Background: Transgender (trans)/nonbinary (NB) individuals—those whose gender identity differs from the sex they were assigned at birth—experience significant health disparities and frequent healthcare discrimination. One-third of 27,715 trans-identifying respondents in a national 2015 survey reported one or more bad experiences with health care in the past year due to being trans, and 23 percent avoided seeking necessary health care because of fear of being mistreated. Trans people experiencing discrimination and limited access to affirming care have worse health outcomes and those living in the South are more likely to have been harassed at school or have lost a job due to bias, and less likely to have health insurance, when compared to those in other parts of the United States.
Proposed Solution: The project team proposes to tackle these challenges by supporting and building the capacity of racially and ethnically diverse trans/NB patients and community members, affirming clinicians and researchers to address stigma, discrimination, and other access barriers to affirming transgender health care in the South. The team will use an intersectional approach to develop a regional transgender health research and education collaborative in the Southern United States by expanding existing efforts in Arkansas (AR) to North Carolina (NC) and Georgia (GA).
Objectives: Long-term Goal 1: Collaboratively conduct patient-centered outcomes and comparative effectiveness research (PCOR/CER) addressing trans healthcare disparities across the South through a multistate southern regional collaborative. Long-term Goal 2: Measurably improve trans/NB patients’ access to medically competent, affirming health care through PCOR in rural southern states. Aim 1: Develop a southern regional collaborative building on partnerships between diverse trans/NB individuals and organizations, and researchers and providers interested in trans/NB health, in AR, NC, and GA through in-state and regional meetings and capacity-building webinars and interactive virtual discussions. Aim 2: Identify/summarize educational and research priorities of collaborative members. Aim 3: Archive/disseminate meeting materials, webinars, and virtual discussions, and develop/disseminate a lessons-learned document focused on building new trans/NB community and provider collaborations.
Activities: The project team’s activities will include monthly regional team meetings; individual and group meetings with community/providers/researchers to develop new partners and to identify priorities; establishing a Facebook group; providing capacity-building webinars; developing a lessons-learned document; and archiving and disseminating meeting materials, webinars, virtual discussions, and other products.
Outcomes: Project outcomes will include a southern regional collaborative with engaged members; archived webinars; a summary of collaborative priorities; improved member knowledge about PCOR/CER; and a lessons-learned document based on partnership-building experience in North Carolina.
Engagement Plan: The project team will engage racially and ethnically diverse trans/NB individuals, providers, researchers, and others across three states using interactive approaches in one-on-one and group meetings, in-person and virtually; by establishing a collaborative Facebook group; and by focusing capacity-building efforts on members’ priorities. The team will compensate trans/NB individuals who contribute; provide food at in-person meetings; and use technology to engage across geographic distances for planning and quarterly meetings.
Project Collaborators: Researchers at University of North Carolina Chapel Hill and University of Georgia Athens will co-lead the project with Arkansas’ team at the University of Arkansas for Medical Sciences. The Arkansas Transgender Equality Coalition, Transform Health Arkansas, Triangle Empowerment, and LaGender are key partners.