Survey Evaluation of the Role of Social Media and Social Support for Transgender, Nonbinary, and Intersex People: Observational Study
Background: Transgender and gender diverse (TGD) people experience a higher number of health disparities compared to cisgender counterparts. Social determinants of health are linked to these health disparities in minority communities, including in the TGD community. Lack of social support contributes significantly to these disparities for the TGD community. Objective: The aim of this study was to evaluate the role of social media and social support groups among TGD patients who attend a transgender clinic. Methods: A questionnaire was developed through an iterative process and emailed to TGD people attending a tertiary care TGD clinic. The survey assessed social media usage (platforms, duration, and adverse effects), social support groups (past participation and interest in current participation), and demographic characteristics (age, gender, race/ethnicity, education, religious affiliation, income). Results: Our survey garnered 48 responses. Of these, 50% identified as transfeminine/transgender woman, 29% identified as transmasculine/trans man, 8% identified as non-binary, 2% as genderfluid, and 10% as another identity. Our respondents’ average age was 35 (standard deviation 15.6). Nearly 70% reported monthly transphobia and 35% reported weekly transphobia. Primary social support was reported as coming from an in-person significant other or friend 49% of the time, and 13% of the time from social media or online friend. Social media was used for the primary purpose of interacting with queer or TGD people by 65% of respondents and the most common sites used were Discord, Reddit and Instagram. Among respondents who either were attending or had attended a gender identity-focused support group, greater than 60% reported them being beneficial. More than half had never attended a support group related to their gender identity; 60% were open to attending a group. Conclusions: This study found that social media is already being used by TGD people for the purpose of interacting with other queer and trans people, but also that there are risks associated with its use. For example, TGD people commonly reported exposure to transphobia on social media. Given this reality, counseling patients on social media use should focus on safety in use and honest discussions of both the risks and benefits associated with its use. Regarding social support groups focused on gender identity, many current or previous attendants reported that support groups were helpful for finding social support, especially early on in one's transition and when other avenues of support are not present. Additionally, many respondents who had never attended a support group were interested in attending for the perceived benefits of increased social support and interest in meeting other community members. Engaging TGD patients in the use of social media and social support groups for gender identity may help improve support, though exposure to hate and transphobia are risks that come with social media use.