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AbstractThe aim of this article is to provide a theoretical application of transformative learning theory and politicized collective identity framework to examine the process cisgender parents and caregivers of transgender and gender diverse (TGD) children undergo to become advocates for TGD justice. With an intensifying anti‐TGD political climate and anti‐TGD rhetoric, this novel approach to understanding identity development through the lens of these two theories provides a timely and relevant framework for future research to explore motivators for participation in civic engagement for TGD justice among parents and caregivers.

Cover -- Endorsements -- Half Title -- Title Page -- Copyright Page -- Dedication -- Table of Contents -- List of tables -- List of contributors -- Acknowledgements -- Glossary -- Introduction Part 1: Introduction to social work and health care with transgender and nonbinary individuals and communities -- Introduction Part 2: Place, joy, and self in trans and nonbinary justice -- PART 1: Health -- 1. Transgender and nonbinary youth and access to medical care -- 2. Transgender and nonbinary adults and access to medical care -- 3. Best practices in sexual and reproductive health care for transgender and nonbinary people -- 4. Affirming and inclusive mental health care for transgender and nonbinary young people -- 5. Culturally responsive mental health care for transgender and nonbinary individuals -- PART 2: Areas of practice -- 6. Substance use and transgender nonbinary populations: Towards inclusive prevention and service provision -- 7. Understanding and working with transgender/nonbinary older adults -- 8. Trans/nonbinary individuals and homelessness -- 9. Working with transgender and nonbinary youth in the child welfare system -- PART 3: Coming out and family -- 10. Supporting transgender and nonbinary youth in their coming out process -- 11. Supporting trans and nonbinary adults in their coming out processes -- 12. Supporting caregivers and families of transgender and nonbinary youth -- 13. Trans and nonbinary parenting -- PART 4: Relationships and sexuality -- 14. Sex and relationship therapy with trans and nonbinary individuals -- 15. Trans/nonbinary sexualities and prioritizing pleasure -- 16. Exploring trans/nonbinary intimate partner violence: What to know to create inclusive spaces and services -- PART 5: Communities -- 17. Transgender and nonbinary youth empowerment.

Forced sex and dating violence are too common among young people and rates are higher for young transgender and gender diverse (TGD) individuals. However, the TGD youth population has differential experiences across gender, race, age, sexual orientation, and other identity factors. This study, using data from the 2015 Healthy Kids Colorado Survey, explores these differential within-group experiences of forced sex and dating violence. Findings indicate that sexual minorities who are also TGD are 2.45–3.73 times more likely to experience forced sex and physical dating violence than their TGD heterosexual peers. Individuals who are transfeminine (4.49 times), transmasculine (2.52 times), and nonbinary (3.86 times) are more likely to experience forced sex, as well as physical dating violence (transfeminine (4.01 times), transmasculine (2.91 times), and nonbinary (4.77 times)), as compared to those individuals questioning their gender. Black individuals (3.93 times) and Multiracial individuals (2.39 times) are more likely to experience dating violence than their White counterparts. Age was related to increased experience of forced sex, with individuals being 1.34 times more likely to have experienced this per year increase of age. These findings indicate the need for more trans-inclusive youth programing around sexual violence and dating violence, as well as taking a more intersectional and personalized approach to prevention work.

Transgender and gender diverse individuals face a variety of barriers when attempting to access healthcare, from discrimination to lack of access to lack of knowledgeable providers. Using data from the 2015 United States Trans Survey (N = 27,715), this study looks at the differences within the TGD population regarding having seen a doctor in the past year, having a primary care provider, and having a primary care provider who is knowledgeable about trans health. Logistic regressions indicate that even within an all transgender and gender diverse sample, a variety of identities and experiences are related to increased or decreased likelihood of each of these outcomes, with significant differences across gender, race/ethnicity, age, sexual orientation, disability status, educational attainment, annual income, disability status, religiosity, military status, overall health, housing status, and insurance coverage. Not only should there be an effort to support transgender and gender diverse individuals in accessing care, but there is a clearly indicated need for additional education for healthcare providers, especially those doing primary care, on how to offer knowledgeable, affirming, and intersectional care to their patients.

Transgender and gender diverse individuals face a variety of barriers when attempting to access healthcare, from discrimination to lack of access to lack of knowledgeable providers. Using data from the 2015 United States Trans Survey (N = 27,715), this study looks at the differences within the TGD population regarding having seen a doctor in the past year, having a primary care provider, and having a primary care provider who is knowledgeable about trans health. Logistic regressions indicate that even within an all transgender and gender diverse sample, a variety of identities and experiences are related to increased or decreased likelihood of each of these outcomes, with significant differences across gender, race/ethnicity, age, sexual orientation, disability status, educational attainment, annual income, disability status, religiosity, military status, overall health, housing status, and insurance coverage. Not only should there be an effort to support transgender and gender diverse individuals in accessing care, but there is a clearly indicated need for additional education for healthcare providers, especially those doing primary care, on how to offer knowledgeable, affirming, and intersectional care to their patients.

Lesbian, gay, bisexual, transgender, queer and questioning (LGBTQ) youth experience numerous disparities, including but not limited to access to health care, HIV risk, safety in school, educational opportunities, and family support. Historically, research on this community lumped together LGBQ experiences with experiences of transgender and nonbinary (trans/NB) individuals, despite sexual orientation and gender identity being unique identities. Using representative statewide data from the 2015 Healthy Kids Colorado Survey (HKCS) ( N = 15,970), this study examines sexual behaviors through a more nuanced and intersectional lens. We find that young LGBQ and trans/NB people in Colorado have differential experiences of sexual behavior compared with their heterosexual and cisgender counterparts. Being LGBQ and especially being trans/NB, having current depression, suicidal ideation, and experiencing electronic bullying are all associated with an increase in the likelihood of ever having sex and total number of partners, and lower age of sexual debut. These findings and their implications highlight the importance of inclusive sexuality education and culturally responsive services for all young people.

AbstractIntroductionTransgender (trans) and nonbinary people (TNB) are disproportionately impacted by HIV. HIV testing is critical to engage TNB people in HIV prevention and care. Yet, scant literature has examined social and structural factors associated with HIV testing among TNB people of diverse genders and in geographies with potentially lower trans acceptance. We: (1) characterized the prevalence of never having been tested for HIV; and (2) identified associated factors, among TNB people in Michigan, United States.MethodsData were from a community‐based participatory cross‐sectional survey (n = 539 sexually experienced TNB people). The prevalence of never having had an HIV test was reported overall and compared across socio‐demographic, clinical, social and structural factors using bivariable and multivariable logistic regression analyses.Results and discussionApproximately one‐quarter (26.2%) of participants had never had an HIV test (20.8% transfeminine; 30.0% transmasculine; 17.8% nonbinary assigned male at‐birth; and 32.0% nonbinary assigned female at‐birth). In a multivariable socio‐demographic model, older age (adjusted odds ratio [aOR] for 1‐year increase: 0.93, 95% CI: 0.90, 0.96, p<0.001) and Black/African American race (vs. White) (aOR: 0.28, 95% CI: 0.09, 0.86, p<0.05) were associated with increased odds of HIV testing (aORs for never testing). In separate multivariable models controlling for socio‐demographics, ever experiencing sexual violence (aOR: 0.38, 95% CI: 0.21, 0.67, p<0.001), not accessed sexual/reproductive healthcare in the past 12 months (aOR: 4.46, 95% CI: 2.68, 7.43, p<0.001) and reporting a very/somewhat inclusive primary care provider (PCP) (aOR: 0.29, 95% CI: 0.17, 0.49, p<0.001) were associated with HIV testing (aORs for never testing).ConclusionsFindings contribute to scant literature about gender‐based differences in HIV testing inclusive of transmasculine and nonbinary people. Lack of statistically significant gender differences suggests that broad TNB interventions may be warranted. These could include training healthcare providers in trans‐inclusive practices with sexual violence survivors and PCPs in trans‐inclusive HIV prevention and care. Findings showing Black participants were less likely to have never had an HIV test suggest the promise of culturally tailored services, though further investigation is needed. Findings identify social and structural factors associated with HIV testing and can inform multi‐level interventions to increase TNB person's HIV testing.