Health Care Experiences of Trans Students Attending Historically Black Colleges

Background and purpose: Trans people of color experience health inequities related to their multiple marginalized identities. While historically Black colleges and universities (HBCUs) provide supportive learning environments for Black students, it is unclear if these protections extend to LGBTQ+ students. As trans youth experience barriers to accessing healthcare, university health centers (UHCs) are positioned to support and protect trans students. UHCs may provide trans students critical opportunities to receive gender-affirming or transition-related healthcare. There is currently little research addressing trans students of color, particularly around issues of health. This study addresses the research question: What is the lived experience of trans HBCU students with accessing and utilizing on-campus physical and mental health services? Methods: Descriptive phenomenology was used to assess the experiences of trans HBCU students with on-campus health services. A convenience sample was recruited via social media, e-mail to LGBTQ+ organizations and allies, and word of mouth. In-depth interviews were conducted with 15 Black trans undergraduate students at 9 HBCUs across North Carolina. One-on-one interviews were conducted via Zoom, with recordings transcribed verbatim. NVivo aided data analysis. Findings: Participants shared detailed information about their campus climates and experiences with physical and mental health care professionals. Findings included detailed information about racial discrimination and misgendering, as well as thoughts about being out on campus and university policies. Participants also identified facilitators and barriers to accessing and utilizing campus health care services. In examining concerns across their experiences, common thoughts regarding discrimination, respect, trust, (in)visibility, and care concordance came through as important aspects of trans HBCU students' experiences. Conclusions and implications: After initial analysis, Intersectional Research for Trans Health Justice was used to identify structures of domination, systems of inequality, and socio-structural processes contributing to health inequities and risk and protective factors for the participants and inform recommendations for policy and practice. Cultural humility training of UHC staff and the development and enforcement of nondiscrimination policies and gender-affirming practices across campus (including within UHCs) will benefit all students and improve retention of LGBTQ+ students. Future research regarding health care, trans students, and the broader LGBTQ+ community within HBCUs is needed. [The dissertation citations contained here are published with the permission of ProQuest LLC. Further reproduction is prohibited without permission. Copies of dissertations may be obtained by Telephone (800) 1-800-521-0600. Web page: http://www.proquest.com/en-US/products/dissertations/individuals.shtml.]