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APHA Scientific Session and Event Listing

Recorded presentation

Judith Bradford, PhD¹, Jessica Xavier, MPH², Mary Ellen Rives, MPA², and Michael Hendricks, PhD². (1) The Fenway Institute, Fenway Community Health Center, 7 Haviland Street, Boston, MA 02115, 617-927-6010, jbradfor@vcu.edu, (2) Community Health Research Initiative, Virginia Commonwealth University, 921 W. Franklin Street, Richmond, VA 23284

Background: Transgender persons encounter multiple barriers to healthcare access. Healthcare providers and organizations need adequate understanding of the social and cultural affiliations, personal characteristics and behaviors, and unique needs of this population in order to provide adequate care. Limited research has been conducted in these areas, and knowledge is generally lacking. Methods: Focus groups were conducted throughout Virginia, with both gender vectors and racial/ethnic diversity. We used results to refine a quantitative survey based on previous literature and made it available on the internet and by network distribution of paper questionnaires. Multiple hurdles had to be overcome during implementation. At each stage of the study, statewide training has been provided to healthcare providers to continuously increase readiness to provide appropriate care. Results: Respondents were 60% MtF and 40% FtM, primarily African American. Social stigma, discrimination and victimization were constants; access to transgender care, especially hormone therapy, was a priority need. Societal factors such as discrimination and provider ignorance led to risk mediating factors including sex work, substance abuse, gender identity validation through sex, and provider insensitivity. These in turn produced direct HIV risks through such factors as unprotected sex, low perception of risk, and IDU and viral transmission risks. Conclusion: With sufficient resources, determination, methodological flexibility, community involvement, and support from the public health system, we conducted a statewide transgender health study. Results will continue to be widely disseminated throughout Virginia to promote increased awareness of transgender health needs and to reduce barriers to care for this underserved population.

Learning Objectives: At the conclusion of the session, participants will be able to

• List the principal health- and healthcare-related challenges faced by transgender people.
• Articulate a clear rationale for the importance of population-based research to support transgender health services.
• Evaluate the feasibility and effectiveness of several methods for gathering data from transgender persons.
• Using data from the Virginia Transgender Health Study, discuss the components of a data-based conceptual pathways model for addressing HIV risk and healthcare access among transgender persons.

Keywords: Access to Health Care, Underserved Populations

Related Web page: www.vdh.state.va.us/std/Research%20Highlights/TG%20Focus%20Group%20Report%20final%201.3.pdf

Presenting author's disclosure statement:

Any relevant financial relationships? No

Recorded presentation