Using the Life History Calendar to Examine Victimization, Mental Health, and Seeking and Attaining Help Among Transgender Women: An Example of a Culturally Relevant Adaptation.

Transgender women are at increased risk for interpersonal violence victimization, including physical and sexual child abuse and mistreatment, intimate partner violence and sexual assault, and transgender-related community violence. Experiencing multiple forms of interpersonal victimization is associated with a range of adverse mental health outcomes. Life course approaches such as the life history calendar (LHC) are useful for examining trajectories of victimization and associated mental health outcomes, yet to date this method has not been used to examine transgender women's victimization trajectories. In this paper, we describe adapting the LHC to examine transgender women's experiences of victimization, adverse mental health, help-seeking, and help-attainment (N = 103), and we share participants' feedback on the acceptability of the LHC. First, we engaged in an iterative and collaborative process to adapt existing LHCs used in studies on victimization among cisgender women to ensure relevancy for our sample and then we conducted one-on-one interviews with participants using the adapted LHC. At the end of the interview, participants were asked for feedback about their experience. Responses were transcribed verbatim and coded using open and thematic coding methods. Overwhelmingly participants (97.8%) found the experience to be "positive" (73.0%) or "neutral" (39.3%). Just two participants' responses were coded as only "challenging." Other themes included enjoying the process of using the calendar to reflect on their life events and feeling good about using their stories to help others. The adaptation and findings from our study demonstrate that despite high levels of victimization and trauma and potential difficulty discussing these topics in a research context, transgender women who participated in this study found the LHC interview to be acceptable and, in many cases, positive. Findings can inform future LHC adaptations and research as well as the development of culturally relevant and effective mental health interventions for transgender women.