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Transform Health Arkansas Partnership– Engaging Transgender/Non-Binary Arkansans in Defining and Addressing Health Research Priorities

Transgender/non-binary (trans/NB) individuals face major healthcare challenges. HIV infection and attempted suicide rates in the transgender community are among the highest known. Discrimination in healthcare settings and provider lack of knowledge create unsafe environments, poor quality of care, underutilization of essential services, and limited access to treatment for gender dysphoria. Trans/NB youth often experience bullying and homelessness and trans/NB people of color are at greatest risk of discrimination, harassment, and violence.

Transform Health Arkansas was initiated by the Arkansas Transgender Equality Coalition (ArTEC) in partnership with faculty at the Fay W. Boozman College of Public Health, University of Arkansas for Medical Sciences in 2015 to engage trans/NB Arkansans in addressing their most pressing health issues. PCORI Tier I and II Pipeline to Proposal awards have supported our work thus far. Together, in Tier I, we built an active partnership, the Transform Health Arkansas Partnership (THAP), comprising trans/NB community members, investigators, providers, and others. The THAP meets monthly to guide our work including work in Tier I to engage trans/NB individuals through an interactive, trans/NB-led process in nine summits across the state and collection of surveys on their research interests. Summits were attended by 54 trans/NB and 29 cisgender individuals. The top five priorities identified by our 140 survey respondents included: 1) transition-related insurance coverage, 2) access to transition care, 3) education of healthcare providers, 4) public education, and 5) supportive healthcare systems. Transform Health Arkansas has also supported trans/NB individuals in educating a range of audiences about transgender issues.

In Tier II, we deepened our engagement with trans/NB Arkansans around the issues they prioritized in Tier I, built capacity and understanding through education, formed new partnerships locally and nationally, assessed existing evidence related to our priority topics, and developed comparative effectiveness research (CER) questions addressing trans/NB priorities.

In Tier III, which began on August 1, 2017, we will submit a letter of intent to PCORI and prepare a CER proposal focused on increasing availability of trans-competent care. Our trans/academic team will co-lead our partnership as we develop our LOI; synthesize and vet existing educational resources about transgender health to use in training; examine options and feasibility of implementation; develop our study design and metrics for assessing outcomes; deepen external stakeholder engagement; communicate our progress to the trans/NB community; and seek additional funding opportunities addressing our priorities.