A Multi-Method Study with Transgender and Gender Diverse People Using Virtual Reality

Background: Transgender and gender diverse people (TGD) experience elevated rates of behavioral health problems, including depression, anxiety, substance misuse, non-suicidal self-harm, and suicidality. Minority stressors, such as discrimination and victimization, contribute to these outcomes. A salient form of discrimination is the use of gender non-affirming language, such as using incorrect pronouns or names. The Minority Stress Theory is one of the most widely used and empirically supported frameworks for understanding the stress-health relationship among TGD people, however gaps still exist. Research is needed to understand the mechanism by which minority stress becomes internalized, resulting in negative coping mechanisms and poor health outcomes, such as substance misuse and suicide. Filling this gap will sharpen our understanding of TGD people and improve public health interventions that support the mental health of TGD. In our study, we proposed psychophysiological mechanisms, such as emotions and physiological reactions in the body and brain that are elicited during stressful or supportive events, help give external events internal meaning. This is important as it can lead to poor health, particularly risky substance use behaviors and suicidal ideation.

Aims: During 2021, a group of seven interdisciplinary scholars (i.e., Social Work, Computer Science, Psychology) and two content consultants in a southern state secured a $28,110 grant to explore the psychophysiological and perceived health-related behaviors during and after gender-affirming and non-affirming interactions among TGD adults who participated in a virtual reality simulation. Further, the grant employed six graduate and undergraduate students across three disciplines to collaborate on this project.

Methods: To create the interactive virtual reality simulation, three researchers conducted three audio-recorded semi-structured focus groups and three individual interviews with TGD adults during Summer 2021. Interviews ranged from 42 to 106 minutes (m=74 minutes) and discussed (1) gender-affirming and non-affirming language and experiences, (2) positive and negative interactions, and the associated emotions, and physiological reactions, (3) stressful and supportive environments, and (4) positive and negative coping mechanisms. Four coders used a thematic analysis approach using Dedoose Software to code the transcribed data and provided evidence-based deliverables to the Computer Science lab to create the virtual reality simulation.

Topics: During our roundtable, we will (1) discuss recent literature pertaining to TGD people that seeks to uncover (a) the Minority Stress Theory, which conceptualizes challenging situations and resilient factors TGD commonly experience, and (b) the proposed psychophysiological mechanisms, such as emotions and physiological reactions in the body and brain that are elicited during stressful or supportive events which help give external events internal meaning leading to poor health outcomes; (2) report qualitative findings from the first phase of data collection with included focus groups and interviews to inform the creation of our virtual reality simulation, and; (3) discuss our experiences working on an interdisciplinary team and employing six undergraduate and graduate students to create and then recruit TGD people for the virtual reality simulation. The faculty research team and the student research assistants will discuss their experiences, challenges, and lessons learned from being involved in this innovative, multidisciplinary, multi-method, multi-phase project.