The Trans Accountability Project: Community Engagement to Address Structural Marginalization and Health Inequities

Abstract:Background: Black and Latina Transgender women face systemic marginalization and harm, increasing vulnerability to social stress and poor health outcomes. These communities have limited access to resources to mobilize and create paths toward health equity.Objectives: In this paper we report on the results of a community partnership to engage Black and Latina transgender communities on the South and West Sides of Chicago and establish service priorities for collective empowerment.Methods: The Trans Accountability Project (TAP), a steering committee of racially diverse transgender and nonbinary representatives from four partner organizations, was established and led the design, recruitment, implementation, and analysis of a community needs assessment. World café and human-centered design methods, guided two community conversations/listening sessions around four activities: the perfect provider, my dream job, safety planning, and a stake-holder reflection.Results: Sixty-three participants completed three activities and envisioned innovations for 1) accessible and holistic gender-affirming health care, 2) autonomous, flexible, and community-focused jobs in the arts, nonprofit/business, and care professions, and 3) safer social interactions and spaces. Ten stakeholders attended to listen and inform their organizational and clinical practices to empower Black and Latina transgender women.Conclusions: TAP prioritized accountability, connectedness, and centering the voices of Black and Latina transgender women as a starting point to intervene upon structural marginalization. Five insights emerged and have directed TAP’s focus toward employment and collective care. Although further structural change remains a priority, TAP represents a mechanism for sharing power, improving communication and collaboration, and increasing transparency across relevant Chicago community-based organizations.