#TranscendentHealth - Adapting an LGB+ Inclusive Teen Pregnancy Prevention Program for Transgender Boys
Center for Innovative Public Health Research
Summary
Transgender and gender-diverse young people who were assigned female at birth (AFAB), including transgender boys, nonbinary youth, and others, face real sexual health disparities. Existing pregnancy and HIV prevention programs are designed for cisgender girls and do not meet the needs of AFAB trans youth, leaving this group without programs that speak to their lives. #TranscendentHealth is a text messaging sexual health program developed specifically for AFAB transgender and gender-diverse youth ages 14 to 18. It builds on Girl2Girl, a program shown to improve sexual health behaviors in LGB+ cisgender girls, and updates the content to reflect the identities, relationships, and health needs of AFAB trans youth. The study has two parts. In the first part, AFAB trans youth help shape the program through focus groups, Content Advisory Teams (youth review panels that give feedback on program messages), and a small pilot test. In the second part, a national randomized controlled trial enrolls 467 AFAB transgender youth ages 14 to 18 across the United States. Participants are randomly assigned to receive either #TranscendentHealth or a general sexual health text messaging program. Both programs are delivered entirely by text message over 5 months, with no in-person visits required. Youth complete short online surveys at the start of the program, at program end (5 months), and at 3 and 6 months after the program ends. The study's main goals are to determine whether #TranscendentHealth improves rates of condom-protected sex, use of other birth control methods (such as the pill, shot, or IUD), and HIV/STI testing. Secondary goals include reducing unintended pregnancy, increasing PrEP uptake among eligible participants, and improving intentions to use sexual health services.
Description
Background AFAB transgender and gender-diverse youth experience substantial sexual health disparities yet are largely absent from evidence-based prevention programs. Pilot data from an earlier cohort recruited by Dr. Ybarra show that, compared with cisgender girls, AFAB trans youth are less likely to use barrier protection at last sex (p \< 0.5) and at least as likely to experience adolescent pregnancy. Programs designed for cisgender girls do not address the social stressors these youth face (including discrimination, gender dysphoria, and rejection) and do not affirm their gender identities…