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Anyone who has recently watched television or movies can tell you that transgender, gender nonbinary or gender expansive people are becoming more visible in these media. This trend reflects the reality that younger generations are increasingly identifying with more fluid and nonbinary gender and sexual identities and are progressively expressing those identities in a more flexible and changing manner (Herman et al., 2022; Wilson & Meyer, 2021). Unsurprisingly then, those individuals are also more visible at work, including in workplaces with employer-mandated dress codes. Indeed, in 2020 the US Supreme Court decided a case involving a transgender woman, Aimee Stephens, who was fired because her employer, a funeral home, required her to conform to its gender-binary dress policy and wear clothing mandatory for people assigned male at birth, rather than appropriate for her female gender identity ( Bostock v. Clayton County, 2020).

However, as the description of Aimee Stephens's own experience illustrates, often these employer appearance codes are based on a binary and fixed conception of gender and gender identity and expression at odds with the increasing number of workers who do not identify within those rigid parameters. Moreover, even when an employee, like Aimee Stephens herself, could have fit within her employer's dress code, the improper application of that policy to her, or employer concerns about customer or co-worker discomfort with an employee's appearance under the policy may mean that a worker's identity and expression may still conflict with a workplace appearance code. For gender nonbinary or nonconforming individuals, these complications are magnified.

This chapter explores the practical problems and barriers that employer dress codes have on employees whose gender identity and/or presentation move beyond the traditional male/female binary. Using insights from queer theory, gender expansive employees serve to interrogate fundamental assumptions behind workplace dress policies and the formal and informal ways in which these policies are policed. The chapter will explore that discordance, examine possible employer resolutions, and evaluate the strengths and weaknesses of those responses.

The disparities of COVID-19 vaccination rates between the rural and urban areas have become apparent during this pandemic. There is a need to understand the root causes of vaccine hesitancy demonstrated by the rural population to increase coverage and to contain the disease spread throughout the United States. This study aimed to explore other factors influencing vaccine hesitancy among rural dwellers besides the geography-related barriers such as poor health care access and individuals having no or suboptimal insurance coverage.

By reviewing existing data and literature about vaccination, health literacy, and behaviors, and prevailing ideologies, we discuss the potential causes of vaccine hesitancy in rural areas that could create barriers for successful public health efforts related to vaccine coverage and provide suggestions to ameliorate the situation.

Geography-related barriers, health literacy, and preconceived notions are key determinants of adopting healthy behaviors and complying with public health authorities' recommendations among rural individuals during a public-health crisis. We argue that ideology, which is much deeper than preconception or misconception on vaccination, should be incorporated as a key factor to redefine the term “vulnerable populations” in public health research.

The limitation of our study is that we have not found an effective way to encourage the populations who hold conservative religious and political ideologies to join the efforts for public health. Even though geography-related barriers may strongly impact the rural dwellers in achieving optimal health, the various forms of ideologies they have toward certain health behaviors cannot be discounted to understand and address vaccine-related disparities in rural areas. There is a need to redefine the term “vulnerable population” particularly as it relates to rural areas in the United States. During large-scale public health disasters, scholars and public health authorities should consider the ideologies of individuals, in addition to other factors such as race/ethnicity, area of residence (rural vs. urban), and socioeconomic factors influencing the existing vulnerabilities and health disparities.