Organizational Support and Burnout Among Gender-Affirming Care Providers: Evidence from an Exploratory Factor and Structural Equation Model

Gender-affirming (GA) healthcare providers face unique occupational stressors as they care for patients from a historically marginalized group that is increasingly the focus of contentious political discourse. While individual coping is often emphasized to manage work stress among providers, less attention has been paid to how organizational supports impact well-being and retention. This study is based on a 2024 US-survey of N =142 GA providers. Well-being was measured with validated instruments for burnout, compassion satisfaction, psychological distress, coping, and turnover intention. Organizational support was measured with items related to autonomy, supervisor support, and workplace climate. Exploratory factor analysis (EFA) identified a three-factor model of organizational support and structural equation modeling (SEM) was used to test the relationships among the variables. Higher perceived organizational support predicted lower burnout and distress, and greater coping and compassion satisfaction. Burnout predicted both psychological distress and intention to leave, mediating the impact of organizational support on these outcomes. Individual coping had only marginal effects. These findings underscore the critical role of organizational support in sustaining a quality GA provider workforce. Consequently, healthcare leaders should consider interventions that strengthen supervisory relationships, enhance clinician autonomy, and foster affirming workplace climates.