September 25, 2023

Measuring the psychological impact of administrative burdens on transgender people

More than 99 million individuals participated in federally funded social safety net services in 2019, a total that represents 30 percent of the United States population. These social programs offer various types of assistance and are crucial in supporting vulnerable communities, such as transgender people, during times of hardship.

Despite their importance, extensive barriers continue to block access to these necessary services. To better understand how these barriers are hindrances to the long-term well-being of transgender people, Isaac Sederbaum, a Ph.D. candidate at the University of Washington’s Evans School of Public Policy & Governance, is conducting groundbreaking research that examines how administrative burdens influence government program enrollment for the transgender population.

According to Sederbaum, administrative burdens are the barriers individuals experience when attempting to access services from the government. These burdens are widespread and can negatively affect health outcomes by preventing people from receiving health-promoting government assistance, such as SNAP benefits and income support. In addition, they may have more direct health impacts, due to the psychological repercussions and stress individuals encounter when attempting to navigate government programs.

Despite the extensive prevalence of administrative burdens, no other previous research has examined the barriers specifically faced by transgender people in the U.S. “Trans individuals are more likely to be low-income and experience homelessness … It is very well documented that the poorer you are the more likely you are to interface with government, and thus experience more burdens,” explained Sederbaum. “So, there should be investigations into the experiences of trans people, [but] there isn’t anything.”

In spring 2023, Sederbaum and his research team were awarded a Population Health Initiative pilot grant to mitigate this gap in research. While there are three categories of administrative burdens, Sederbaum’s project specifically focuses on the psychological costs (i.e., stigma, stress and a loss of autonomy) that transgender people face when seeking access to social programs. The project’s overall goal is to better understand if these negative psychological barriers impact transgender people’s enrollment in government services and whether these repercussions have prolonged effects on overall well-being.

Sederbaum’s first step involves recruiting and training an all-transgender advisory board, which will initially pilot the interview protocol and supply input and feedback during the entirety of the investigation. “The goal is to assemble the advisory board in July and then take time in August to finalize the survey questions. We hope to have the survey go live in September,” said Sederbaum.

After the finalization of the survey, Sederbaum will conduct virtual interviews with 50 transgender people. Those responses will then be transcribed and analyzed using a codebook developed by the advisory board.

Sederbaum hopes the study findings will serve as a foundation for future empirical research regarding psychological administrative burdens. Additionally, the research team, in partnership with the advisory board, hopes to write methods papers about the study design, which will document how to design and implement participatory policy research for transgender people.

“Trans people have historically been kept out of research. There’s been a lot of gatekeeping and pathologizing trans people as being mentally ill. Trans people, for many years now, have been a target,” emphasized Sederbaum. “Right now is the time to look at these burdens and bring out these voices and experiences.”