Trans* in the Big Sky | A PhotoVoice Project
AN ASSESSMENT OF THE HEALTH NEEDS OF THE TRANSGENDER COMMUNITY IN MONTANA
A Statewide Collaborative Project:
Gender Expansion Project
Community Health Program, Health & Human Performance - University of Montana
Montana Department of Public Health & Human Services – HIV/STD/HCV Section
Trans* and gender diverse populations are a significantly oppressed minority. With no legal protections at a state or federal level, discrimination is often all too real for most individuals outside of the cisgender binaries. Frequently, trans* individuals are denied equal access to healthcare and may also lack culturally competent healthcare. This is especially true in rural environments. In fact, living in a rural environment affects many aspects of quality of life for transgender people.
Unfortunately, rural states like Montana have very little information about their trans* and gender diverse communities. For this reason, with support from the Montana Department of Public Health and Human Services, researchers in the Community Health program at the University of Montana partnered with the director of the Gender Expansion Project in early 2013 to develop a comprehensive needs assessment.
The overall goal of the assessment was to give voice to individuals in the trans* community and ultimately provide an accurate portrayal of the lives of trans* and gender diverse Montanans. A second goal was to begin the process of gathering accurate data related to current HIV and STD transmission risk factors.
Our hope is that information from this project will be disseminated widely and that it will serve as a vehicle for creating a greater awareness and understanding of the challenges facing the trans* community. Furthermore, the Montana Department of Public Health and Human services and other health care organizations will use this information to develop HIV prevention interventions that are tailored to meet the needs of the trans* population.
(*The term Trans*, as used in this context is meant to be radically inclusive. It can be used to describe various communities and individuals with nonconforming gender identities and/or expressions.)
The findings presented here represent the results of the first phase of a research study using interviews and Photovoice methodologies to explore the contextual factors that influence transgender individuals’ quality of life and risk of HIV infection. The second phase of the study includes widespread distribution of a comprehensive questionnaire that is linked to this website.
The transgender needs assessment team consists of two principle investigators from the Community Health program at the University of Montana, as well as the director of the Gender Expansion Project; a rural Northwest Regional based non-profit organization dedicated to gender equality.
Key Informant Participants: Seven individuals who are viewed as leaders in the trans* community were interviewed for this study. They represented five different counties in Montana, and ranged in age from mid-20s to over 50 years. The interviews ranged in duration from forty minutes to one hour. Six were conducted face-to-face, while one was completed via Skype. All of the interviews were conducted by one of the co-investigators.
Photovoice Participants: Nine individuals who identified as trans* or gender diverse participated in the Photovoice phase of the study. All participants attended one of several orientation sessions during which the Photovoice methodology was explained and questions were answered. Approximately two weeks after the orientation, individual interviews were scheduled for participants to share their photographs and descriptions of their photos. Some individuals chose to share one photograph while others chose to share five. Interviews lasted from 15 minutes to one hour, and participants ranged in age from 19 to 36 years. Six interviews were conducted in person, and three were conducted via phone as the images were viewed on the computer.
Analysis of key informant and Photovoice interview data revealed two overarching themes and ten sub-themes related to the needs of the trans* community in Montana. The overarching themes were gender binarism and minority stress. Sub-themes were organized into ten categories: 1) sense of self, 2) age of transition, 3) the importance of love, 4) the availability of support, 5) passing as your identified gender, 6) ignorance surrounding gender variance, 7) normalization in society, 8) access to gender inclusive health care, 9) legal issues affecting transition, and 10) life in Montana.
The attached report provides a complete description of the study methods and of the resulting overarching themes and sub-themes.