TRANSLATE: Transgender and Gender Nonconforming Individuals' Access to Healthcare

Summary

Transgender and gender nonconforming (TGNC) individuals face a number of health disparities, many of which can be tied to a lack of access to or use of primary care. Stigma and misunderstanding make simple doctor's visits into ordeals only worth enduring for the most serious of problems. This project addresses those issues by enlisting TGNC people as experts on their own experience. TGNC individuals will form a year-long cohort that will form the basis for this research. Collectively, they will define the scope of challenges faced when seeking healthcare, what medical advocacy training they desire, and how to address groups of healthcare providers and staff. Healthcare providers, including MDs, nurses, and Physicians Assistants (PAs), will attend two facilitated sessions with the TGNC cohort to meet as peers with knowledge exchanged in both directions. Similar meetings will occur with clinic staff, as TGNC individuals have expressed how stigma begins from the moment they call a medical office. Our hypothesis is that when TGNC individuals are given the tools to navigate the healthcare system and the ability to speak with medical professionals as peers, rather than patients, through a participatory action research design they will be better able to access appropriate care through increased confidence and mutual support. The complementary hypothesis for medical providers is that direct interaction with a variety of TGNC individuals who articulate their needs will decrease stigma and increase comfort when treating TGNC people as patients. As a partnership between academic, medical, and community institutions, this project has the potential to directly impact the lives of TGNC individuals who participate and indirectly impact others served by the LGBT Center. This proposal works on three levels: 1) at the academic level - an assessment of participatory action research as an intervention to decrease health disparities, 2) at the individual level - the potential for individuals to increase personal knowledge and skills, and 3) at the institutional level - as actors within the TGNC community develop relationships with individual healthcare providers, medical clinics and activist groups and community partners and educational institutions are concurrently forming networks that will have positive, although probably more diffuse, impact on TGNC individuals as these institutions come together to support TGNC health care.

Conditions

• Gender Identity

Interventions

BEHAVIORAL

TGNC Directed Advocacy Meetings

Series of 18 meetings with TGNC cohort, including 3 facilitated dialogues with the healthcare participants, to articulate barriers to access and to enter into dialogue with medical providers and staff.

BEHAVIORAL

Facilitated Dialogues between TGNC Cohort and Healthcare Participants

Healthcare Participants attend a facilitated dialogue with the TGNC cohort. 3 total facilitated dialogues were held, but each healthcare participant attends only 1 session.

Sponsors & Collaborators

• LGBT Community Center of Greater Cleveland

  collaborator OTHER

• MetroHealth Medical Center

  collaborator OTHER

• Case Western Reserve University

  lead OTHER

Principal Investigators

• Daniel J Flannery, PhD · Director, Begun Center for Violence Prevention Research and Education; Jack, Joseph and Morton Mandel School of Applied Social Sciences

Study Design

Allocation

NON_RANDOMIZED

Purpose

SUPPORTIVE_CARE

Masking

NONE

Model

PARALLEL

Eligibility

Min Age

14 Years

Sex

ALL

Healthy Volunteers

Yes

Timeline & Regulatory

Start

2019-02-01

Primary Completion

2019-12-10

Completion

2020-12-10

Countries

• United States

Study Locations