmania, Australia. Drawing on queer and trans temporalities as a theoretical framework, we analyzed qualitative survey responses from 84 trans adults to understand their experiences of urgency, anticipation, and futures within healthcare settings. Results: Participants described healthcare delays as deeply distressing, disrupting their sense of time and self. Health system timelines, characterized by extended wait times and linear transition pathways, often clashed with participants’ personal temporalities, contributing to feelings of stagnation and uncertainty. However, participants demonstrated resilience in navigating these challenges, advocating for timely, flexible, and person-centred care pathways. Conclusion: This study highlights the influence of healthcare timelines on trans wellbeing and life trajectories. It emphasizes the importance of timely, patient-centred care that respects diverse temporalities to support trans people in navigating their affirmation journeys.