Exploring Barriers and Facilitators in Achieving a Positive Sexual Health among Trans-Femme Young Adults: Community-Based Participatory Research Project
Bibliographic record
Abstract
Transgender people face unique multiple levels of barriers and challenges regarding sexual health and wellbeing. While there has been a significant number of studies exploring sexual health among the 2SLGBTQ+ population, there is a paucity of research that uses a participatory approach targeted towards the trans-femme community. Moreover, young adults' perspectives on sexual health are rarely explored. Guided by a community-based participatory research approach and arts-based techniques, I explored the views of the trans-femme young adults, the perceived facilitators and barriers of positive sexual health and wellbeing and made possible recommendations for the improvements in sexual health. Situated within a transformative paradigm, I worked with trans-femme young adults and peer advisory in Edmonton, Alberta, to explore the sexual health-related concerns and needs. Using a photovoice inquiry to guide the data generation strategies, I conducted four small group conversations with eight co-researchers and dialogue with practitioners and service providers. I continued young adults' engagement for data analysis and knowledge translation work. Due to the Covid-19 pandemic and social distancing in place, all the meetings were conducted online using Zoom video communication software. Through this research, we identified inter-related barriers around different system levels: the individual experience, experiences with the healthcare system, experiences relating to the non-healthcare sector, and experiences within the society in general. Facilitators included opportunities to navigate and embrace identities, reclaiming femininity, navigating and experiencing sexual pleasure, euphoria from access to hormone replacement therapy, and having pride in trans identity. Barriers included financial limitations, health conditions, challenges accessing competent trans-friendly health service providers, inadequate resources on trans sexual health, perceived and increased reliance of health service providers on trans people, prejudice-motivated refusal of health care, lack of proper and accurate media representation, heteronormativity, cisnormativity, gender stereotyping, transmisogyny and accessing safe space. Results of this study provide an understanding of the experiences and concerns around sexual of trans-femme young adults. The participatory data analysis conducted in this research is very unique and powerful on its own. Using various arts-based ways and artistic expressions to gather data and share our findings allows trans-femme co-researchers to communicate directly with the community and the targeted audience. Disseminating the findings via virtual exhibition and webpage in the form of arts, such as participatory films, digital stories, and postcards, helped to incorporate the lived experiences of the young adults and connect with the target audience, generate suggestions for policymakers and advocate for their sexual health needs. This research also contributed to empowering trans-femme young adults by engaging them in the overall research process and decision-making.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.021 | 0.012 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.010 | 0.004 |
| Scholarly communication | 0.003 | 0.002 |
| Open science | 0.002 | 0.006 |
| Research integrity | 0.002 | 0.003 |
| Insufficient payload (model declined to judge) | 0.004 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".