Transgender and nonbinary (TNB) emerging adults in the United States experience mistreatment inside and outside healthcare settings, which may contribute to known mental health and substance use inequities. The purpose of our study was to examine associations between provider and healthcare setting mistreatment with past 30-day severe psychological distress, illicit substance use, binge drinking, and past year suicidal ideation among TNB emerging adults (18–25 years; N = 10,203) who sought healthcare in the previous year. In sociodemographic-adjusted, multivariate, logistic regression models, all mistreatment types were associated with worse mental health and illicit substance use. Structural interventions to improve interdisciplinary healthcare providers’ attitudes and knowledge, combined with inclusive healthcare policies are needed to ensure TNB emerging adults are treated with respect and dignity.
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