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

dc.contributor.authorVan Gerwen, Olivia T.
dc.contributor.authorSherman, Z. Alex
dc.contributor.authorKay, Emma Sophia
dc.contributor.authorWall, Jay
dc.contributor.authorLewis, Joy
dc.contributor.authorEastlund, Isaac
dc.contributor.authorGraves, Keonte J.
dc.contributor.authorRichter, Saralyn
dc.contributor.authorPontius, Angela
dc.contributor.authorAaron, Kristal J.
dc.contributor.authorSiwakoti, Krishmita
dc.contributor.authorRogers, Ben
dc.contributor.authorToh, Evelyn
dc.contributor.authorElnaggar, Jacob H.
dc.contributor.authorTaylor, Christopher M.
dc.contributor.authorVan Wagoner, Nicholas J.
dc.contributor.authorMuzny, Christina A.
dc.contributor.departmentMicrobiology and Immunology, School of Medicine
dc.date.accessioned2024-10-15T13:18:10Z
dc.date.available2024-10-15T13:18:10Z
dc.date.issued2024-08-12
dc.description.abstractBackground: 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. Methods: 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. Results: 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. Conclusion: 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.
dc.eprint.versionFinal published version
dc.identifier.citationVan Gerwen OT, Sherman ZA, Kay ES, et al. Recruiting transgender men in the Southeastern United States for genital microbiome research: Lessons learned. PLoS One. 2024;19(8):e0308603. Published 2024 Aug 12. doi:10.1371/journal.pone.0308603
dc.identifier.urihttps://hdl.handle.net/1805/43971
dc.language.isoen_US
dc.publisherPublic Library of Science
dc.relation.isversionof10.1371/journal.pone.0308603
dc.relation.journalPLoS One
dc.rightsAttribution 4.0 Internationalen
dc.rights.urihttps://creativecommons.org/licenses/by/4.0
dc.sourcePMC
dc.subjectMicrobiota
dc.subjectPatient selection
dc.subjectTestosterone
dc.subjectTransgender persons
dc.subjectBacterial vaginosis
dc.titleRecruiting transgender men in the Southeastern United States for genital microbiome research: Lessons learned
dc.typeArticle
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