The Oregon Trans and Gender Diverse Survey was designed to provide data for advocacy efforts related to better healthcare for the gender diverse community in Oregon. Though Oregon’s Medicaid program has provided coverage of gender-affirming hormones and surgeries since 2015, the prevalence of utilization and unmet need for gender-affirming care among gender diverse adults receiving Medicaid is unknown. Compare unmet need for gender-affirming hormones among Medicaid beneficiaries to privately insured and uninsured.