Virginia Transgender Health Initiative Study (THIS), 2005-2006

The Virginia Transgender Health Initiative Study (THIS) was a multi-phase, multi-year project to improve the health of transgender Virginians. THIS included a quantitative survey, conducted from September 2005 to July 2006 with 387 respondents and a final analysis sample of 350, including 229 MTFs (male-to-females) and 121 FTMs (female-to-males). Participants were drawn from 60 of the 136 cities and counties in Virginia. The conceptual model that guided the study posits that transgenderism and its associated social stigma are root causes of poor health status, producing societal factors such as the prioritization of access to transgender-related medical services by transgender people, health care provider ignorance of transgender health, discrimination, and low self-esteem. These societal factors produce mediating factors such as provider hostility/insensitivity, lack of health insurance, insurance failure to cover transgender care, poverty, sex work, substance abuse, and gender identity validation through sex. The final products of these mediators are direct risk factors including self-medication with transgender hormones, injection silicone use, unprotected sex, and injection drug use. The survey measured demographics, access to regular medical services, access to transgender care services, employment discrimination, housing discrimination, sexual and physical violence, social support and self-esteem, suicidal ideation and attempts, substance abuse and tobacco use, HIV knowledge and perception of risk, HIV risk behaviors, HIV testing and status, and access to HIV/AIDS prevention and treatment services. Demographic variables include sex, gender, sexual orientation, race/ethnicity, age, language, education, birthplace, residency status, income, and occupation.