Participant-Engaged Methods for Psychedelic Research with Transgender and Gender Expansive People

Background and Purpose: This study describes methodological challenges and opportunities in research on the experiences of transgender and gender expansive people (TGE; e.g., transgender men, transgender women, non-binary, gender fluid, genderqueer, agender, two-spirit, or third gender people) who have used psychedelic substances (e.g., psilocybin, LSD, MDMA). TGE people have been underrepresented in studies of the utility of psychedelics and psychedelic assisted therapy for mental health challenges (e.g., depression, anxiety) and there is societal stigma around both gender identity and substance use. Research with this population, especially TGE people of color and others who are multiply marginalized, requires considerations around building trust and communicating about stigmatized and sensitive topics. Further research is needed on suitable approaches for research given these contexts.

Methods: We present a case study detailing innovative research methods used in a participant-engaged qualitative research study on the experiences of TGE people who have used psychedelics and their mental health. First, we will describe the process of purposively recruiting and meaningfully engaging those who are underrepresented in research on the topic (e.g., people of color, two-spirit and agender people, TG/GE people over age 50 or under age 21). Strategies used to build rapport and increase participants’ comfort sharing sensitive information through strategic self-disclosure of interviewer’s identities during qualitative interviews and other methods will be described. Next, we will discuss opportunities for involving study participants in the data analysis and results validation process through member check interviews where they provided feedback on the codebook. Efforts to disseminate research findings to study participants and the broader community will also be described.

Results: This study successfully collected rich qualitative interview data from a diverse sample of 20 TGE participants. Participants were actively included the research process in accordance with the principles of Black Feminist Epistemology. Five of these participants were further engaged in the research process through member checks. Participants identified few issues with the preliminary codebook, which allowed for minor refinement before the codebook was applied to other interviews. Several participants expressed appreciation for a chance to be included to a greater extent in the analytical process.

Conclusions and Implications: Exploring TGE psychedelic experiences is a novel research topic and therefore is an area of research that can and should be lead with community voices, ideally with staff that share similar identities to the study population. We found these methods to be feasible to researchers, acceptable to study participants, and have yielded results that are relevant to the community.