Publications

Could community health workers take on parts of HIV prevention now handled by clinicians? To find out, researchers interviewed 19 clinicians and 14 community health workers in Ontario in 2020 about shifting HIV and STBBI testing and PrEP services, analysed the transcripts, and checked the findings with a community consultation. Both groups largely agreed that community health workers could deliver rapid HIV testing and that AIDS service organisations would be good places for self-testing kits. Workers were also seen as capable of non-clinical PrEP tasks like pre-counselling and follow-up. The authors recommend training, supervision, and a publicly funded provincial PrEP program.

What should trans health research actually be asking? A group of trans and nonbinary researchers set the agenda themselves, with the first author interviewing every coauthor and circulating drafts until the group reached consensus. They call for long-term research on the risks and benefits of gender-affirming hormones and surgeries, and for a scope well beyond medical transition: routine and general healthcare, life before and without gender affirmation, sexuality, fertility, social determinants, legal gender recognition, and healing within trans communities. Researchers, they argue, must centre trans community expertise, work transparently and accountably. The authors note their group is mostly White and Global North-based.

Trans women living with and affected by HIV want better services, not just more studies. A national research priority setting process gathered semi-structured interviews and focus groups with 76 trans women across five Canadian urban centres, exploring how they navigate health and social service programming where they live. Participants offered practical fixes grounded in lived experience: trans-friendly and trans-specific services, integrated care with help navigating overlapping systems, and comprehensive community-based supports. Many suggested hiring trans women as care coordinators or case managers to build affirming environments. The authors also challenge the framing of trans women as a hard-to-reach population.

Many older gay men keep their sexual identity to themselves at the doctor's office, expecting the stigma they have met before. To understand that pattern, researchers returned to interview data originally gathered from 27 gay men aged 50 and over about their healthcare experiences, conducting a secondary grounded theory analysis focused on how the men constructed their sexual identity. Findings show that varying exposure to intersecting systems of oppression, combined with how the men read different healthcare settings, shaped those constructions. The work supports policies and practices that tackle stigma and discrimination as real barriers to disclosure.

Social work scholarship increasingly recognizes transgender and gender diverse people, but evidence on what equitable practice actually involves remains scarce. This Canadian qualitative study interviewed 20 trans and gender diverse social service users and 10 social workers in the same province, using critical ecosystemic and intersectional lenses alongside constructivist grounded theory. Four components of equitable practice emerged: accounting for social and historical context, practising allyship through humility and reflexivity, challenging cisnormativity both interpersonally and organisationally, and promoting structural measures of trans inclusion. The authors urge scholars, educators, and practitioners to adopt reflexive, relational, organisational, and structural changes supporting equity and justice.