Transgender and Non-Binary Needs and Protective Factors: A Cross-Sectional Survey

Excerpt

We seek to conduct a medical and mental health needs assessment for Transgender & non-binary identifying adults in SNJ.

Research Project Summary

Approximately 0.44% of New Jersey (NJ) residents identify as transgender (NJTETF, 2019), with nearly 8,000 living in South Jersey (SJ). A recent global cross-sectional survey of transgender- and non-binary-identifying individuals (TGNB), reported that the shelter-in-place orders during the COVID-19 pandemic led to reduced access to gender-affirming resources and limited TGNB-identifying persons’ ability to live according to their gender (Jarett, et al., 2021). Many hospitals cancelled or postponed elective procedures, such as gender-affirming surgeries, in order to prevent overload of healthcare systems and preserve resources during the COVID-19 pandemic (Wang, Pan, Wilson, Ou, & Chen, 2020). Delays and cancellations of gender-affirming products and services has been connected with negative mental health consequences; access to these services protects against depression, anxiety, and suicidal ideations among the TGNB population (Murad, 2010; Peitzmeier, Gardner, Weinand, Corbet, & Acevedo, 2017; Valentine & Shipherd, 2018; Wernick, Busa, Matouk, Nicholson, & Janssen, 2019). Thus it is no surprise that worldwide prevalence rates of depression, anxiety, and suicidal ideation increased among those who reported reduced access to gender-affirming services during the COVID-19 pandemic (Jarett, et al., 2021).

TGNB persons are often disadvantaged both medically and socially, and face a number of health disparities and mental health problems. Prior to the pandemic, TGNB persons experienced barriers to healthcare, including lack of gender-affirming healthcare providers (Wang, Pan, Wilson, Ou, & Chen, 2020). Many TGNB individuals do not receive gender-affirming surgeries and hormone interventions for this reason (Zhu, Gao, & Gillespie, 2019). In SJ—where TGNB-friendly health and community services are scarce—it is possible that the COVID-19 pandemic may have further worsened social and health disparities among members of the TGNB community. However, such data have not been collected.

Local organizations, such as the Center for LGBTQ+ Health at Cooper University Health Care is interested in closing the resource gap experienced by TGNB persons. However, at this time the exact medical, mental health, and social-service needs among TGNB in SJ are not known. We propose a cross-sectional survey of SJ TGNB individuals to assess social, medical, and mental health needs—and pandemic-related delays that may have affected these needs. Moreover, we will assess resilience and protective factors among SJ’s TGNB-identifying persons; these data that can help identify psychosocial targets for future intervention.
Objectives:

    1. Describe the current status of medical, mental health, and community factors among TGNB, such as use of preventative services and rates of mental illness.
    2. To identify correlates of preventative health behaviors such as vaccinations and annual check-ups
    3. To assess the extent to which COVID-19 impacted the lives of TGNB persons in SJ.
    4. To assess resilience and stress and identify protective factors among TGNB persons in SJ.

To accomplish these objectives, we will create an internet-based survey to be completed by members of the SJ TGNB population. Respondents will be screened for TGNB status and zip code. Recruitment efforts will focus on Camden, Burlington, and Gloucester counties, as these areas are most directly serviced by the Cooper University Health Care System, however responses from TGNB individuals from Atlantic, Cumberland, Cape May, and Salem counties are welcomed. The survey will include questions to assess the following: demographics, housing status, primary source of transportation, interest in TGNB support groups, interest in gender-affirming services, barriers to appointments, health care status (e.g., health insurance status, primary care doctor), preventative services (e.g., cancer screens, STD tests, vaccinations, PrEP, gynecological exams), current health status (e.g., heart disease, cancer, diabetes, general mental health, substance use), impact of COVID-19 pandemic on life and well-being, stress and resilience. Given known trans-phobia experienced by TGNB-identifying individuals, we are interested in the extent to which respondents feel supported by their healthcare providers.

Broadly, we are interested in assessing the overall health of the TGNB-identifying population residing in SJ, learning how COVID-19-related stressors may have impacted quality of life, and identifying protective/resilience factors. To our knowledge, these data are not available for the TGNB population in SJ. We believe the results of this project can be used as the foundation upon which we can build and improve healthcare and community services for TGNB-identifying individuals in SJ.

Research Project Goals

Our proposed project will produce much-needed data on the social, medical, and mental health needs of SJ’s TGNB-identifying population. Only in 2018, did NJ create a Transgender Equality Taskforce; their 2019 report highlighted the dearth of data on the needs of TGNB-identifying individuals in NJ (NJTETF, 2019). The data produced from our project can be used not only to identify what services are needed, but also identify in what towns these services are needed. With this knowledge, others will be able to take a data-driven approach to advocating for the expansion of health and community services to reach TGNB-identifying individuals.

Research Project Objectives

1. Describe the current status of medical, mental health, and community factors among TGNB, such as use of preventative services and rates of mental illness.

2. To identify correlates of preventative health behaviors such as vaccinations and annual check-ups.

3. To assess the extent to which COVID-19 impacted the lives of TGNB persons in SJ.

4. To assess resilience and stress and identify protective factors among TGNB persons in SJ.