Chapter 4. Research Methods and Procedures 65!
4.4. Procedure 73 !
The Victoria University Human Research Ethics Committee
provided ethical approval for the project that was carried out in accordance with the National Statement on Ethical Conduct in Human Research
(2007) produced by the National Health and Medical Research Council of Australia.
4.4.1. Materials and development of the interview schedule.
• Participant Information form for Gender participants (Appendix A) • Participant Information form forPractitioner participants
(Appendix B)
• Expression of Interest form for Gender participants (Appendix C) • Expression of Interest form for Practitioner participants (Appendix
• Informed Consent form (Appendix E)
• Interview Schedule for Gender participants (Appendix F) • Interview Schedule for Practitioner participants (Appendix G)
A semi-structured interview schedule consisting of 10 demographic questions and 9 open-ended exploratory questions was developed
through a literature review on the mental health experiences of
transgender individuals. Questions were designed to be flexible and lead to further inquiry and elaboration if appropriate. As recommended by Charmaz (2006), initial concepts from the literature were incorporated into general questions in the initial interview guide, for instance, participants were asked what kind of things they found “helpful” and “unhelpful” or contributed positively and negatively to mental health for themselves and/or other transgender individuals. In keeping with constructivist contemporary grounded theory methods, the interview protocol were adapted to the participants’ different identities and evolved to include questions prompted from previous participants. For example, Andy spoke about the complexities associated with accessing resources and how this impacted his mental health. This concept was then included as a question and explored in subsequent interviews. Questions evolved and were refined as the interviews proceeded, as is typical in grounded theory studies (Levitt & Ippolito, 2014b).
4.4.2. Organizing and conducting the interviews. Groups, organizations and services associated with the gender diverse community and field were contacted verbally and sent a written outline of the project,
and asked to distribute and make the information available to their
network, to let people know about the project and the potential opportunity to contribute to it (See Appendix A and B). These project information flyers including telephone contact details for the research team were passed on to the identified individuals who then decided whether they wished to contact the researcher to discuss participation. Throughout the duration of the research project, I had ongoing involvement with a peer supervision group for mental health practitioners who work with sex and gender diverse clients. I discussed aspects of the project with members of this group who specialized in transgender mental health and asked them to consider people (trans or practitioner) whom they thought may like to contribute to the project.
Those who expressed interest in potentially contributing to the project contacted me directly (using methods outlined in project
information flyers, see Appendices A and B) to discuss the research further and to arrange an interview if they wished to do so. During this initial
telephone contact, I ascertained whether participants met the necessary inclusion criteria. Transgender individuals were able to participate if they were over 18 years of age, self-identified as transgender (or more specifically had questioned their gender identity, considered gender transition, and/or taken steps to transition and affirm gender identity)
,
and were not currently experiencing crisis or an acute episode of serious mental illness. Mental health practitioners were selected for participation based on their level of clinical experience in working with at least five transgender and gender diverse individuals. Eight transgender individualsmade contact to seek further information about the project; five of these chose to participate. Three individuals chose not to participate for various reasons, including lack of interest and prior commitments. All practitioners who expressed interest in the project went on to participate in an interview.
During the initial telephone conversation and prior to an interview being scheduled, I explained the full details of the project to every
participant who made an inquiry or expressed interest. The ten interviews were conducted in person at a time and location that was mutually agreed upon as convenient and private. On the day of the interview, participants read the Plain Language Statement for Participants, I verbally summarized the Plain Language Statement and the project again, and I asked for confirmation that the participant understood the project, that participation was voluntary, and that there would be no consequence for withdrawing from the project. Participants were reminded that the interview would be audio recorded, with their consent. An explanation of how the results would be presented, with the use of pseudonyms at all times, was provided. I explained my intention to hold a culturally sensitive, flexible, and respectful interview session and encouraged the participants to only answer the questions they felt comfortable with and to provide elaboration or feedback as desired throughout the interview. I proceeded with
interviews once I was satisfied that the participant had fully understood the nature of the project, was in an appropriate state of mind, wished to
participate, and had signed the Informed Consent form (Appendix E). All participants were interviewed using open-ended questions (see Appendix F and G) in a semi-structured format, with questions designed to
prompt, and not direct, participant stories, experiences, observations, and knowledge. Participants were encouraged to reflect on their own
experiences as well as those of others that they knew. Interviews ranged from forty five to one hundred minutes, and were sixty minutes on
average. Interviews with transgender participants were generally longer than interviews with mental health practitioners; this could be due to time constraints, professional experience in articulating issues, and the depth to the experiences of the transgender participants. At the end of the
interview, the participants were given time to discuss the interview and their experiences of it, and this frequently also led to them providing further reflections and experiences. At various points throughout the interviews, some transgender participants experienced sadness when discussing elements of their experiences. For example, one participant reportedly found it difficult to think about and describe the depression he experienced when anticipating the social impact of affirming his gender. I provided containment and offered to move on to a less distressing topic, however the participant reported that it was helpful for him to discuss and reflect on his experiences and how far he had come since that difficult time.