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“Nowhere else to be found”: Drawing on peer support experiences among transgender and gender-diverse people to substantiate community-driven gender-affirming care

Author

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  • Kia, Hannah
  • Kenney, K.A.
  • Abramovich, Alex
  • Ferlatte, Olivier
  • MacKinnon, Kinnon Ross
  • Knight, Rod

Abstract

Increasingly, applied social scientists and clinicians recognize the value of engaging transgender and gender-diverse (TGD) people, particularly TGD individuals with lived experience as care recipients (peers), to inform the provision of gender-affirming care. Despite this trend, few researchers have systematically examined how this group can contribute to and enhance the development and delivery of interventions intended to affirm gender diversity. In this article, we address limitations in the literature by drawing on a secondary analysis of qualitative data – originally collected to examine the peer support experiences of TGD individuals – to explore the potential that TGD peers hold for elevating gender-affirming care. The study was informed methodologically by an abductive approach to grounded theory, and conceptually by critical resilience and intersectional scholarship. Data collection involved virtual, semi-structured interviews with 35 TGD individuals in two Canadian cities who indicated having experiences of seeking, receiving, and/or providing peer support. Data analysis comprised an iterative, abductive process of cross-referencing participant accounts with relevant scholarship to arrive at an account of how TGD peers may contribute to the growth of gender-affirming care. Our findings suggest, broadly, that TGD peers may enhance gender-affirming care by: (1) validating a growing diversity of embodiments and experiences in healthcare decision-making, (2) nurturing and diversifying relevant networks of safety, community support, and advocacy outside formal systems of care, and (3) strengthening possibilities for resisting and transforming existing healthcare systems. After outlining these findings, we briefly consider the implications of our analysis and leverage our inferences to substantiate the notion of community-driven gender-affirming care, meaning care that is intentional in its incorporation of relevant community stakeholders to shape governance and service provision. We conclude with reflections on the promise of community-driven care at a time of heightened volatility across systems serving TGD populations.

Suggested Citation

  • Kia, Hannah & Kenney, K.A. & Abramovich, Alex & Ferlatte, Olivier & MacKinnon, Kinnon Ross & Knight, Rod, 2023. "“Nowhere else to be found”: Drawing on peer support experiences among transgender and gender-diverse people to substantiate community-driven gender-affirming care," Social Science & Medicine, Elsevier, vol. 339(C).
  • Handle: RePEc:eee:socmed:v:339:y:2023:i:c:s0277953623007633
    DOI: 10.1016/j.socscimed.2023.116406
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    References listed on IDEAS

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    1. M. Killian Kinney & Darren Cosgrove, 2022. "“Truly Listen to Us”: Recommendations for Health Professionals to Bolster Wellbeing of Nonbinary Individuals," IJERPH, MDPI, vol. 19(15), pages 1-22, July.
    2. Geoff DeVerteuil & Oleg Golubchikov, 2016. "Can resilience be redeemed?," City, Taylor & Francis Journals, vol. 20(1), pages 143-151, February.
    3. Kia, Hannah & MacKinnon, Kinnon Ross & Abramovich, Alex & Bonato, Sarah, 2021. "Peer support as a protective factor against suicide in trans populations: A scoping review," Social Science & Medicine, Elsevier, vol. 279(C).
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    1. Smith-Johnson, Madeline & Alexander, Katherine, 2025. "Gender affirming medical care access: The role of healthcare stereotype threat and social support in a national probability sample of transgender adults," Social Science & Medicine, Elsevier, vol. 373(C).
    2. D'Angelo, Alexa B. & Dearolf, Michelle & Restar, Arjee & Tsui, Emma K. & Zewde, Naomi & Grov, Christian, 2025. "Navigating payment and policy barriers to gender-affirming care for transmasculine individuals: A qualitative study and policy assessment," Social Science & Medicine, Elsevier, vol. 366(C).
    3. Shuster, Stef M. & Pfeffer, Carla A. & Kirkland, Anna, 2024. "Introduction to: Unequal care: Trans medicine and health in dangerous times," Social Science & Medicine, Elsevier, vol. 359(C).

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