Transgender Youth Focus Group Guide

Form Approved

OMB No: 0920-0840

Exp. Date: 01/31/2019

Transgender Youth Focus Group Guide

Public reporting burden of this collection of information is estimated to average 3 hours per response, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. An agency may not conduct or sponsor, and a person is not required to respond to a collection of information unless it displays a currently valid OMB control number. Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden to CDC/ATSDR Reports Clearance Officer; 1600 Clifton Road NE, MS D-74, Atlanta, Georgia 30333; Attn: OMB-PRA (0920-0840)

Note: All participants will complete a short close-ended background survey and assent/consent form prior to beginning the focus group.

On-line note: Participants will have the opportunity to respond to questions twice per day over three days.

Introduction

Thank you for agreeing to talk to me about the Prevention Strategies Youth Focus Group Project, sponsored by the Centers for Disease Control and Prevention (CDC). [TODAY/OVER THE NEXT 3 DAYS], we will talk about relationships, gender, sexuality, and health. Who are we? A group of transgender youth, and me, the facilitator.

As the facilitator, my job is to:

• Explain what we are doing

• Set up some ground rules

• Start discussions/ask questions

• Make sure that everyone has a chance to answer

• Keep us moving along so that we can talk about a number of important issues

The reason that we are doing this project is because we want to make sure that all youth have access to information, support, and resources that help them to feel good about themselves and to take care of their health.

We invited you to be in our discussion group because we want to understand what it is like for younger transgender people to:

• find boyfriends and/or girlfriends

• make decisions about sex

• communicate with parents/guardians, doctors/nurses, and teachers about gender, sexuality, and health

Here are some things to keep in mind:

• We can have some things in common and also have different ideas, opinions, and experiences. Some people have had sex already, some have not. Some people like girls and guys, some like guys only. Some people are able to live as the gender they feel, while others cannot. Let’s respect our differences. And, let’s try to understand where someone is coming from and why.

• In a discussion group like ours, there are no wrong answers. So, let’s respect each other’s reality and opinions. Let’s try to hear and understand where someone is coming from. That might mean asking someone to explain about a comment they have made. For instance, “That’s interesting, can you say more about that? I’m not following, can you explain?”

• If at any time you would like to talk with the moderator privately, you can use the chat function.

Any questions? Comments?

OK, let’s get started.

ESTABLISHING RAPPORT

1. Tell us about one superpower that you have.

2. Tell us about one superpower that you would LIKE to have and why.

SET 1. FORMING RELATIONSHIPS & SEX I.

FORMING RELATIONSHIPS

1. Tell us about a guy you think is really cute, maybe he is someone you are attracted to and want to get to know. (Use his first name or initials only.) How did you meet? How would you let him know that you are interested?

2. 2. Is the guy you think is cute transgender or cisgender? What does the term cisgender mean?

3. Who do you talk to about your crushes on guys? What do you talk about? What comes up during these conversations? Does being transgender come up? If so, how?

4. Who can you ask for advice about dating guys?

6. Who can you talk to about your crushes on girls? How about dating girls?

7. If you are attracted to girls, are the girls you are attracted to transgender, cisgender, or both?

8. Does the relationship advice that you get support your gender identity (meaning, support you as a transgender youth and respect your gender identity)?

NOTE: BREAK OUT INTO SEXUALLY ACTIVE/INACTIVE GROUPS

SEX I.

1. Who do you talk about sex with? What do you talk about?

2. When you use the word sex, what do you mean? What is sex? What counts as sex?

SET 2. SEX II.

1. OK, let’s talk about parents/guardians.

• If your parent/guardian had a conversation about sex with you, what did they say? What was helpful about it? What could have been better?

• Imagine an ideal conversation about sex between a parent/guardian and a transgender youth. What would the parent/guardian say?

• Has your parent/guardian had a conversation like this with you? If no, would you like them to?

2. Now, let’s think about schools.

• What, if anything, have you learned about sex at school? What was helpful about it? What could have been better?

• Imagine that you have been given the opportunity to develop a sex ed class for high school students. What information should be covered? Who should teach it? How?

SET 3. SEX III.

1. Let’s talk about health providers, doctors and nurses.

• Tell us about a time that the health care you got supported your gender identity. (By supported, I mean made you feel comfortable and cared for by someone knowledgeable about transgender health.)

• Tell us about a time that the health care you got did not support your gender identity.

• Tell us about a time you had a conversation about sex with your doctor/nurse. What do you talk about? What was helpful about it? What could have been better?

• Now, imagine an ideal conversation about sex between a doctor or nurse and a transgender youth your age . What should the doctor or nurse say or do?

2. Sometimes we learn about sex from people and places other than parents/guardians, at school, or from doctors/nurses. These other sources include: on-line, TV/movies, porn, friends, sexual partners, and church.

• Have you learned about sex from any of these sources? If so, which were helpful? Why? What did you like about them? What could have been better?

3. As a transgender youth, is there anything about sex that you would like to know? What is it? How would you like to get that information? Who would you like to get that information from?

4. (SEXUALLY INACTIVE ONLY). One final question before we wrap up this topic. People have and don’t have sex for a number of reasons. What are the main reasons you have not had sex?

SET 4. HIV PREVENTION I.

There are some things that people can do to reduce their risk of getting or passing on HIV. We want to know what you think about these suggestions. We are interested in your opinions.

1. Experts recommend not having vaginal (sometimes called frontal sex) or anal sex, but finding other ways to be intimate like oral sex or hand to genital contact.

• What do you think about not having vaginal (sometimes called frontal sex) or anal sex, but finding other ways to be intimate like oral sex or hand to genital contact?

• How realistic is this for transgender youth your age to find other ways to be intimate?

• Now, we are going to ask a couple of questions about sex with cisgender guys and transgender women, because the risk of passing on HIV during sex is higher.

  • How realistic is it NOT to have vaginal or anal sex with cisgender guys?

  • How realistic is it NOT to have vaginal or anal sex with transgender women?

• What would make it hard to do this?

• What would make it easier to do this?

2. Experts recommend using condoms and lube every time for vaginal/frontal and anal sex (whether you are giving or receiving anal sex).

• What do you think about using condoms and lube every time for vaginal/frontal and anal sex?

• How realistic is this for transgender youth your age to use condoms and lube every time for anal sex (whether you are giving or receiving anal sex)?

  • How realistic is it USE CONDOMS AND LUBE EVERY TIME for ANAL SEX with cisgender guys?

• How realistic is it USE CONDOMS AND LUBE EVERY TIME for ANAL SEX with transgender women? What would make it hard to do this?

• What would make it easier to do this?

3. Does being transgender affect your ability to ask for what you want from a sexual partner? How and why?

4. Experts recommend taking a medication called PrEP. Taking a PrEP pill every day can keep a person from getting HIV if they are exposed to it. [PrEP stands for pre-exposure prophylaxis which means taking HIV medication to prevent getting HIV before you are exposed to it.]

5. What do you think about this recommendation?

• How realistic is it to get PrEP from a doctor and take it every day?

• What would make it hard to do this?

• What would make it easier to do this?

• As a transgender person, do you have any other concerns about PrEP?

SET 5. HIV PREVENTION II.

1. Experts recommend getting tested for HIV and then, if you have HIV, taking HIV medications every day. This is a way to help reduce your risk of passing on HIV if you have it.

2. What do you think about getting tested for HIV?

• How realistic is it to get tested for HIV?

• What would make it hard to do this?

• What would make it easier to do this?

3. How realistic is it to take medication every day if you have HIV?

• What would make it hard to do this?

• What would make it easier to do this?

4. Experts also recommend getting tested for sexually transmitted infections such as syphilis, gonorrhea and chlamydia and taking medication for a few days to clear them up. This is a way to help reduce your risk of getting and passing on HIV.

5. What do you think about this recommendation?

• How realistic is it to get tested for sexually transmitted infections and to take medication if you have one?

• What would make it hard to do this?

• What would make it easier to do this?

SET 6. IDENTITY AND SUPPORT

1. What words do you use to describe your gender identity?

3. What words do you use to describe your sexuality? Why?

4. Where do you get support for being transgender? What is most helpful? What support would you like?

5. What support do you get related to your sexuality? What is most helpful? What support would you like?

6. What support do you get related to your race-ethnicity? What is most helpful? What support would you like?

Anything else that you would like to say related to getting support for all parts of who you are?

Wrap-up

We’ve reached the end of my questions.

1. Is there anything else that you would like to add?

2. How was this focus group experience for you?

3. If anyone is feeling sad or stressed or upset in any way, please let me know so that our team can check in with you. Also everyone should know the Trevor Project because it is an important resource for any LGBT youth who is feeling like hurting him or herself. The telephone number is (866) 488-7386.

Thank you so much for your thoughts and ideas! What you’ve shared will help us develop resourced for young people. Our goal is for all youth to have access to information, support, and resources that enable them to feel good about themselves, including feeling good about their gender and sexuality, and to take care of their health.

Do you have any questions?

Here are some resources that you might consider accessing if you have remaining questions or concerns related to what we talked about today. We will be sending your gift certificates shortly.

THANK YOU!