141st APHA Annual Meeting

In This section

290296
"so as not to offend the man in your stirrup": Barriers to accessing health services for trans men who have sex with men

Tuesday, November 5, 2013 : 11:00 AM - 11:15 AM

Victoria Adams, B.A. , Department of Health Behavior Health Education, University of Michigan School of Public Health, Ann Arbor, MI
Kevin Jefferson, B.S. , Department of Health Behavior Health Education, University of Michigan School of Public Health, Ann Arbor, MI
Emily Pingel, MPH , Health Behavior and Health Education, University of Michigan School of Public Health, Ann Arbor, MI
Michael Moore, B.A. , Department of Health Behavior Health Education, University of Michigan School of Public Health, Ann Arbor, MI
Jorge Soler, MPH , Department of Health Behavior and Health Education, University of Michigan School of Public Health, Ann Arbor, MI
José Arturo Bauermeister, MPH, PhD , Department of Health Behavior and Health Education, University of Michigan, Ann Arbor, MI
Trans men who have sex with men (TMSM) are often excluded from campaigns addressing health and well-being, or find their needs conflated with those of other sexual minority individuals. The inadequacy of current research, and funding, for this population has prevented effective public health programming from being implemented, placing an additional burden on TMSM's access to health and safety resources. To address this gap, we designed NGender, a 2012 study based in the San Francisco Bay Area. We recruited fifteen TMSM for in-depth semi-structured interviews regarding community, health, and personal processes involving genders and sexualities. We then transcribed and coded these interviews so as to conduct a thematic analysis. In discourse around personal experiences and perceptions of community narratives towards health care access, TMSM cited several common barriers to service. TMSM perceived providers as using stereotypes and assumptions about transmasculine bodies, sexual practices, and identities. Participants also noted a difficulty in locating appropriate health practitioners. TMSM felt alienated by the language and images used to describe their identities in healthcare settings. Having to disclose both their transgender status and sexual orientation deterred many from seeking medical care. Furthermore, a lack of accessible knowledge around bodies and sexual practices prevented some TMSM from knowing which services they needed and how to procure them. We discuss participants' suggestions for improvement of services, techniques TMSM use to navigate these barriers, and previous literature around health access for marginalized populations as recommendations for healthcare providers.

Learning Areas:
Planning of health education strategies, interventions, and programs
Provision of health care to the public
Public health or related research
Social and behavioral sciences

Learning Objectives:
Define self-identified barriers TMSM encounter when accessing health services Describe suggestions for more inclusive public health materials or programs Discuss implications for healthcare providers working with transgender populations.

Keywords: Gender, Patient Perspective

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am a first-year student at the University of Michigan School of Public Health and a research assistant within the Center for Sexuality and Health Disparities (SexLab). I have worked at the Center for Sex and Culture, the New England Learning Center for Women in Transition, and the Illinois Caucus for Adolescent Health. I am trained as a rape crisis responder and HIV test counselor and have experience conducting qualitative research in human sexuality.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.