Bridging Efforts to Enhance Support for the Transgender Community: A Grand Challenge for Social Work

Background: While a growing body of literature illustrates disparate experiences of risk, discrimination, and victimization among transgender and gender non-conforming (TGNC) individuals (Grant, Mottet, Tanis, Harrison, Herman, & Keisling, 2011), there remains a paucity of research exploring needs, experiences, and resources associated with well-being among members of the TGNC community.  A grand human rights challenge facing social workers is the development and delivery of targeted transgender affirming social, mental health, and medical services. This study focuses on advancing understanding of needs and experiences associated with accessing supportive trans-specific health and community services.

Methods: Bridging Efforts to Enhance Support for the Transgender Community (BEST Project), a mixed methods study of TGNC individuals (n=65) explores perceptions of and experiences with (1) therapeutic support, (2) physical and/or medical needs related to living authentically, and (3) community resources and support.  Survey data was gathered from TGNC individuals attending the 24^thannual Southern Comfort Transgender Conference.  SPSS 20 was used to conduct descriptive analyses, as well as chi square analyses exploring age and gender identity subgroup differences.  Qualitative data was explored using thematic analysis within a grounded theory framework (Charmaz, 2014).

Sample characteristics: Self reported gender identities included: transwoman (28%), transman (26%), transgender (17%), man (11%), transsexual (9%), woman (3%), and other (6%); sexual orientations of participants were identified as: straight (40%), pansexual (22%), lesbian (13%), bisexual (13%), gay (3%) and other (9%).  The mean age of participants was 44 (range 20-76).  

Findings: A vast majority (78%) of participants had at least one experience with a therapist, 53% of those being current or past year experiences.  While obtaining a “gender letter” for the purposes of transitioning was identified as a common reason for accessing therapeutic services, participants reported entering therapy to address myriad concerns, such as exploring gender identity (18%), family/couples therapy (12%), and coming out (10%).  Importantly, all participants strongly agreed (73%) or agreed (27%) that they could be honest with therapists about gender identity.  Across all age groups, community resources such as transgender support groups were identified as integral to well-being.  Social media was viewed as a key source of support among participants of all ages; however, subgroup differences emerged with transmasculine participants perceiving YouTube to be particularly valuable compared to other participants (x¹=7.487, p=.042).  Additional subgroup differences include the greater value placed on “passing” among younger (aged 20-34) participants (x¹=18.43, p=.005), as well as the greater value placed on gender fluidity in gender identities and roles among younger participants (x¹=13.43, p=.037).  Qualitative findings expand understanding of specific needs (e.g., services addressing hair removal) and barriers (e.g., prohibitive expenses of transitioning) associated with living authentically, as well as highlight opportunities for targeted service delivery and advocacy.

Implications: Findings indicate that TGNC individuals access therapeutic services at high rates and for a variety of concerns.  This study advances our understanding about universal experiences, as well as distinct subgroup needs and experiences among TGNC individuals accessing supportive services. Implications for enhancing support for TGNC individuals through affirmative social work research and practice will be discussed.