Reducing Health Disparities Faced by Transgender and Gender Nonconforming Individuals

Rod of Asclepius in front of horizontal stripes of blue, pink, and white

Research has shown repeatedly that transgender people are more at risk for poor health outcomes than the general population, and Ohio is consistent with larger national trends of transgender people having negative interactions in healthcare settings, often related to stigma and misunderstanding. Gender nonconforming individuals may face even greater challenges in receiving inappropriate care. More research is needed in the area of transgender and gender nonconforming health, and dedicated researchers and service providers in Cleveland are interested in providing it.

The LGBT Community Center of Greater Cleveland (LGBT Center) and the Begun Center for Violence Prevention Research and Education at Case Western Reserve University's Mandel School (Begun Center) have received funding to improve quality of life by reducing health disparities suffered by transgender and gender nonconforming (TGNC) individuals though increasing their access to and use of primary health care. This project will continue through November 2019 and is funded by the National Institutes of Health through Metro Health.

The overarching goal of this project is to determine whether interactive dialogues result in an increase in TGNC individuals’ confidence in, access to, and use of primary care services, as well as an increase in cultural competency for healthcare providers when it comes to TGNC primary care. Healthcare providers will include medical doctors, nurses, physicians’ assistants, and clinical staff.

This funding will facilitate the formation of a cohort of self-identified TGNC individuals to participate in a nine-month program divided into three month increments.

  • The first three months will focus on learning from these individuals about the barriers they face and promoting confidence in interacting with medical providers and staff. Health literacy training will be developed in consultation with the CWRU School of Nursing.
  • Months 4-6 will consist of three facilitated meetings between the TGNC cohort and medical professionals where both groups share knowledge and teach one another. This section recognizes and respects that TGNC individuals are experts of their own experiences and aims to increase the cultural competence of the healthcare providers in interacting with TGNC clients.
  • The final three months will encourage both groups - the TGNC individuals and the healthcare providers - to continue to engage in advocacy by becoming peer educators and sharing their perspectives with colleagues and peers.

The Begun Center team, led by Misty Luminais, PhD, will study the outcomes of this process and examine whether it results in higher confidence on behalf of TGNC individuals and/or increased cultural competence on behalf of the healthcare providers. Luminais also intends to teach an interdisciplinary course at CWRU based in either anthropology or medicine with focus on TGNC individuals.

The LGBT Center will use this project to enhance objectives for their TGNC programming, including the hiring of a new Trans Youth Coordinator who will pursue other research and evaluation opportunities for the Center. Such opportunities will leverage future funding for the Center. Future opportunities being explored include the possibility of convening a conference directed by TGNC individuals to address the needs of TGNC individuals in medical settings.

The innovative and exciting aspect of this project is its emphasis on being driven by the clients themselves. It is uncommon for research to ask TGNC individuals what issues to prioritize, and TGNC individuals are often the research subjects and not recognized as experts themselves. This project calls for a sustained dialogue between TGNC individuals and healthcare providers, and intentional dialogue has certainly shown great capacity for positive change.