The Trans Youth Health Experiences Study: Recruitment, - - PowerPoint PPT Presentation

The Trans Youth Health Experiences Study:

A l i c S h o o k , R N , B S N , P h D c R W J F F u t u r e o f N u r s i n g S c h o l a r U n i v e r s i t y o f W a s h i n g t o n , S e a t t l e

Recruitment, Representation, and Centering Youth Voices in Research about their Lives

Cisnormativity Discourse = C i s n

• r

m a t i v i t y

C i s n

• r

m a t i v i t y

Represents the dominant framework for understanding sex/gender binary Grounded in historical privileging and naturalization of cisgender bodies & psychic experiences Has changed throughout history as ideas about sex & gender has changed

C i s n

• r

m a t i v i t y

B a c k g r

• u

n d

B a c k g r

• u

n d

Participants already engaged in care in existing gender clinics; issue of consent Overwhelmingly White Rely on parent report and/or participants 18+ Limited inclusion/lack of representation of trans youth

What are the experiences of transgender youth navigating healthcare?

D i s c o u r s e A n a l y s i s A I M # 1 A n a l y z e t h e d i s c u r s i v e f r a m i n g

• f c o n t e m p o r a r y t r a n s g e n d e r

y o u t h i n t h e e x t a n t l i t e r a t u r e

U n d e r s t a n d t h e r o l e t h a t c o n s e n t p l a y s i n r e g u l a t i n g a c c e s s t o c a r e f o r t r a n s g e n d e r y o u t h A I M # 2 A I M # 3 D e s c r i b e t h e n a r r a t i v e s o f h e a l t h c a r e a c c e s s a m o n g t r a n s g e n d e r y o u t h

D i s c

• u

r s e A n a l y s i s

Arises from linguistic studies, literary criticism, and semiotic performative theories of language Explores language as a form of action Seeks to understand how people & institutions use language to create & enact identities & activities Concerned with power relations Issues prominent in DA research include gender issues, issues of racism, media discourses, etc.

D i s c

• u

r s e A n a l y s i s

C r i t i c a l T r a n s T h e

• r

y

Is a critical social theory e.g. feminist, critical race, disability studies, etc. Interdisciplinarity; concerned w/ material conditions & representation practices --> How do representational practices impact everyday lives of trans people? How are embodied differences transformed into social hierarchies? What is the relationship of discourse to regulation of gender as a social category?

Trans people = experts of their own experience

C

• m

m u n i t y B a s e d P a r t i c i p a t

• r

y R e s e a r c h

Focused on issues of equity & empowerment Knowledge generation & data arise from within communities Re-envisioning of young people...

Young people = expert co-creators of knowledge

Engages youth & their expertise in research conducted about them

W a i v e r

• f

P a r e n t a l P e r m i s s i

• n

I s s u e o f d i s c l o s u r e / s a f e t y M a y b e b e t t e r i n f o r m e d t h a n p a r e n t s a b o u t t h e i r h e a l t h n e e d s R e p r e s e n t a v u l n e r a b l e s e g m e n t o f t h e l a r g e r p o p u l a t i o n o f t r a n s y o u t h

50%

• f youth

participated without their parents.

P r e v i o u s l y u s e d i n r e s e a r c h w / q u e e r y o u t h & r e s e a r c h r e l a t e d t o H I V / S T I t e s t i n g & s e r v i c e s A d d e d o p t i o n o f y o u t h a d v o c a t e d u r i n g c o n s e n t & d u r i n g / a f t e r i n t e r v i e w s

R e c r u i t m e n t

O n l y r e c r u i t e d o u t s i d e " c l i n i c a l s a m p l e s " O u t i n g m y s e l f i n r e c r u i t m e n t m a t e r i a l s I s s u e o f d o m i n a n t d i s c o u r s e i n s t r a t e g y & m a t e r i a l s

Public Libraries Youthcare Friends of Youth 45th Street Clinic Alphabet Alliance of Color Entre Hermanos Garfield Teen Life Center Oasis Youth Center The Rainbow Center Stonewall Youth

Gender Diversity Gay City Lambert House Facebook Instagram Ingersoll Camp Ten Trees UW Rainbow Grads GLSEN

R e c r u i t m e n t

n = 3 n = 1 n = 1 n = 4 n = 2 n = 2 n = 1

R e c r u i t m e n t

R e c r u i t m e n t

R e c r u i t m e n t

Good Parent Discourse

I n t e r v i e w s

3/7

7/14

1/7

2/7

Presence of Youth Advocate Interview Locations

lived independent of parents interviewed at home community spaces for queer & trans youth private spaces on UW campuses public library

9 2 2 2 1

I n t e r v i e w s

I n t e r v i e w s

D i s c u r s i v e i n t e r v i e w s f o c u s o n u n d e r s t a n d i n g h o w i d e n t i t y i n f o r m s h e a l t h c a r e e n c o u n t e r s B o t h i n t e r v i e w e r / i n t e r v i e w e e e n g a g e i n d i a l o g u e I n t e r v i e w e r p r o b e s f o r i n t e r t e x t u a l m e a n i n g Yo u t h a d v o c a t e a s a c t i v e p a r t i c i p a n t I n v i t e y o u t h t o c o m m e n t o n i n t e r v i e w p r o c e s s

A n a l y s i s

M u l t i p l e , o v e r l a p p i n g , i t e r a t i v e s t e p s C o n t i n u o u s f e e d b a c k b e t w e e n a n a l y s i s & d a t a c o l l e c t i o n

W h a t i s d i s c o u r s e d o i n g i n t h e c o n t e x t o f t h e h e a l t h c a r e e n c o u n t e r ? W h a t n a r r a t i v e s a b o u t t r a n s e m b o d i m e n t d o e s i t p r o d u c e , n o r m a l i z e , p a t h o l o g i z e , o r d i s r e g a r d ? H o w d o p a r t i c i p a n t s m a k e u s e o f t h e d o m i n a n t d i s c o u r s e , e n g a g e w i t h i t , o r d e c i d e t o d i s r e g a r d i t e n t i r e l y ? H o w d o i s s u e s o f a g e , a u t o n o m y , a n d a u t h o r i t y

• f k n o w l e d g e s h o w u p f o r y o u t h i n s e e k i n g

h e a l t h s e r v i c e s & i n t e r v e n t i o n s ?

A n a l y s i s

2 2 1

trans youth participant-researchers trans/queer grad student researchers faculty mentor

Analyst examines own place in the discourse(s) *Centrality of member-checking

R e s e a r c h & P r a c t i c e I m p l i c a t i

• n

s

Improve delivery of care models Increase access to care Improve quality of healthcare encounters across multiple sectors of health service provision Inform policy development, particularly related to consent for minors Inform what questions get asked in research about trans people & trans-therapeutics

R e s e a r c h & P r a c t i c e I m p l i c a t i

• n

s

I l l u s t r a t

• r

DEAN WEILER deanweiler3@gmail.com @blinking.fish

R e f e r e n c e s

Bryant, K. (2006). Making gender identity disorder of childhood: Historical lessons for contemporary debates. Sexuality Research & Social Policy, 3(3), 23–39. Castañeda, C. (2015). Developing gender: The medical treatment of transgender young people. Social Science and Medicine, 143, 262–270. https://doi.org/10.1016/j.socscimed.2014.11.031 Gill-Peterson, J. (2018). Histories of the Transgender Child. Minneapolis: University of Minnesota Press. Gridley, S. J., Crouch, J. M., Evans, Y., Eng, W., Antoon, E., Lyapustina, M., … Breland, D. J. (2016). Youth and Caregiver Perspectives on Barriers to Gender-Affirming Health Care for Transgender Youth. Journal of Adolescent Health, 59(3), 254–261. https://doi.org/10.1016/j.jadohealth.2016.03.017 Karkazis, K. (2008). Fixing Sex: Intersex, Medical Authority, and Lived Experience. Durham, NC: Duke University Press. Mak, G. (2012). doubting sex: Inscriptions, bodies, and selves in nineteenth-century hermaphrodite case histories. New York, NY: Manchester University Press. Meadow, T. (2018). Trans Kids: Being Gendered in the Twenty-First Century. University of California Press. Meyerwitz, J. (2002). How Sex Changed: a History of Transsexuality in the United States. Cambridge, Massachusetts: Harvard University Press. Olson-Kennedy, J., Cohen-Kettenis, P . T., Kreukels, B. P . C., Meyer-Bahlburg, H. F . L., Garofalo, R., Meyer, W., & Rosenthal, S.

• M. (2016). Research priorities for gender nonconforming/transgender youth. Current Opinion in Endocrinology & Diabetes

and Obesity, 23(2), 172–179. https://doi.org/10.1097/MED.0000000000000236 Pickles, J. (2019). Including and involving young people (under 18’s) in hate research without the consent of parents. Qualitative Research, 1–17. https://doi.org/10.1177/1468794118816622 Plemons, E. (2017). The Look of A Woman. Duke University Press. Roen, K. (2011). The discursive and clinical production of trans youth: Gender variant youth who seek puberty

• suppression. Psychology and Sexuality, 2(1), 58–68. https://doi.org/10.1080/19419899.2011.536316

Roen, K. (2018). Rethinking queer failure: Trans youth embodiments of distress. Sexualities, 1–17. Sadjadi, S. (2013). The Endocrinologist’s Office - Puberty Suppression: Saving Children from a Natural Disaster? Journal

• f Medical Humanities, (34), 255–260.

Serano, J. (2007). Whipping Girl: A transexual woman on sexism and the scapegoating of femininity. Berkeley, CA: Seal Press. Starks, H., & Trinidad, S. B. (2007). Choose your method: A comparison of phenomenology, discourse analysis, and grounded theory. Qualitative Health Research, 17(10), 1372–1380. https://doi.org/10.1177/1049732307307031 Stryker, S. (2016). (De) Subjugated Knowledges: An Introduction to Transgender Studies. In S. Stryker & S. Whittle (Eds.), The Transgender Studies Reader (pp. 1–17). New York: Routledge. Stryker, S. (2017). Transgender History: The Roots of Today’s Revolution. New York: Seal Press. Travers, A. (2018). The Trans Generation: How Trans Kids (and Their Parents) are Creating a Gender Revolution. New York: New York University Press. Wodak, R., Meyer, M. (2001). Methods of Critical Discourse Analysis. https://doi.org/10.1017/CBO9781107415324.004