. Author manuscript; available in PMC: 2019 Apr 1.

Published in final edited form as: Rural Ment Health. 2018 May 21;42(2):116–132. doi: 10.1037/rmh0000089

Table 2.

Qualitative Findings-Themes and Subthemes

Key theme	Subthemes^a	n, %
Societal and community-level factors	Linking rural environment with conservative community attitudes and discrimination.	22, 73.3
	Impact of community policies on well-being	10, 33.3
	Impact of workplace policies on well-being.	10, 33.3
	Barriers to accessing general and mental health services.	18, 60.0
Interpersonal factors	Impact of support from family and friends on mental health and well-being.	30, 100.0
	(Re) building own support network through transition.	20, 66.6
	Redefining sexuality and intimate relationships.	20, 66.6
Impact of society, community, and interpersonal factors on individual factors—specifically mental health and well-being throughout the transition process	Gender policing and bullying	26, 86.6
	Impact on well-being before, during, and post-transition.	24, 80.0
	Cultural significance of Two-Spirit identities and well-being^b	7, 23.3

The cutoff for subthemes was n = 10.

Although only 7 individuals endorsed this subtheme, we report it to ensure the representation of Two-Spirit perspectives and experiences.