Transforming Social Work Research through the Leadership of Black Trans Women in the US South: Phase 1 Findings and Reflections from the TAC-SAGES Team

Background and Purpose:

The US’ acceleration of systemic racism and transmisogynoir (Bailey, T., 2014) has a particular stronghold in the US South and shapes the health and wellness of minoritized communities. The region’s oppressive socio-political context (e.g. lack of medicaid expansion, passed anti-rights policies) further health inequities. Additionally, these conditions continue to drive the HIV epidemic, with Black and brown transgender women being one of the most systematically impacted (Black AIDS Institute, 2020; CDC, 2022; Reif et al., 2019; Smart et al., 2020; Scott et al., 2021).

Despite the structural conditions, Black trans women Southerners continue to thrive. In 2020, the Trans Ally Collective (i.e., TAC) was established to uplift and empower Black Trans Women. In partnership with the SUSTAIN Center at the University of Houston Graduate College of Social Work, a co-researcher cohort of Black Trans Women (i.e. SAGES) was formed in 2023. TAC-SAGES shared a desire to fuel change and impact within their community through research driven work. Informed by Meaningful Involvement of People Living with HIV/AIDS (US PLHC, 2019), this study employed Community Based Participatory Action Research methods with a Black trans liberation focus (TLC, 2019). This study aims to better understand Black trans women’s experiences with accessing gender affirming physical (i.e. primary, transition related, and HIV prevention/care) and mental/behavioral health services in the Greater Houston Area.

Methods:

This qualitative study employs Community Based Participatory Action Research methods with a Black trans liberation lens. Participants (N=8) were recruited through purposive sampling methods. Semi-structured interviews were conducted by TAC-SAGES members who completed the CITI Program, per University of Houston requirements, and a qualitative research curriculum in partnership with CBPAR research-activists at the SUSTAIN Center. The data were analyzed through thematic analysis. Note: The findings below are based on preliminary data from the ongoing study. If accepted, findings from a full analysis will be presented.

Findings:

Preliminary analyses are based on data from 8 participants. The age range of participants was between 20-50 years, averaging 35.75 years. Of the 8 participants, 100% reported having health insurance. However, most (75%) reported an annual income of $19,000 or less. In addition, most participants reported losing access to a type of gender affirming service since January 2025. All participants reported wanting at least 1 type of affirming service including primary/general health, mental/behavioral health, transition-related, HIV prevention/care, vision, and dental care.

Regarding qualitative findings, facilitators and barriers to accessing gender affirming services among Black trans women in the Houston Area will be discussed. In addition, themes related to visions and dreams about the future of affirming services will be shared. These themes include community mentorship, roles, and resources.

Conclusion and Implications:

This study highlights 2 main points: 1) the successful utilization of principled community based participatory action research methods, and 2) critical findings from the TAC-SAGES Phase 1 study. Implications for Social Work span across research, policy, and practice. More specifically, transforming infrastructure, shifting power, and gaps will be discussed.