Trans Wellness/Trans Brilliance is the culmination of a body of work from 2015 when we first investigated coping skills and community resilience in the cross-sectional survey Finding Our Strength (2016). Influenced by the minority stress theory, Finding Our Strength explored the anticipation of discrimination of transgender and gender diverse adults, such as felt stigma and heightened vigilance. We explored these experiences across healthcare, academic, work, and home settings. We also examined coping responses and community strengths.

Driven by our belief in applied research, i.e., translating findings into tangible benefits for our community, Finding Our Strength influenced a range of provider/ally trainings, peer support services, and continued research.

We were unsatisfied with merely learning about community coping. We wanted to affect even greater change by building a program that would bring members of the trans/gender diverse community together, to learn, explore, practice, and discuss different behavioral health strategies to improve emotional wellness and thriving. We sought to ensure the accessibility of such a program so that members across the state of Michigan may participate in and benefit from the program.

With support from researchers at the University of Michigan School of Social Work, we led the design, development, implementation, and evaluation of a community-based wellness program, Trans Wellness/Trans Brilliance, piloted in the spring of 2023. Learn more about the program and its development below.

As a community-led and informed multi-study initiative, we sought to develop an eight-week wellness program for transgender and gender diverse Michiganders that was virtually available and peer-led. The program aimed to support participants in honing skills for well-being, emotional wellness, resilience, and thriving while increasing connections with the community. 

Objectives for Participants:

• Offer a safe space to process and build skills in a group setting (co-learning) 
• Teach participants how to recognize and respond to their feelings
• Provide participants with the skills to deepen their practice of mindfulness, body awareness, embodiment, and presence
• Unpack gender norms and reclaim our unique experiences as transgender, nonbinary, gender non-conforming (gender diverse) people, celebrating gender, identity, and expression
• Promote skills that are transferrable to different aspects of their lives, such as interpersonal relationships, dating, a sense of self-confidence, and self-concept
• Improve mental health, wellness, and resilience
• Increase self-efficacy and self-compassion
• Improve stress tolerance and bodily awareness
• Decrease feelings of isolation and foster community connections 

Objectives for Peer Support Specialists: 

• Develop peer facilitation skills within the trans/gender diverse community 
• Increase empowerment 
• Obtain feedback on the pilot from adjunct provider vantage points  

Trans Wellness/Trans Brilliance was the first program of its kind in the state of Michigan. It underscores community ingenuity in devising solutions to the challenges we face. As calls have been made for research to extend beyond merely documenting health disparities and, instead, implementing psychosocial interventions which affect positive change (Mustanski & Macapagal, 2023), Trans Wellness/Trans Brilliance heeds this call.

Trans Wellness/Trans Brilliance solves for an array of needs:

• Understanding that the mental health challenges stem from the stigmatization of trans/gender diverse individuals, Trans Wellness/Trans Brilliance was developed to build skills and counter these experiences, fostering resilience.
• Further, trans/gender diverse individuals may delay seeking care, for reasons of affordability, lacking insurance coverage, not believing care would be effective, not expecting providers to understand TGD needs, the lack of affirming and available providers, or not trusting mental health providers(^21).
• Researchers call to gaps in adapting interventions (e.g., mindfulness-based) to be culturally responsive to the trans/gender diverse population (^22). As a comnunity-led and -developed program, it is built around the needs and experiences of members of the trans/gender diverse community. 

Review of the Literature

We began by conducting a literature review of virtual, peer- and group-based interventions to improve mental health measures. Our literature review identified duration, format, and other potential characteristics to consider while developing TWTB intervention.

Study 1: Qualitative Interviews with Community Stakeholders to Develop the Intervention

We consulted with five trans/gender diverse individuals who also provide support to members of our trans/gender diverse community. Given the dual role of support provider and peer, we felt this was an important perspective. Recruitment took place through partner networks, listservs, and reaching out to LGBTQ community centers. We gained insights from a mental health clinician, a leader of support/youth programs, community organizers, a grassroots wellness worker (informal), and a workshop facilitator for creative, emotional processing, and gender exploration. Through our semi-structured discussions, we examined community strengths, weaknesses, existing programs, gaps in existing support services, proposed objectives for such a wellness program, target skills to improve emotional wellness and resilience, and recommendations for program content, exercises, and resources to provide participants. We also assessed the key characteristics of peer support specialists for eventual recruitment purposes. All interviews were conducted over Zoom (BAM, SKK), between 60 and 90 minutes long, and took place during 2020 and 2021. Interviews were transcribed and analyzed independently for key themes before meeting to build consensus and agreement.

Program Development

We collated these findings into program objectives and an eight-week curriculum. We organized topics into a narrative arc. We incorporated resources and exercises recommended in the community consultants’ interviews. We researched additional exercises to produce a complete program that encompassed personal values, mindfulness, emotion/sensations, coping ahead, navigating interpersonal relationships, navigating the world around us, distress tolerance skills, and topics exploring gender identity and expression. We consulted with our advisory team, which consists of a trans/gender diverse peer counselor and accessibility advisor, as well as a licensed clinical social worker with extensive experience providing trauma-informed care to trans/gender diverse clients.

Study 2: Qualitative Focus Group Session to Assess and Validate the Proposed Intervention

We recruited six trans/gender diverse Michiganders from across the state, spanning various age groups, genders, expressions, races/ethnicities, socioeconomic and disability statuses. The virtual focus group was held on Zoom, 90 minutes long, and incorporated features such as polling, directed and voluntary chat responses, and open discussion to increase avenues for fuller participation. Participants were guided through discussions that examined the TWTB program objectives, individual session format, weekly topics, and sample exercises. Participants provided feedback that validated the desirability of such a program and provided recommendations on recruitment strategies. We obtained beneficial feedback, which we incorporated into further refinement of TWTB.

Study 3: The Uncontrolled Pre- and Post-test Intervention

In preparation for the pilot, we recruited over 170+ applicants across Michigan via email listservs, social media posts, and social media advertisements. We invited 32 individuals to join four cohorts of eight participants each. All participants received informed consent by email, which included program limitations (i.e., not clinical care or therapy; not a substitute for clinical care or therapy), followed up by a phone screen with a member of the research team (CM, BAM) to confirm participant eligibility, review informed consent together, identify availability, and assess their ability to join the video call in a private location. Participants completed a baseline measure before the program and a post-test survey upon completion of the pilot. Weekly debrief surveys were provided to participants to measure skill exposure and obtain timely feedback on exercises and activities. Sessions were 90 to 120 minutes long, held weekly for eight weeks over Zoom, and led by two facilitators, a Peer Support Specialist, and a mental health clinician for backup support.

“Community-engaged research” is a broadly used phrase and takes many forms. However, the researchers seldom define it in sufficient detail. In the case of Trans Wellness/Trans Brilliance, our initiative exceeded mere community engagement and was community-led. 

Brayden Misiolek and Cecil McGhee presented the preliminary findings of Trans Wellness/Trans Brilliance via a webinar.

Several manuscripts are in development. 

Check back for updates or email brayden@transcendthebinary.org.