Transgender people in rural America struggle to find doctors willing or able to provide care

For Tammy Rainey, finding a health care provider who knows about gender-affirming care has been a challenge in the rural northern Mississippi town where she lives.

As a transgender woman, Rainey needs the hormone estrogen, which allows her to physically transition by developing more feminine features. But when she asked her doctor for an estrogen prescription, he said he couldn't provide that type of care.

"He's generally a good guy and doesn't act prejudiced. He gets my name and pronouns right," said Rainey. "But when I asked him about hormones, he said, 'I just don't feel like I know enough about that. I don't want to get involved in that.'"

So Rainey drives around 170 miles round trip every six months to get a supply of estrogen from a clinic in Memphis, Tennessee, to take home with her.

The obstacles Rainey overcomes to access care illustrate a type of medical inequity that transgender people who live in the rural U.S. often face: a general lack of education about trans-related care among small-town health professionals who might also be reluctant to learn.