A review of top performing rural community and critical access hospitals' web resources for transgender patients in the United States

Objective: This cross-sectional study examined the prevalence of "LGBT" and "transgender" terminology and type of resources available to transgender patients on the websites of top performing rural/community hospitals and critical access hospitals in the U.S. The effect of hospital control (e.g. type of operating parent organization) on the presence of transgender resources on these websites was also evaluated.

Methods: The rural and critical access hospitals selected for inclusion in this study were those published on the Chartis Group's 2020 "top performing" hospital lists. Each hospital website was reviewed for the presence of "transgender" and "LGBT" terminology, as well several control terms commonly found on hospital websites.

Results: Findings suggest a lack of resources for sexual and gender minorities among rural community and critical access hospitals within this sample; the term "transgender" appeared on 26% of rural community hospitals and 21% of critical access hospitals (N = 200). There was no significant relationship between hospital classification and the type of transgender resources offered by the hospitals (p = 0.248). There was a significant relationship between hospital control and presence of the term "transgender" on the websites of critical access hospitals (p = 0.002, Fisher's Exact Test).

Conclusions: Few facilities provided links to external resources for transgender patients, advertised LGBT-friendly providers, or provided any information pertaining to gender-affirming healthcare. Additional research is needed to determine what barriers or social forces prevent these hospitals from using their websites to create a more inclusive environment for transgender patients within the communities they serve.