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Trans* Health Literacy: Supporting Colorado Communities through Research, Education, and Policy Advocacy

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By: Drs. Donny Gerke, Jennifer Greenfield, & Eugene Walls

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The Colorado Transgender Health Literacy project is a collaboration between the Graduate School of Social Work and One Colorado – the state’s leading advocacy organization dedicated to advancing equality for lesbian, gay, bisexual, transgender, and queer (LGBTQ) Coloradans and their families. Through a mixed methods, statewide research study, the project sought to understand the state of healthcare for transgender and nonbinary individuals in Colorado in order to determine the extent of health disparities, unmet healthcare needs, discriminatory practices, lack of competent providers, and policy barriers in the state. Additionally, the project sought to document positive aspects of healthcare literacy and access including the prevalence and use of mutual aid, psychological resilience, help-seeking behaviors, gender affirming experiences, and experiences of gender euphoria among members of the transgender and nonbinary community living in the state. Previous needs assessment projects of the transgender/nonbinary community in Colorado (the last of which took place in 2019) have had an underrepresentation of people of color, young adults, older adults, and rural and low-income community members. As such, the project sought to increase the number of respondents from these communities among project participants.

The initial phase of the study was a qualitative study consisting of (7) focus groups (Denver x2, Ft. Collins, Durango, Colorado Springs/Pueblo, Grand Junction, and online) with 46 members of

the transgender/nonbinary community in Colorado. The data collected in the focus groups resulted in three peer-reviewed publications, two peer-reviewed presentations, a research report, and an online presentation of findings to One Colorado.

The second phase of the study was a quantitative survey covering a wide range of health- and mental health-related topics that garnered over 500 respondents across the state. The quantitative survey built on the findings of the qualitative phase and data collection was completed in December, 2022. From these data, numerous manuscripts and reports are planned to further the scholarship on transgender/nonbinary risk and resilience in the healthcare system as well as to support the policy advocacy work of One Colorado in the upcoming year.

The project had a number of impacts beyond the scholarly products listed in #3 below. These include:

  • The project was featured in an article, Reducing LGBTIQA+ Health Disparities, in the August 27, 2020 GSSW Newsletter to GSSW community and alumni
  • The project has provided feedback to One Colorado on the impact of previous and ongoing policy work (e.g., Jude’s Law, inclusion of transition-related care in Colorado Medicaid coverage) and the most recent data collection survey is poised to continue to inform future policy advocacy activities
  • Increased transgender and nonbinary health-related research at GSSW to include:
    • Transgender and nonbinary inclusion in PrEP (HIV biomedical research) project currently being undertaken by Dr. Gerke
    • Training opportunities on best practice approach to research with transgender and nonbinary individuals and communities for multiple graduate students (at both the MSW and PhD levels)
  • Other local LGBTQ+ health and social service organizations have identified PIs as potential research collaborators
  • Scheduled interview with Colorado Public Radio on the project as well as healthcare issues for transgender and nonbinary communities in Colorado.