A Qualitative Study on the Health Perceptions and Needs of Queer and Transgender Pacific Islanders

Abstract

Background The historical trauma of colonization and of epistemicide of Pacific Islander knowledge systems may cause Queer and Transgender Pacific Islanders (QTPI) to experience greater health disparities compared to non-QTPI Pacific Islanders. Although little is known about QTPI health disparities, the “Indigenist” Stress and Coping Model suggests that cultural determinants of health could be utilized to promote QTPI Health. Although interventions utilizing these determinants exist and demonstrate efficacy, the mechanisms by which they can improve QTPI health have yet to be explored. Methods Using semi-structured qualitative interviews and Community Based Participatory research principles, the study aimed to examine: the health issues experienced by QTPI community, ways to collect health information from QTPI populations, and identify mechanisms by which culturally-rooted health interventions can produce better health for QTPI people. 12 interviews were conducted with Queer and Transgender Pacific Islander adults who spoke English. Data collection was constrained by COVID-19 and more data is needed to achieve inductive thematic and data saturation. Common and unique themes were identified in relation to QTPI’s health experiences. Results QTPI views of their health were related to harmonious relationships between their mind, body, and spirit that were shaped by cultural and social norms. Cultural responsiveness, and a simultaneous understanding of QTPI’s culture; gender; and sexuality, creates comfort and greater ability to talk about their health with providers. Agofli’e and alofa (“Visibility and Love”) were identified as important cultural mechanisms to improve QTPI mental health and the relationship between their mind, body, and spirit. Conclusions Culture is critical to understanding and improving QTPI Health. Providers should consider utilizing culturally responsive practices when discussing health with QTPI. Pacific cultural values that embody visibility and love for QTPI should be included in future models and culturally rooted health interventions that seek to improve QTPI health.