Exploring Service Barriers with Non-Binary Young Adults: Using Arts-Based Participatory Action Research for Change

Background and Purpose: There is a growing body of social work research focusing on the experiences and needs of transgender communities. Although this research has addressed a concerning gap in the literature, much of it focuses on exclusively on transgender men and women. Nearly absent from the literature is a specific focus on those whose gender is outside of a dichotomous binary. As social work seeks to advance gender-inclusive and affirming practices and services, it is important that research represents the experiences of non-binary people and promotes an understanding of gender that does not perpetuate essentialist and reductionist notions of identity.

This paper provides an overview of an arts-based participatory action research (PAR) study where nine non-binary young adults explored experiences they had with services providers where they felt their identity was supported and experiences where they felt stigmatized. The research was grounded in social work’s core values and intentionally engaged in processes related to social justice and transformation, and the prioritization of local emic knowledge.

Methods: Nine non-binary young adults between the ages 18-23 participated in seven research group meetings and utilized photovoice methodology to explore group-identified topics. The group was predominately White (1 Black, 2 Bi-Racial, and 6 White). Group members were positioned as participant co-researchers who worked with the primary investigator to develop research questions, engage in group activities and photographic data collection and analysis. Following identification of findings, the research team presented their work to community leaders, social work practitioners and health care providers during a community exhibit. Participant co-researchers and exhibit guests discussed how service providers could improve the accessibility and quality of services to non-binary young adults. Following group meetings, the primary investigator and research assistant uploaded data to ATLAS.ti version 1.6.0 and engaged in interpretive phenomenological analysis to further develop group identified themes.

Findings: Group-based and interpretative phenomenological analysis revealed three key themes related to non-binary experiences with service providers. Themes highlight 1) experiences with pervasive gender assumptions, 2) bifurcation of identities, and 3) the pathologization of gender by service providers. Group members also emphasized several actions that social workers can take to increase and improve the gender-affirmation of those they serve. Attention was paid to clinical care as well as community engagement and relationship building. Finally, this study also revealed the ways in which participant-led and group-based research processes can support the development of critical awareness among research participants, individual empowerment and increased social connectedness among those who experience community-based marginalization.

Conclusion and Implications: Study findings and group members’ reflections on the research process present implications for social work researchers and practitioners. Findings emphasize ways in which non-binary communities may continue to experience erasure and invisibility despite increasing literature and practice attention paid to their binary transgender peers. By intentionally disrupting exclusively binary gender paradigms, centering clients as research participants and experts, and providing individuals the opportunity to communicate and express diverse genders without pathologization, social workers can engage in practices that hold potential for individual and community transformation.