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LGBTQ+

A Restorative Justice Approach to Examining Trans-Inclusive Healthcare: An ‘X’ Analysis Study

(PS8-28) A Restorative Justice Approach to Examining Trans-inclusive Healthcare: an ‘X’ Analysis Study

Saturday, November 16, 2024

10:00 AM – 11:00 AM EST

Location: Franklin Hall, Level 4, Marriott Downtown

Author(s)

Shannon L. Exley, M.S.

Graduate Student
Uniformed Services University of the Health Sciences
Washington, District of Columbia, United States

Co-Author(s)

KH

Krista Highland, Ph.D.

Associate Professor
Uniformed Services University
Bethesda, Maryland, United States
AB

Alexis Battista, Ph.D.

Associate Professor of Medicine
Uniformed Services University of the Health Sciences
Bethesda, Maryland, United States
DJ

David Johnson, B.S.

Graduate Student
Texas Tech University
Lubbock, Texas, United States
RK

Raymond B. Kroma, M.S.

Medical Student
Drexel University
Philadelphia, Pennsylvania, United States
John Liedle, B.S.

Medical Student
Uniformed Services University of the Health Sciences
San Diego, California, United States
KA

Keeley S. Adams, B.S.

Medical Student
Uniformed Services University of the Health Sciences
Bethesda, Maryland, United States
Fazlah Rahaman, None

Medical Student
USUHS
Washington, District of Columbia, United States
AT

Ashley M. Tyburski, None

Medical Student
Uniformed Services University of the Health Sciences
Plainfield, Illinois, United States
ET

Ella G. Tiller, B.S.

Medical Student
Uniformed Services University of the Health Sciences
Bethesda, Maryland, United States
ZM

Zachery Malec, M.S.

Student
Uniformed Services University of the Health Sciences
Bethesda, Maryland, United States
Casi Wogenrich, M.S.

Clinical Psychology Student
Uniformed Services University of the Health Sciences
Bethesda, Maryland, United States
SR

Sorana Raiciulescu, M.S.

Statistician
Uniformed Services University of the Health Sciences
Bethesda, Maryland, United States
NS

Natasha Schvey, Ph.D.

Associate Professor
Uniformed Services University of the Health Sciences
Bethesda, Maryland, United States

Abstract Text:

Background: Cisgender-heteronormative systems persist within healthcare, maintaining structural and systemic oppression of trans people. The emphasis on restorative justice in this project focuses on elevating voices and lived experiences of trans folx regarding trans-inclusive healthcare; examining social media is one method for elevating narratives. To date, social media analyses have focused on the healthcare experiences of LGBTQ+ folx broadly but not the experiences of transgender people specifically. The goal of the current project was to elevate the healthcare experiences of trans people using ‘X’ (formerly Twitter). This study aimed to elucidate themes and identify sentiment of posts, determine the geographic distribution of posts, and determine if the sentiment of posts varied by geographic region.

Methods: ‘X’ Application Programming Interface and R were used to identify, extract, and organize posts meeting inclusion criteria. Posts were extracted using healthcare-related search queries and were included in the study if they were authored by U.S.-located trans and gender diverse ‘X’ users and posted within a specified 30-day time period (Nov 1-14 and 27-30, and Dec 1-14, 2023). Posts were mapped by U.S. geographic region, and sentiment analysis was conducted using NVivo. The primary author will elaborate theme summaries and recommendations for healthcare providers based on thematic analysis by a 9-member coding team, with review by trans partners for accuracy and resonance.

Results: Of included posts (N = 300), 60% were posted between Dec 1-14, 2023. Most posts (79%) had one sentiment (e.g., positive or negative), of which the most common sentiment was moderately negative (n = 105). The remaining 21% had mixed sentiment (e.g., positive and negative), of which the most common combination was moderately positive and moderately negative (n = 31). Post sentiment did not vary by region, and negative sentiment was not more frequently observed in posts from regions where more legislation has been introduced or passed restricting access to gender-affirming healthcare.

Discussion: This study identified a sample of narratives from trans ‘X’ users regarding healthcare. Sentiment analysis indicated primarily negative conversations from trans folx regarding their discussion on healthcare-related topics. Thematic coding is expected to identify areas of improvement and recommendations to optimize affirming, responsive, and inclusive healthcare practices, structures, and systems. Findings may inform future research to identify best practices in gender-affirming and inclusive healthcare for trans and gender diverse people.