"We Already Knew What Time It Was:" HIV, COVID19, and Black Transgender Women in the South.

Black transgender women in the Southeast are at the center of the modern-day HIV crisis in the U.S. This focus group study was aimed at understanding the impacts of the COVID-19 pandemic on the health and well-being of Black transgender women in the U.S. Southeast who are affected by HIV. From April-June 2022, we completed seven focus group interviews with 56 participants. Themes identified across the focus groups show: 1) the challenges that pre-dated COVID-19; 2) the challenges of managing COVID-19 risk; 3) negative consequences for mental health, physical health, and overall well-being; 4) negative trends in coping with pandemic stress; 5) the importance of self-care and social support for managing pandemic stress; and 6) the need for more community-based resources. Findings demonstrate that understanding these social determinants of health is vital to developing support resources in this ongoing health crisis and crises yet to come.

Common barriers to healthcare for transgender people in the U.S. Southeast.

Background: Transgender and non-binary people are more likely to face barriers to healthcare than their cisgender counterparts. The majority of work in this area centers on the experiences of transgender people in northern cities and urban enclaves, yet over 500,000 transgender people live in the U.S. Southeast. Aims: The purpose of this study is to explore barriers to healthcare among transgender people in the U.S. Southeast. Methods: The research team conducted four 120-minute focus groups (eligibility criteria: 18 years or older, self-identify as transgender, live in the U.S. Southeast). Participants completed a demographic questionnaire prior to the start of the focus group. Each focus group explored access to and experiences of receiving basic healthcare as a transgender person in the U.S. Southeast. Established qualitative methods were used to conduct the focus groups and data analysis. Results: Participants (n = 48) ranged in age from 19 to 65, with the majority identifying as trans women (43.8%) and non-binary (33.3%). The sample was racially diverse: White (50%), Black (37.5%), and Latinx or Multiracial (12.5%). Multiple barriers to care were identified: (1) fear and mistrust of providers; (2) inconsistency in access to healthcare; (3) disrespect from providers; and, (4) mistreatment due to intersecting experiences of gender, race, class, and location. Discussion: Transgender Southerners face barriers to care at the structural, cultural, and interpersonal levels. The study results have implications for researchers, as well as providers, practices, and health care systems throughout the region.