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Researchers and practitioners have recently called for greater involvement of school health professionals (SHPs; e.g., school psychologists, nurses, guidance counselors) in interventions to identify and address bullying of lesbian, gay, bisexual, transgender, and queer/questioning (LGBTQ) students. To inform future interventions, this study explored the perspectives of LGBTQ students and SHPs on LGBTQ bullying and SHPs' responses to LGBTQ bullying. Five online, asynchronous focus groups were held in 2018 with 28 LGBTQ students and 19 SHPs recruited from Massachusetts, US. Methods were guided by Rapid Qualitative Inquiry. Results revealed a disconnect in perceptions of LGBTQ bullying among LGBTQ students versus SHPs, with LGBTQ students reporting a range of often significant verbal, social, and physical bullying CONTACT Valerie A. Earnshaw,

In the United States, sexually transmitted infections (STIs) confer significant morbidity in adolescents and young adults. STIs are not well characterized in transgender and other gender minority youth (TGMY) who have a gender identity that differs from the sex assigned to them at birth. This study sought to fill this gap. In 2015-2016, the Adolescent Medicine Trials Network for HIV/AIDS Interventions conducted Protocol 130, Affirming Voices for Action, enrolling a diverse sample of TGMY 16-24 years of age from 14 US geographic locations. Multivariable analyses regressed lifetime STI diagnosis on ''situated vulnerabilities'' (demographics, social/economic issues, mental/behavioral health conditions, and health care experience). Approximately onethird were living with HIV infection (31%); 33% had a history of one or more STIs, excluding HIV. The most frequently diagnosed STIs were 55% chlamydia, 48% syphilis, and 47% gonorrhea. The odds of STI was 4.06 times higher for trans feminine youth assigned a male sex at birth compared to trans masculine youth assigned a female sex at birth (p = 0.03). Additional risk factors for lifetime STI were as follows: nonbinary gender identity (p = 0.004), medical gender affirmation (p = 0.03), and transactional sex (p = 0.01). Nearly one-third (31%) reported condomless vaginal and/or anal sex in the last 6 months, suggesting a need for ongoing STI prevention, screening, diagnosis, and treatment. TGMY are a vulnerable group to STIs in need of public health attention. Clinical care for STIs will benefit from considering risk factors facing youth in general (e.g., sex work), alongside those vulnerabilities unique to TGMY (e.g., medical gender affirmation).

Background The purpose of this formative study was to assess barriers and facilitators to participation of transgender and gender diverse (TGD) patients in clinical research to solicit specific feedback on perceived acceptability and feasibility of research methods to inform creation of a multisite longitudinal cohort of primary care patients engaged in care at two community health centers. Method Between September–November 2018, four focus groups (FGs) were convened at two community health centers in Boston, MA and New York, NY (N = 28 participants across all 4 groups; 11 in Boston and 17 in New York). FG guides asked about patient outreach, acceptability of study methods and measures, and ideas for study retention. FGs were facilitated by TGD study staff, lasted approximately 90 min in duration, were audio recorded, and then transcribed verbatim by a professional transcription service. Thematic analyses were conducted by two independent analysts applying a constant comparison method. Consistency and consensus were achieved across code creation and application aided by Dedoose software. Results Participants were a mean age of 33.9 years (SD 12.3; Range 18–66). Participants varied in gender identity with 4 (14.3%) men, 3 (10.7%) women, 8 (28.6%) transgender men, 10 (35.7%) transgender women, and 3 (10.7%) nonbinary. Eight (26.6%) were Latinx, 5 (17.9%) Black, 3 (10.7%) Asian, 3 (10.7%) another race, and 5 (17.9%) multiracial. Motivators and facilitators to participation were: research creating community, research led by TGD staff, compensation, research integrated into healthcare, research applicable to TGD and non-TGD people, and research helping TGD communities. Barriers were: being research/healthcare averse, not identifying as TGD, overlooking questioning individuals, research coming from a ‘cisgender lens”, distrust of how the research will be used, research not being accessible to TGD people, and research being exploitative. Conclusion Though similarities emerged between the perspectives of TGD people and research citing perspectives of other underserved populations, there are barriers and facilitators to research which are unique to TGD populations. It is important for TGD people to be involved as collaborators in all aspects of research that concerns them.

Background: The purpose of this formative study was to assess barriers and facilitators to participation of transgender and gender diverse (TGD) patients in clinical research to solicit specific feedback on perceived acceptability and feasibility of research methods to inform creation of a multisite longitudinal cohort of primary care patients engaged in care at two community health centers.Method: Between September-November 2018, four focus groups (FGs) were convened at two community health centers in Boston, MA and New York, NY (N=28 participants across all 4 groups; 11 in Boston and 17 in New York). FG guides asked about patient outreach, acceptability of study methods and measures, and ideas for study retention. FGs were facilitated by TGD study staff, lasted approximately 90 min in duration, were audio recorded, and then transcribed verbatim by a professional transcription service. Thematic analyses were conducted by two independent analysts applying a constant comparison method. Consistency and consensus were achieved across code creation and application aided by Dedoose software.Results: Participants were a mean age of 33.9 years (SD 12.3; Range 18-66). Participants varied in gender identity with 4 (14.3%) being male, 3 (10.7%) female, 8 (28.6%) transgender male, 10 (35.7%) transgender female, and 3 (10.7%) nonbinary. Eight (26.6%) were Latinx, 5 (17.9%) Black, 3 (10.7%) Asian, 3 (10.7%) another race, and 5 (17.9%) multiracial. Motivators and facilitators to participation were: research creating community, research led by TGD staff, compensation, research integrated into healthcare, research applicable to TGD and non-TGD people, and research helping TGD communities. Barriers were: being research/healthcare averse, not identifying as TGD, overlooking questioning individuals, research coming from a ‘cisgender lens”, distrust of how the research will be used, research not being accessible to TGD people, and research being exploitative.Conclusion: Though similarities emerged between the perspectives of TGD people and research citing perspectives of other underserved populations, there are barriers and facilitators to research which are unique to TGD populations. It is important for TGD people to be involved as collaborators in all aspects of research that concerns them.