Semin Speech Lang 2023; 44(02): 119-136
DOI: 10.1055/s-0043-1762568
Review Article

Guidance for Research with Trans and Gender-Diverse People

Sterling Quinn
1   Department of Speech Pathology, School of Allied Health, Human Services and Sport, La Trobe University, Bundoora, Victoria, Australia
,
2   Department Speech, Language, and Hearing Sciences, George Washington University, Washington, District of Columbia
› Author Affiliations

Abstract

When engaging in research with marginalized communities, it is important for researchers to reflect on their practice and consider what steps they can take to avoid perpetuating inequality or causing harm. This article provides guidance for researchers working with trans and gender-diverse individuals from the perspective of two speech-language pathologists. Key considerations presented by the authors include the importance of engaging in reflexive research practices—thinking deeply about and acknowledging impacts of one's personal beliefs, values, and practices on one's research—and developing an awareness of factors that contribute to the trans and gender-diverse community's ongoing minority stress. Specific suggestions to redress power imbalance between the researcher and the researched community are provided. Finally, practical methods for implementing the guidance are presented: the community-based participatory research model and an example in speech-language pathology research with trans and gender-diverse individuals.



Publication History

Article published online:
07 March 2023

© 2023. Thieme. All rights reserved.

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  • References

  • ACON. (2019). A language guide: Trans and gender diverse inclusion. https://www.acon.org.au/wp-content/uploads/2019/07/TGD_Language-Guide.pdf
  • Adams, N., Pearce, R., Veale, J., Radix, A., Castro, D., Sarkar, A., & Thom, K. C. (2017). Guidance and ethical considerations for undertaking transgender health research and institutional review boards adjudicating this research. Transgender Health, 2(1), 165–175
  • Adler, R., Sandy, H., & Mordaunt, M. (eds.). (2019). Voice and Communication Therapy for the Transgender/Gender Diverse Client: A Comprehensive Clinical Guide. (3rd ed.). Plural Publishing
  • Azul, D., & Hancock, A. B. (2020). Who or what has the capacity to influence voice production? Development of a transdisciplinary theoretical approach to clinical practice addressing voice and the communication of speaker socio-cultural positioning. International Journal of Speech-Language Pathology, 22(5), 559–570
  • Azul, D., Hancock, A. B., Lundberg, T., Nygren, U., & Dhejne, C. (2022). Supporting well-being in gender-diverse people: a tutorial for implementing conceptual and practical shifts toward culturally responsive, person-centered care in speech-language pathology. American Journal of Speech-Language Pathology, 31(4), 1574–1587
  • Bauer, G., Devor, A., Heinz, M., Marshall, Z., Pullen Sansfaçon, A., & Pyne, J. (2019). CPATH ethical guidelines for research involving transgender people & communities. Canadian Professional Association for Transgender Health. https://cpath.ca/wp-content/uploads/2019/08/CPATH-Ethical-Guidelines-EN.pdf
  • Braun, V., & Clarke, V. (2006). Using thematic analysis in psychology. Qualitative Research in Psychology, 3(2), 77–101
  • Braun, V., & Clarke, V. (2019). Reflecting on reflexive thematic analysis. Qualitative Research in Sport, Exercise and Health, 11(4), 589–597
  • Coleman, E., Radix, A. E., Bouman, W. P., Brown, G. R., de Vries, A. L. C., Deutsch, M. B., Ettner, R., Fraser, L., Goodman, M., Green, J., Hancock, A. B., Johnson, T. W., Karasic, D. H., Knudson, G. A., Leibowitz, S. F., Meyer-Bahlburg, H. F. L., Monstrey, S. J., Motmans, J., Nahata, L., … Arcelus, J. (2022). Standards of care for the health of transgender and gender diverse people, version 8. International Journal of Transgender Health, 23(Suppl 1), S1–S259
  • Cornwall, A., & Jewkes, R. (1995). What is participatory research? Social Science & Medicine, 41(12), 1667–1676
  • Deutsch, M. B., & Buchholz, D. (2015). Electronic health records and transgender patients–practical recommendations for the collection of gender identity data. Journal of General Internal Medicine, 30(6), 843–847
  • Ekman, I., Swedberg, K., Taft, C., Lindseth, A., Norberg, A., Brink, E., Carlsson, J., Dahlin-Ivanoff, S., Johansson, I. L., Kjellgren, K., Lidén, E., Öhlén, J., Olsson, L. E., Rosén, H., Rydmark, M., & Sunnerhagen, K. S. (2011). Person-centered care–ready for prime time. European Journal of Cardiovascular Nursing, 10(4), 248–251
  • Fiani, C. N., & Han, H. J. (2019). Navigating identity: experiences of binary and non-binary transgender and gender non-conforming (TGNC) adults. International Journal of Transgenderism, 20(2-3), 181–194
  • Finlay, L. (2002). Negotiating the swamp: the opportunity and challenge of reflexivity in research practice. Qualitative Research, 2(2), 209–230
  • Galupo, M. P., Cusack, C. E., & Morris, E. R. (2021). “Having a non-normative body for me is about survival”: androgynous body ideal among trans and nonbinary individuals. Body Image, 39(4), 68–76
  • Garrison, S. (2018). On the limits of “trans enough”: authenticating trans identity narratives. Gender & Society, 32(5), 613–637
  • Greenbank, P. (2003). The role of values in educational research: The case for reflexivity. British Educational Research Journal, 29(6), 791-801
  • Hancock, A. B., & Downs, S. C. (2021). Listening to gender-diverse people of color: Barriers to accessing voice and communication care. American Journal of Speech-Language Pathology, 30(5), 2251–2262
  • Hancock, A. B., Downs, S., Yazdani, D., Giegerich, A., Schwandes, K., & Griffiths, S. (2019, September 4–8). Investigating and improving access to voice and communication support for gender-diverse people [Conference presentation]. USPATH Conference 2019, Washington, DC
  • Hancock, A. B., & Siegfriedt, L. L. (2020). Transforming Voice and Communication with Transgender and Gender-Diverse People: An Evidence-Based Process. Plural Publishing
  • Hendricks, M. L., & Testa, R. J. (2012). A conceptual framework for clinical work with transgender and gender nonconforming clients: an adaptation of the minority stress model. Professional Psychology, Research and Practice, 43(5), 460–467
  • Holmes, A. G. D. (2020). Researcher positionality - a consideration of its influence and place in qualitative research - a new researcher guide. Shanlax International Journal of Education, 8(4), 1–10
  • Holt, Y., & Asagbra, E. (2021). Implementing dialogic reading intervention through community-based participatory research: a tutorial. Language, Speech, and Hearing Services in Schools, 52(1), 4–15
  • Hughto, J. M. W., Reisner, S. L., & Pachankis, J. E. (2015). Transgender stigma and health: A critical review of stigma determinants, mechanisms, and interventions. Social Science & Medicine, 147(December), 222–231
  • Jagosh, J., Bush, P. L., Salsberg, J., Macaulay, A. C., Greenhalgh, T., Wong, G., Cargo, M., Green, L. W., Herbert, C. P., & Pluye, P. (2015). A realist evaluation of community-based participatory research: partnership synergy, trust building and related ripple effects. BMC Public Health, 15, Article 725
  • Jootun, D., McGhee, G., & Marland, G. R. (2009). Reflexivity: promoting rigour in qualitative research. Nursing Standard, 23(23), 42–46
  • Koopman, W. J., Watling, C. J., & LaDonna, K. A. (2020). Autoethnography as a strategy for engaging in reflexivity. Global Qualitative Nursing Research, 7(46), Article 2333393620970508
  • Kronk, C. A., Everhart, A. R., Ashley, F., Thompson, H. M., Schall, T. E., Goetz, T. G., Hiatt, L., Derrick, Z., Queen, R., Ram, A., Guthman, E. M., Danforth, O. M., Lett, E., Potter, E., Sun, S. E. D., Marshall, Z., & Karnoski, R. (2022). Transgender data collection in the electronic health record: current concepts and issues. Journal of the American Medical Informatics Association, 29(2), 271–284
  • Leung, L. (2015). Validity, reliability, and generalizability in qualitative research. Journal of Family Medicine and Primary Care, 4(3), 324–327
  • Levesque, J.-F., Harris, M. F., & Russell, G. (2013). Patient-centred access to health care: conceptualising access at the interface of health systems and populations. International Journal for Equity in Health, 12(18), Article 18
  • Linander, I., Alm, E., Goicolea, I., & Harryson, L. (2019). “It was like I had to fit into a category”: care-seekers' experiences of gender regulation in the Swedish trans-specific healthcare. Health, 23(1), 21–38
  • Matsuno, E., & Budge, S. L. (2017). Non-binary/genderqueer identities: a critical review of the literature. Current Sexual Health Reports, 9(3), 116–120
  • Maxwell, J. A., & Mittapalli, K. (2010). Realism as a stance for mixed methods research. In: A. Tashakkori & C. Teddlie (eds.), SAGE Handbook of Mixed Methods in Social and Behavioural Research (pp. 145–168). SAGE Publications
  • Meyer, I. H. (2003). Prejudice, social stress, and mental health in lesbian, gay, and bisexual populations: conceptual issues and research evidence. Psychological Bulletin, 129(5), 674–697
  • Mills, M., Stoneham, G., Barker, M. J., Retief, C., & van Horn, E. (2020). Voice and Communication Therapy with Trans and Non-Binary People: Sharing the Clinical Space. Jessica Kingsley Publishers
  • Muhammad, M., Wallerstein, N., Sussman, A. L., Avila, M., Belone, L., & Duran, B. (2015). Reflections on researcher identity and power: the impact of positionality on community based participatory research (CBPR) processes and outcomes. Critical Sociology, 41(7-8), 1045–1063
  • Nordmarken, S. (2014). Microaggressions. Transgender Studies Quarterly, 1(1–2), 129–134
  • Olmos-Vega, F. M., Stalmeijer, R. E., Varpio, L., & Kahlke, R. (2022). A practical guide to reflexivity in qualitative research: AMEE Guide No. 149. Medical Teacher. Advance online publication. Article 10.1080/0142159X.2022.2057287
  • Quinn, S., Oates, J., & Dacakis, G. (2021). The experiences of trans and gender diverse clients in an intensive voice training program: A mixed-methodological study. Journal of Voice. Advance online publication. Article 10.1016/j.jvoice.2020.12.033
  • Reisner, S. L., Poteat, T., Keatley, J., Cabral, M., Mothopeng, T., Dunham, E., Holland, C. E., Max, R., & Baral, S. D. (2016). Global health burden and needs of transgender populations: a review. Lancet, 388(10042), 412–436
  • Roberts, S. O., Bareket-Shavit, C., Dollins, F. A., Goldie, P. D., & Mortenson, E. (2020). Racial inequality in psychological research: trends of the past and recommendations for the future. Perspectives on Psychological Science, 15(6), 1295–1309
  • Safer, J. D., Coleman, E., Feldman, J., Garofalo, R., Hembree, W., Radix, A., & Sevelius, J. (2016). Barriers to healthcare for transgender individuals. Current Opinion in Endocrinology, Diabetes and Obesity, 23(2), 168–171
  • Sikes, P. (2004). Methodology, procedures and ethical concerns. In C. Opie (Ed.), Doing Educational Research: A Guide to First-Time Researchers (pp. 15–33). Sage Publications
  • Subramani, S. (2019). Practising reflexivity: Ethics, methology and theory construction. Methodologica Innovations, 12(2). Article 10.1177/2059799119863276
  • Sultana, F. (2007). Reflexivity, positionality and participatory ethics: negotiating fieldwork dilemmas in international research. ACME: An International E-Journal for Critical Geographies, 6(3), 374–385
  • Tebbe, E. A., & Budge, S. L. (2016). Research with trans communities: applying a process-oriented approach to methodological considerations and research recommendations. The Counseling Psychologist, 44(7), 996–1024
  • Testa, R. J., Habarth, J., Peta, J., Balsam, K., & Bockting, W. (2015). Development of the gender minority stress and resilience measure. Psychology of Sexual Orientation and Gender Diversity, 2(1), 65–77
  • Valentine, S. E., & Shipherd, J. C. (2018). A systematic review of social stress and mental health among transgender and gender non-conforming people in the United States. Clinical Psychology Review, 66(March), 24–38
  • Vincent, B. (2018a). Introducing trans terminology. In: Transgender Health: A Practitioner's Guide to Binary and Non-Binary Trans Patient Care (pp. 17–38). Jessica Kingsley Publishers
  • Vincent B. (2018b). Studying trans: recommendations for ethical recruitment and collaboration with transgender participants in academic research. Psychology and Sexuality, 9(2), 102–116
  • Vincent, B. (2019). Breaking down barriers and binaries in trans healthcare: the validation of non-binary people. International Journal of Transgenderism, 20(2-3), 132–137
  • Walsh, R. (2003). The methods of reflexivity. The Humanistic Psychologist, 31(4), 51–66
  • Ward, M., Schulz, A. J., Israel, B. A., Rice, K., Martenies, S. E., & Markarian, E. (2018). A conceptual framework for evaluating health equity promotion within community-based participatory research partnerships. Evaluation and program planning, 70(October), 25–34
  • Witteman, H. O., Chipenda Dansokho, S., Colquhoun, H., Fagerlin, A., Giguere, A. M. C., Glouberman, S., Haslett, L., Hoffman, A., Ivers, N. M., Légaré, F., Légaré, J., Levin, C. A., Lopez, K., Montori, V. M., Renaud, J. S., Sparling, K., Stacey, D., & Volk, R. J. (2018). Twelve lessons learned for effective research partnerships between patients, caregivers, clinicians, academic researchers, and other stakeholders. Journal of General Internal Medicine, 33(4), 558–562
  • Zeeman, L., Sherriff, N., Browne, K., McGlynn, N., Mirandola, M., Gios, L., Davis, R., Sanchez-Lambert, J., Aujean, S., Pinto, N., Farinella, F., Donisi, V., Niedźwiedzka-Stadnik, M., Rosińska, M., Pierson, A., Amaddeo, F., Taibjee, R., Toskin, I., Jonas, K., … De Sutter, P., & the Health4LGBTI Network. (2019). A review of lesbian, gay, bisexual, trans and intersex (LGBTI) health and healthcare inequalities. European Journal of Public Health, 29(5), 974–980