Recruiting transgender men in the Southeastern United States for genital microbiome research: Lessons learned.

<h4>Background</h4>Transgender men (TGM) are underrepresented in genital microbiome research. Our prospective study in Birmingham, AL investigated genital microbiota changes over time in TGM initiating testosterone, including the development of incident bacterial vaginosis (iBV). Here, w...

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Main Authors: Olivia T Van Gerwen, Z Alex Sherman, Emma Sophia Kay, Jay Wall, Joy Lewis, Isaac Eastlund, Keonte J Graves, Saralyn Richter, Angela Pontius, Kristal J Aaron, Krishmita Siwakoti, Ben Rogers, Evelyn Toh, Jacob H Elnaggar, Christopher M Taylor, Nicholas J Van Wagoner, Christina A Muzny
Format: Article
Language:English
Published: Public Library of Science (PLoS) 2024-01-01
Series:PLoS ONE
Online Access:https://doi.org/10.1371/journal.pone.0308603
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author Olivia T Van Gerwen
Z Alex Sherman
Emma Sophia Kay
Jay Wall
Joy Lewis
Isaac Eastlund
Keonte J Graves
Saralyn Richter
Angela Pontius
Kristal J Aaron
Krishmita Siwakoti
Ben Rogers
Evelyn Toh
Jacob H Elnaggar
Christopher M Taylor
Nicholas J Van Wagoner
Christina A Muzny
author_facet Olivia T Van Gerwen
Z Alex Sherman
Emma Sophia Kay
Jay Wall
Joy Lewis
Isaac Eastlund
Keonte J Graves
Saralyn Richter
Angela Pontius
Kristal J Aaron
Krishmita Siwakoti
Ben Rogers
Evelyn Toh
Jacob H Elnaggar
Christopher M Taylor
Nicholas J Van Wagoner
Christina A Muzny
author_sort Olivia T Van Gerwen
collection DOAJ
description <h4>Background</h4>Transgender men (TGM) are underrepresented in genital microbiome research. Our prospective study in Birmingham, AL investigated genital microbiota changes over time in TGM initiating testosterone, including the development of incident bacterial vaginosis (iBV). Here, we present lessons learned from recruitment challenges encountered during the conduct of this study.<h4>Methods</h4>Inclusion criteria were assigned female sex at birth, TGM or non-binary identity, age ≥18 years, interested in injectable testosterone but willing to wait 7 days after enrollment before starting, and engaged with a testosterone-prescribing provider. Exclusion criteria were recent antibiotic use, HIV/STI infection, current vaginal infection, pregnancy, or past 6 months testosterone use. Recruitment initiatives included community advertisements via flyers, social media posts, and referrals from local gender health clinics.<h4>Results</h4>Between February 2022 and October 2023, 61 individuals contacted the study, 17 (27.9%) completed an in-person screening visit, and 10 (58.8%) of those screened were enrolled. The primary reasons for individuals failing study screening were having limited access to testosterone-prescribing providers, already being on testosterone, being unwilling to wait 7 days to initiate testosterone therapy, or desiring the use of topical testosterone. Engagement of non-White TGM was also minimal.<h4>Conclusion</h4>Despite robust study inquiry by TGM, screening and enrollment challenges were faced including engagement by TGM not yet in care and specific study eligibility criteria. Excitement among TGM for research representation should be leveraged in future work by engaging transgender community stakeholders at the inception of study development, particularly regarding feasibility of study inclusion and exclusion criteria, as well as recruitment of TGM of color. These results also highlight the need for more clinical resources for prescribing gender-affirming hormone therapy, especially in the Southeastern US.
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spelling doaj-art-4d2c2eec5f7c4619b8a5806066fb26962024-11-17T05:31:18ZengPublic Library of Science (PLoS)PLoS ONE1932-62032024-01-01198e030860310.1371/journal.pone.0308603Recruiting transgender men in the Southeastern United States for genital microbiome research: Lessons learned.Olivia T Van GerwenZ Alex ShermanEmma Sophia KayJay WallJoy LewisIsaac EastlundKeonte J GravesSaralyn RichterAngela PontiusKristal J AaronKrishmita SiwakotiBen RogersEvelyn TohJacob H ElnaggarChristopher M TaylorNicholas J Van WagonerChristina A Muzny<h4>Background</h4>Transgender men (TGM) are underrepresented in genital microbiome research. Our prospective study in Birmingham, AL investigated genital microbiota changes over time in TGM initiating testosterone, including the development of incident bacterial vaginosis (iBV). Here, we present lessons learned from recruitment challenges encountered during the conduct of this study.<h4>Methods</h4>Inclusion criteria were assigned female sex at birth, TGM or non-binary identity, age ≥18 years, interested in injectable testosterone but willing to wait 7 days after enrollment before starting, and engaged with a testosterone-prescribing provider. Exclusion criteria were recent antibiotic use, HIV/STI infection, current vaginal infection, pregnancy, or past 6 months testosterone use. Recruitment initiatives included community advertisements via flyers, social media posts, and referrals from local gender health clinics.<h4>Results</h4>Between February 2022 and October 2023, 61 individuals contacted the study, 17 (27.9%) completed an in-person screening visit, and 10 (58.8%) of those screened were enrolled. The primary reasons for individuals failing study screening were having limited access to testosterone-prescribing providers, already being on testosterone, being unwilling to wait 7 days to initiate testosterone therapy, or desiring the use of topical testosterone. Engagement of non-White TGM was also minimal.<h4>Conclusion</h4>Despite robust study inquiry by TGM, screening and enrollment challenges were faced including engagement by TGM not yet in care and specific study eligibility criteria. Excitement among TGM for research representation should be leveraged in future work by engaging transgender community stakeholders at the inception of study development, particularly regarding feasibility of study inclusion and exclusion criteria, as well as recruitment of TGM of color. These results also highlight the need for more clinical resources for prescribing gender-affirming hormone therapy, especially in the Southeastern US.https://doi.org/10.1371/journal.pone.0308603
spellingShingle Olivia T Van Gerwen
Z Alex Sherman
Emma Sophia Kay
Jay Wall
Joy Lewis
Isaac Eastlund
Keonte J Graves
Saralyn Richter
Angela Pontius
Kristal J Aaron
Krishmita Siwakoti
Ben Rogers
Evelyn Toh
Jacob H Elnaggar
Christopher M Taylor
Nicholas J Van Wagoner
Christina A Muzny
Recruiting transgender men in the Southeastern United States for genital microbiome research: Lessons learned.
PLoS ONE
title Recruiting transgender men in the Southeastern United States for genital microbiome research: Lessons learned.
title_full Recruiting transgender men in the Southeastern United States for genital microbiome research: Lessons learned.
title_fullStr Recruiting transgender men in the Southeastern United States for genital microbiome research: Lessons learned.
title_full_unstemmed Recruiting transgender men in the Southeastern United States for genital microbiome research: Lessons learned.
title_short Recruiting transgender men in the Southeastern United States for genital microbiome research: Lessons learned.
title_sort recruiting transgender men in the southeastern united states for genital microbiome research lessons learned
url https://doi.org/10.1371/journal.pone.0308603
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