 This study examined the relationship between structural stigma and access to gender affirming care, gender identity disclosure in healthcare, and experiences of discrimination in healthcare among transgender people in Europe. It found that structural stigma was negatively associated with experiences of seeking gender affirming care and positively associated with concealing one's transgender identity to healthcare providers. Additionally, it showed that identity concealment was associated with a lower likelihood of experiencing discrimination in the healthcare setting across all countries, regardless of their level of structural stigma. This suggests that structural stigma may be a barrier to accessing gender affirming care and that efforts to reduce structural stigma could improve access to such care. Furthermore, the study also revealed that the most common reasons for not seeking gender affirming care were fear, which were shared between low and high structural stigma countries. These findings suggest that measures to reduce structural stigma should focus on decreasing fear and increasing access to gender affirming care. This article was authored by Felicitos Fork and Richard Brandstrom. We are article.tv, links in the description below.