“Speak directly to us…earn our trust”: how to recruit transgender and nonbinary cancer patients to participate in research

Purpose Transgender and nonbinary (TGNB) cancer patients are under-represented in cancer research, with very few studies focused on this population. In the current sociopolitical climate and with reduced research funding for TGNB studies in the United States, the challenge of recruiting TGNB cancer patients to participate in research has intensified. This qualitative study used an intersectionality lens and explored TGNB cancer patients’ experiences with cancer care and research participation, as well as their recommendations for improving recruitment. Methods We used multiple strategies to recruit TGNB cancer patients in the United States who participated in semi-structured one-on-one interviews. Interviews were professionally transcribed, de-identified, and coded using reflexive thematic analysis. Results Four themes characterized participants’ responses from interviews (N = 42; 45–90 min). First, Am I Safe to Be Myself? elaborates the structural factors, safety considerations, and additional concerns that influence research engagement. Second, Speak Directly to Us recommends addressing power relations and participant identities specifically, with accountability to historical harms and distrust. Third, Are You Willing to Do the Work? details the importance of building sustained relationships, which include resource sharing and reciprocity, to involve the most marginalized TGNB community members. Fourth, Helping Future Me’s explains how co-producing knowledge with marginalized communities can create connection, repair, and motivation for participation. Conclusion Findings present a pathway for involving TGNB cancer patients in research studies, even amidst a volatile sociopolitical climate. Themes resonate with both intersectionality and community-based participatory action research approaches to guide trust-building and to enhance recruitment numbers and data integrity.