Transgender and gender diverse (TGD) individuals face a long-term, multi-faceted process if they choose to begin a gender affirmation journey. Decisions to go on hormone therapy and/or have a surgical procedure necessitate the TGD individual to set up an appointment with a healthcare provider. However, when TGD patients interact with healthcare practitioners, problems can arise. This article documents and categorizes the types of unmet expectations that are common in the TGD patient-healthcare provider social dynamic in the Central Great Plains of the United States. Utilizing a community-based participatory research model, qualitative in-depth interviews were conducted with 27 TGD individuals about their healthcare experiences. From this, the researchers identified four main themes of unmet expectations: probing, gatekeeping, stigmatizing stance, and misgendering/deadnaming. Steps that can be taken by both the healthcare provider and the TGD individual to have a more successful encounter are discussed
