CHAPTER THREE: RESEARCH METHODS

Introduction

This chapter explores the methodological founda= tions of the study, describes the design, and details the actual process of conducting the study. It begi= ns with an introduction to the research methods and the theoretical framework = of the research. Conceptual chal= lenges to the study are outlined and the social location of the researcher is explored. Following this, the methods are documented in detail, including a description of the sampling p= lan; a detailed account of the outreach used for recruitment; data collection st= rategies; and the process for analyzing the data.&nb= sp; The chapter then concludes with a short discussion on plans for the study findings.

The Research Plan: A Triangulation of Qualita= tive Methods

This research pro= ject is being approached from the twin disciplines of sociology and public health. With this orientation, I begin to = not only explore the health issues related to a particular population, but as a sociologist I examine how social relations constitute that health outcome.<= span style=3D'mso-spacerun:yes'> From within these disciplines I us= e the feminist paradigm, rejecting the androcentric approach of positivist scient= ific methods, and focusing on gender, race, class, and sex interactions.<= !--[if supportFields]>= ADDIN EN.CITE <EndNote><Cite><Author>Yaiser</Author><Y= ear>2004</Year><RecNum>3</RecNum><record><rec= -number>3</rec-number><ref-type name=3D'Book'>6</ref-type><contributors><authors><a= uthor>Yaiser, Michelle L.</author><author>Hesse-Biber, Sharlene Nagy</author></authors></contributors><titles><t= itle>Feminist perspectives on social research edited by Sharlene Nagy Hesse-Biber, Michel= le L. Yaiser</title></titles><pages>xiv, 434</pages><keywords><keyword>Women Social conditions Research.</keyword><keyword>Women Social conditions.</keyword><keyword>Women's studies Research.</keyword><keyword>Feminism.</keyword></keywo= rds><dates><year>2004</year></dates><pub-loca= tion>New York</pub-location><publisher>Oxford University Press</publi= sher><isbn>0195171748 (cloth alk. paper)0195158113 (pbk. alk. paper)</isbn><call-num>HQ1180 .F455 2004HQ1180</call-num><urls></urls></record>= ;</Cite><Cite><Author>Marshall</Author><Year>= 1999</Year><RecNum>10</RecNum><record><rec-numbe= r>10</rec-number><ref-type name=3D'Book'>6</ref-type><contributors><authors><a= uthor>Marshall, Catherine</author><author>Rossman, Gretchen B.</author></authors></contributors><titles><tit= le>Designing qualitative research</title></titles><pages>xvi, 224</pages><edition>3rd</edition><keywords><keyw= ord>Social sciences Research Methodology.</keyword></keywords><dates>= ;<year>1999</year></dates><pub-location>Thousand Oaks, Calif.</pub-location><publisher>Sage Publications</publisher><isbn>0761913408 (pbk.)0761913= 3940761913408 (pbk.)</isbn><call-num>H62 .M277 1999H62</call-num><urls></urls></record>&l= t;/Cite><Cite><Author>Denzin</Author><Year>1998&= lt;/Year><RecNum>11</RecNum><record><rec-number>= 11</rec-number><ref-type name=3D'Book'>6</ref-type><contributors><authors><a= uthor>Denzin, Norman K.</author><author>Lincoln, Yvonna S.</author><= /authors></contributors><titles><title>Strategies of qualitative inquiry</title></titles><pages>xxii, 346</pages><keywords><keyword>Social sciences Methodology.</keyword><keyword>Social sciences Research Methodology.</keyword></keywords><dates><year>1998&= lt;/year></dates><pub-location>Thousand Oaks, Calif.</pub-location><publisher>Sage Publications</publisher><isbn>0761914358 (pbk. acid-free paper)</isbn><call-num>H61 .S8823 1998H61</call-num= ><urls></urls></record></Cite></EndNote>^162-164 = Despite my strong commitment to quantitative research, I believe addressing the questions that arise out of a review of existing literature on transgender health would not be possible through quantitative analysis. In contrast, qualitative methods o= ffered an opportunity to explore a substantive subject of which little is known, u= sing a naturalistic method that respects the humanity of the participants in the study. Qualitative findings e= volve out of holistic descriptions of natural phenomena. They are naturally interpretive and grounded in the lived experiences of people.^{163, 165, 166} = They explore the how and why of a phenomena, not just the what or= how much of quantitative methods.<= /span>¹⁶⁷ =

According to Denz= in, “no single method ever adequately solves the problem of rival interpretive, causal factors.” (p. 25)¹⁶⁸ = To overcome this weakness, a triangulation of methods should always be built i= nto the research design. Denzin identifies four basic types of triangulation: data, investigator, theory, a= nd methodological.¹⁶⁴ = Janesick later adds a fifth type, interdisciplinary triangulation.¹⁶⁹ Three of these methods have been incorporated into this research design.

Interdisciplinary triangulation resulted from the dual approaches of public health and sociol= ogy mentioned previously. I estab= lished data triangulation by deliberately soliciting participants with different perspectives on transgender health. Participants were divided into two major classes, transgender people= and key-influencers. Transgender = people were asked for information related to their own personal experiences of soc= ial determinants. Then, to frame = this knowledge, I interviewed a second category of people, a group I termed R= 20;key influencers”. A key influencer is someone who has information relevant to social determinants of transgender health either through their professional position, their role a= s a community ally, or their role as a partner of a transgender person. Lastly, I built triangulation of methodology into the study by choosing to use three different data collecti= on formats: life history interviews, focus groups, and short interviews.

Life history inte= rviews were chosen as the foundation of the data collection. With a long history of use in the anthropological and sociological fields, a life history interview provides = the greatest depth of information about a person.¹⁷⁰ = It emphasizes individual meaning, or “how a person copes with society ra= ther than how society copes with the stream of individuals.” (p.121)¹⁶³ = Of particular value to this study, a life history helps “capture cultural patterns and how the patterns are linked to the life of an individual.̶= 1; (p. 121)¹⁶³ I theorized that a series of life history interviews with a diversity of transgender people would provide a basis of information on social determina= nts for these individuals. But wh= ile life histories contribute valuable information about individual experiences= , I also wished to explore community-level knowledge. To accomplish this, the life histo= ry interviews were supplemented by focus groups. As Morgan states, focus groups are= best suited for creating data and insights that are dependent on group interacti= on.¹⁷¹ = This is done as people take different experiences and attempt to make “collec= tive sense” of them. (p.259)¹⁷² Wilkinson argues that focus groups = also shift the balance of power away from the researcher, reducing exploitation = and making them well-suited for soliciting information from underrepresented so= cial groups.¹⁷³ = Both of these traits made the limited use of focus groups a valuable addition to the data collection for this study. The two aforementioned methods were appropriate for the transgender participants. In order to best accommodate the key influencer participants, a third method was used, semi-structured in-depth interviews. Basically a “conversation with a purpose” (p. 149),¹⁷⁴ these interviews allowed me to explore topics related to health in the transgender communities, while allowing the respon= dent to determine the structure of their responses. These interviews were planne= d to last approximately thirty to forty-five minutes. In practice, they ended up ranging= from thirty minutes to three hours.

The three data co= llection methods above formed the methodological basis for my research plan. After considering the amount of da= ta that might emerge from each category, and the need for variation within interviewees, I decided to balance the different data collection methods as outlined in the table below. = In practice I ended up conducting one additional key informant and life history interview, and had a total of 521 single spaced transcript pages of data.

Research Plan=
Method	How many?	n per event	total n
Life histories=	12	1=	12
Focus groups	2=	8=	16
Key informant inter= views	8=	1=	8=
Planned number of study participants	36

Research Outcome
Method	How many?	n per event	total n
Life histories=	13	1=	13
Focus Groups	2=	6 FTM, 10 MTF<= /o:p>	16
Key informant inter= views	9=	1=	9=
Actual number of study participants	38

Theoretical Foundation

In 1983, feminist theorist Nancy Hartsock argued that current theoretical models were insufficient for understanding a women’s experience in the world. She proposed an alternative, stand= point theory. This theory argued th= at it was essential to create a new frame of reference for power relations. Standpoint theory attempts to understand power relations from the eyes of a dominated or marginalized population rather than from the point of view of = the dominant population group. Hartsock lo= oked at power relations from the eyes of women rather than men, showing that “one could begin to see the outline of a very different type of commu= nity if one took the mother/infant relation rather than market exchange as the prototypic human interaction.”^{=
175<=
/span>} = Later work on the theory emphasized the production of “concrete multiplicit= y,” or a call for many different marginalized standpoints to be explored, emphasizing within them the creation of communal knowledge.^{=
176<=
/span>} = In standpoint theory, “All knowledge attempts are socially situated and = some of the objective social locations are better than others as starting points…” (p.44)¹⁶² Beginning to create knowledge from within the dominant paradigm is inherently limiting, but doing so from a marginalized position can provide = more opportunity for critical perspective on social organization.

Standpoint theory= holds that gender, race, class and sexuality are not discrete influences, but rat= her intermix to create mutually constitutive identities.^{=
177,=
178} People create knowledge from their experiential standpoint, sometime= s in direct contradiction to dominant social messages. For example, “For Black wome= n, constructed knowledge of self emerges from the struggle to reject controlli= ng images and integrate knowledge deemed personally important. Usually knowledge essential to Bla= ck women’s survival.” (p.95)^{=
178<=
/span>} = Shannon Sullivan further develops this theory by exploring the notion of one’s body as not interactive with the world, but rather as “transactional.” = In this interpretation, there is “an active and dynamic relationship bet= ween things such that those things are co-constitutive of each other” (p.1= 2).¹⁷⁹ Accordingly, bodies and their environments are always transacting, a= nd the mind cannot be artificially separated from its transactional body. Sullivan argues that the transacti= onal body can and should be used to “free ourselves of the rigidity and stagnation of the self that accompany gender binarism” (p.110), but w= arns that this is inherently a dangerous process: “To challenge the rigid confines of one’s gender is therefore to commit gender treachery̷= 0; it is to risk all the psychological, physical, emotional, financial, and ot= her punishments meted out to gender traitors in our society.”(p.90)¹⁷⁹ = The concept of a body and ones world being co-constitutive dovetails with resea= rch showing how oral narratives are a constructed phenomena. Researchers have sometimes dismiss= ed oral narratives having little validity¹⁸⁰. Recently there is increasing respect for the role of oral narratives within research studies but with an understanding that the stories told are themselves a creation of intention, memory, interpretation, and historical facts^181-184.

The phenomena of = mutually constitutive identities and transactional bodies are both particularly rele= vant to the population being studied here. This project explores social influences on a group of highly marginalized people, transgenders, about whom dominant messages are persistently and extremely negative. In this group, communal knowledge is aggressively built. Whether through sharing the names = of accepting health care providers, or sharing the horror stories of death by street violence, the rapid creation of communal knowledge is a survival ski= ll for these populations. In additio= n, the transgender population experiences a unique relationship between mental self-perception and physical body. As individuals transform their bodies in an effort to achieve congru= ence between mental and physical gender identity, their gender variance is often publicly exposed. This exposu= re impacts personal identity and mediates the level of external gender oppress= ion experienced. Understanding the experience of transgender people from the lens of the dominant social parad= igms is an exercise in futility, because from this perspective there is no prece= dent for understanding the group at all. As is key to standpoint theory, the lived experience of the people m= ust be given primacy. The explora= tion of their constructed knowledge can then highlight deficiencies in the assumptions inherent in dominant paradigms.

Conceptual and Empirical Challenges in Studying Transgender People

The small size of= the transgender population makes it challenging to study this group of people.<= span style=3D'mso-spacerun:yes'> In addition, the often extreme discrimination experienced by transgender people results in many individuals hiding this identification, or trying to pass as non-transgender. Among community members, there is notable concern over those who have “disappeared” or “gone stealth”; that is, transitioned into the opposite sex and then, throu= gh their ability to pass, severed ties with transgender people and submerged themselves in the gender normative world.&= nbsp; Several concerns emerge as a result of this relative isolation of stealth transgender people: how are their stories included in research; how= do social service agencies reach out to them with support services; what effect does it have to isolate oneself from people similar to you? One barrier researchers encounter = when studying transgender people is that potential study participants must acknowledge some level of gender variance.= Study recruitment is therefore very likely to overlook people who ha= ve gone stealth, and as a result, not include their experiences. The design of the present study co= uld not overcome this limitation.

Another barrier is language. As has been discuss= ed, there is no single word that adequately captures the range of gender variant people. While “transgen= der” has been deliberately used here as the most adequate term, it is a heuristic tool that has distinct limitations. One author amusingly refers to it as a “spongy neologism”= ;¹⁸⁵; a direct reference to the dubious nature of gathering disparate groups under one term.= Many people who present as gender variant would never self-identify = as transgender. Some of this gro= up does acknowledge that the word is intended to include them, and will respon= d to it when it is used by others (e.g. responding “yes” to a survey question about being transgender). For others, not only will they not identify with the word transgende= r, they also may not even consider that the term would ever include them. An experience at the beginning of = my fieldwork highlighted this issue.

One of my first interactions with the transgender community in New York was as facilitator for an his= toric meeting of transgender activists from across the state. They had gathered to form a new al= liance to help pass statewide anti-discrimination legislation. The first order of business was to= agree on one or more identifying terms for the name of their alliance. After hours of debate, and a final consensus on using the controversial term ‘transgender,’ some participants expressed surprise that they had reached any agreement at all. This is how strongly the divisions over this term are felt within the community.

As is noted in Da= vid Valentine’s exploration of identity within the transgender communitie= s, the word “transgender” is less likely to be used in some communities of color.⁹ = This was a particular issue as I sought out an African American elder female butch f= or the study. Experience led me = to understand that few if any in this group would ever consider identifying as transgender, but I hypothesized that the gender variant experiences of these individuals would share commonalities with those of other participants. In recruiting the person interview= ed, I had to surmount the barrier of having the word “transgender” in= the study title and provide an explanation as to why she fit the study population. Ultimately the participant did not balk at the study title, and as her story shows her his= tory was profoundly influenced by her gender variance.

The final and most notable barrier in studying transgender people is the great diversity of pe= ople under this single category. Transexuals, gender queers, drag queens, butch women, effeminant mal= es, and cross-dressers of every possible social and cultural backgrounds all cluster under this grouping. The variation in identities directly reflects the variation in perso= nal experiences. Possibly, this i= s much too large a population to easily categorize and plumb for those desired com= mon experiences. Alternately, in = the words of C. Wright Mills, “Perhaps the variety is not as ‘disorderly’ as the mere listing of the small part makes it seem.” (p.131)¹⁸⁶ = In fact, this research takes as an assumption that research on this broad group will find common themes, reflecting a level of common experiences belied by the = diversity of personal identifying labels. This level of diversity begs for closer scrutiny, and future dissertations could easily be done, for example, on Latino male cross-dress= ers alone. But the nature of work= ing in a relatively unexplored area means that a broad spectrum of information abo= ut the transgender people is most valuable right now. To meet this need, this research p= roject deliberately uses a triangulation of qualitative methods to cull stories fr= om a variety of community perspectives. Congruent with this approach, the findings are intended to be illustrative, not generalizable. They are to be used as would the findings any exploratory research project, to help create a basis of knowledge about these populations, and inform more specialized research to follow. This said, there is also no = reason to believe that the stories contained herein are exceptional, and as the sampling and outreach sections describe, no efforts were made whatsoever to= recruit people with exceptional stories into the study.

The Researcher’s Role

Post-positivist f= eminist research acknowledges that research is an interaction between the subjects = and the researcher that creates situated knowledge. A researcher’s past experien= ces, opinions, and enculturation all act as a lens through which the incoming da= ta is filtered. The participant’s reactions to the researcher are influenced by the same factors.^{162, 163} = These principles are all taken as given in this study. As such, I will explicitly explore= my own social location in relationship to this research below.

There has been mu= ch discussion about whether it is necessary, or even beneficial, for a researc= her to study a community of which they are a member.¹⁸⁷ = A level of perceived commonality can be very beneficial for getting hard-to-reach target populations to be accepting and forthright with a researcher. Additionally, lived experience as a community-member may be particularly valuable in studying highly stigmatized populations