How do we support the health and wellbeing of transgender communities?
Transgender individuals face a tremendous number of challenges to quality of life, including systemic prejudice, routine discrimination in housing, employment, education health care, and social service setting, and interpersonal stigma and mistreatment. At the same time, transgender communities demonstrate tremendous power and resilience, and have been pioneers in the fight for human rights for all persons. At HART, Dr. Gus Klein leads our Transgender Health Research Initiative, which focuses on supporting health and well-being by developing new strategies to increase the availability of competent, comprehensive, affirming care. Our team of transgender researchers collaborate with cisgender colleagues and community-based partners to create projects that both inform and support the communities with whom we work.
Over 1,500 respondents to TM Survey
In May 2016, HART launched the Trans Masculine Health Survey, designed to engage transmen in identifying their highest priority sexual health needs and informing a research and advocacy agenda to improve trans-affirming health care. The research team, led by HART trans researchers Gus Klein and Charlie Solidum, successfully recruited over 2000 transmen and nonbinary individuals of trans masculine experience. Survey participants came from all 50 states and over 15 different countries, making it possibly the largest and most diverse sample of transmasculine individuals ever compiled.
The NIH-funded study is one of the few trans-masculine focused project currently funded by NIH. The survey was developed through formative qualitative research with a diverse group of 30 trans masculine participants, and documents a wide range of wants and needs for the future provision of transgender health. The survey closed in July 2018 -- stay tuned for updates on findings, recommendations, and future research.
Biomedical Prevention Adherence Dynamics in a High Priority Population (R21MH116757; Golub, PI, Radix/Klein, Co-Is)
This project collaborates with Callen-Lorde Community Health Center to identify factors associated with PrEP uptake and persistence among transgender women, and examine the association between self-reported PrEP adherence, tenofovir levels, and estradiol levels among transgender women taking PrEP. Many transgender women express concerns about the interaction between PrEP medication and gender-affirming hormones; this project is designed to provide data for the community to directly answer and address this concern.
Leveraging Biomedical HIV Prevention as a Gateway to Gender Affirming Health Care (R01AA022067-04S1 ; Golub, PI)
This project is designed to identify social, behavioral, and structural factors that influence access to and utilization of sexual heath and primary care services among transgender men. Through a combination of qualitative and quantitative data collection, we are working to develop a valid, reliable, and affirming assessment tool for engaging transmen in conversations about their sexual health. Transmen are often left out of conversations around PrEP, and this project is also focused on developing strategies for greater inclusion and leveraging engagement of PrEP toward improving overall health of TM.
Family Decision-Making and Quality of Life Goals for Gender Expansive Youth (Pilot Project; Klein/Golub, PIs)
This project is being conducted in collaboration with Camp Aranu'tiq and surveys parents of transgender and gender expansive youth to better understand and support decision-making about hormone therapy and other interventions. The goal of this project is to compile data from families about their goals, decision-making processes, and experiences in order to develop a framework that might be useful for new families embarking on this journey.
Supporting Patient-Focused Decision-Making around Gender Affirming Therapy (Pilot Project; Klein, PIs)
In collaboration with Dr. Rachel Bluebond-Langner and her multidisciplinary team at NYU Langone Medical Center’s Transgender Surgery Program, we are examining patients' decision-making processes in approaching gender affirming surgical intervention. This project is designed to develop better tools and support services for patients both pre- and post-surgery.
Facilitators and Barriers to Pre-exposure Prophylaxis (PrEP) Use among Transgender Women at Risk for HIV (Dissertation Project; Klein, PI)
This project focuses on the barriers to PrEP access experienced by transgender women, and the potential for PrEP to improve the sexual health care transwomen receive. Through interviews with transgender women who have chosen to use PrEP as well as women who have decided that PrEP is not the right prevention choice for them, this study examines sexual health decision-making for transgender women and the ways in which programs and policies can be designed to support them.
Lelutiu-Weinberger, C., Pollard-Thomas, P., Pagano, W., Levitt, N., Lopez, E. I., Golub, S. A., & Radix, A. E. (2016). Implementation and Evaluation of a Pilot Training to Improve Transgender Competency among Medical Staff in an Urban Clinic. Transgender Health, 1(1), 45-53.
Golub, S.A., Walker, J.J., Longmire-Avital, B., Bimbi, D.S., & Parsons, J.T. (2010) The role of religiosity, social support, and stress-related growth in protecting against HIV risk among transgender women. Journal of Health Psychology, 15(8): 1135-44.