European Society of Medicine, General Assembly 2022

August 4th to August 6th in Madrid, Spain


Transgender adults’ worry about discrimination in healthcare:

Community-Driven Research

Community-driven research methodology.

Our community led the development of this research, from survey construction, recruitment, data analysis and interpretation, to dissemination. We facilitated focus group testing with peers of various backgrounds and intersectional experiences. Our efforts were supported by volunteer statisticians, public health professionals, and researchers from the University of Michigan to ensure data integrity in both design, and analysis.

Community-driven is community empowerment.


A trans-led community care organization, with support from researchers at the University of Michigan, piloted a U.S.-based survey, Finding Our Strength. The mixed-methods survey explores the burden of minority stress upon transgender/gender diverse (T/GD) adults, measuring self-reported worry about discrimination in various settings (including healthcare) and coping behaviors. Key themes include recognizing the significance of stress within the T/GD population across multiple realms in daily life and the important role healthcare plays in supporting wellness outcomes. Better understanding the community’s anticipatory worries and coping responses equip practitioners to deliver culturally responsive care. This oral presentation leverages programmatic insights of a trans-led community care organization along with research themes calling for engagement with T/GD populations to improve gender-affirming care. As community-based participatory research is quickly growing in recognition in the U.S., this survey piloted a distinct methodology in which every stage of the research process was led by the community, employing a range of qualitative interviews, peer-review sessions, and focus group testing. The T/GD community defined survey objectives, designed the questionnaire, facilitated feedback and review sessions, implemented the survey, analyzed data, determined key themes, and disseminated findings through multiple avenues. A traveling, interactive, art-meets-exhibit was produced from the dataset. Results were used to create continuous education for healthcare professionals and ally training for significant others and loved ones. Findings were used to enhance services and programs for the T/GD population. 

Learners can expect to:
● Better understand trans/gender diverse patient worries and coping responses within healthcare settings.
● Recognize the unique position pharmacists/clinicians have within T/GDhealthcare and the importance of culturally responsive care.
● Understand the benefits of community-driven and community-participatory research.

Meet your presentor

Brayden A. Misiolek
he/him or they/them

Graduate of James Madison College at Michigan State University
B.A., Political Theory & Constitutional Law
Minor, Philosophy & Law
Cognate, Linguistics

Mx. Misiolek has over 7 years of experience envisioning and building community care programs and services for the trans/gender diverse community. As a founding partner, established Transcend the Binary along with the late Darnell Jones, RPh. Has led the development of community-driven research, as well as engaged in community participatory research to generate awareness about the needs, gaps, and experiences of the community, in efforts to solve barriers to wellness. An aspiring scientist-clinician, Mx. Misiolek, is currently preparing to launch a pilot intervention, measuring the efficacy and effectiveness of an 8-week, peer-led, virtual wellness program (self-report pretest/posttest) while preparing for (hopeful) admittance into a doctorate of clinical psychology program for fall 2023.


Co-collaborators of this work (and co-authors) include:

Nancy JW Lewis, PharmD, MPH
University of Michigan, Adjunct Professors
Transcend the Binary, Program & Resresearch Design

Peter Batra
formerly Institute of Social Research, University of Michigan
currently RTI Institute

Caleb N. Cogswell, PharmD
Transcend the Binary, Provider Education Development

Caitlin A. Tupper, LCSW
CAT Counseling, Founder
formerly Anti-Violence Director, Center on Halsted (largest LGBTQ center in the Midwest, USA)
Transcend the Binary, Mental Health Consultant



  1. Agency for Healthcare Research and Quality. (2009). AHRQ Activities Using Community-Based Participatory Research to Address Health Care Disparities.
  2. Misiolek, BA., Kattari, SK. (2020). Trans Health Research: Research Priorities, Best Practices, Dissemination Guidelines created by the Michigan Trans Health Research Advisory Board of 2018-2019. Transcend the Binary and the University of Michigan.
  3. Lewis, N. JW, Batra, P., Misiolek, B.A., Rockafellow, S., Tupper, CA. (2019). Transgender/gender nonconforming adults’ worries and coping actions related to discrimination: Relevance to pharmacist care. American Journal of Health-System Pharmacy, 76(8), 512-520.
  4. Lewis, N. JW, Batra, P., Rockafellow, S., Misiolek, B.A., Tupper, CA. (2017). Finding Our Strength Survey: Actions taken to cope with discrimination by the transgender/gender-nonconforming community. Transcend the Binary.



European Society of Medicine
2022 General Assembly

Aug. 4th to August 6th, 2022

Madrid, Spain

We sought to get to the heart of our day-to-day experience. 

Check out our report. 

Coping with Discrimination: Actions Taken by the Trans/Gender Non-conforming Community
This survey report is intended to create awareness about trans lives, generate new perspectives that can translate into greater individual and community resiliency, and stimulate public conversations that foster an environment that is affirming of the trans community. Download the full report, below. 

We’re spreading our knowledge to better our community.  

Our goal is to spread awareness on what hurts the community, and what helps. Intentional discussions with medical care providers, allies and workplaces about creating affirming environments for our community will greatly help both individuals and our community as a whole. Check out where our research has been presented.