Background: Sexual and gender minorities fare worse in the healthcare system and have poorer health outcomes than the general population. Transgender people experience inequities that stem from discrimination, stigma, harassment, poverty, and lack of transgender-specific health information.
The Williams Institute estimates 1.4 million adults in the United States identify as transgender, including 124,500 Texans. Gaps in research compound the experience of many transgender people in being ignored or maligned by medicine and medical research. The PRIDE Study is the first large-scale, long-term health study of people who identify as LGBTQ designed to address research gaps.
Proposed Solution: TransFORWARD works to establish trust in the transgender community. The goal is to connect transgender people with clinicians and researchers, ensuring medical care for transgender people is informed by evidence-based data.
Create a 28-person Research Engagement Advisory Council (REAC) to lead collaborative network development
Establish a network spanning all eight Texas regions using technology to reduce distance, time zone, and location differences. Train 10 transgender people and 10 medical providers/researchers in each region to increase research capacity
Host a capstone summit bringing together regional representatives to continue engagement and identify best practices, lessons learned, and tools for continued dissemination of research opportunities and results
Activities: Transgender Patient-Powered Engagement - PCOR/CER Research Capacity Building
Ensure 2,500 transgender people are recruited into the PRIDE Study
Continuously disseminate research results
Develop evaluation instruments
Submit at least two ancillary research studies to the PRIDE Study
Develop a culture of patient-centeredness in research and meaningful partnerships
Secure one transgender and one clinician/researcher stakeholder in each of the eight regions to lead state and regional efforts
Increase the number of transgender people taking part in The PRIDE Study to 2,500 Texans
Increase the number of engaged transgender people/family members, clinicians, and researchers in each of the eight regions participating in knowledge discovery, identifying, and disseminating research
Submit at least two ancillary research studies for PRIDE Study review
Measure the degree to which participants apply what they learn during online and in-person training and the degree to which targeted near-term outcomes occur as a result of the training
Develop a sustainability plan for the statewide network
Patient and Stakeholder Engagement Plan: “Nothing about us without us,” guides all project phases. One project co-lead, a transgender man, will liaise with the transgender community. A second project co-lead, a transgender-competent surgeon, will liaise with the clinician/researcher community. A modified key stakeholder matrix is used to balance stakeholder perspectives ensuring ethnicity, age, income, education, and engagement perspectives are considered.
Equality Texas Foundation
This project enhancement will yield critical emerging information on the impact of the COVID-19 pandemic on the transgender and gender-diverse communities. Already, trans people are less likely to seek or be able to access culturally-competent transgender medical care.
They are at a higher risk for social isolation and suicide compared to the general population. They are also much less likely to be included in patient-centered outcomes research. This is especially true in trans communities of color who may have limited access to surveys or medical care.
The enhancement will surface new PCOR/CER transgender-focused research opportunities specific to COVID-19.