Community learning and healthcare access among trans women in Indonesia: a comparative study of peer navigator succession

Background Peer navigation can support transgender health care access, yet little is known about what happens when navigation responsibility changes hands.Aims This study examined how successor navigators acquire practical knowledge and under what conditions clients and health professionals accept their assistance.Methods This comparative, case-linked qualitative study retrospectively reconstructed 12 succession episodes in Palembang and Bandung, Indonesia, involving 40 participants across four roles: trans women clients, incoming and outgoing navigators, and health professionals. Semi-structured interviews were analyzed using a case-linked adaptation of the Framework Method.Results Successors learned through observation, accompaniment, and increasing responsibility. Procedural knowledge transferred more readily than relational recognition. Peer authorization, client trust, and provider acceptance developed on different timelines. Participants described access difficulties involving provider changes, administrative requirements, and costs.Conclusions Succession is a relational and service-level process. Peer navigation programs need handover arrangements that preserve client choice, practical support, and workable access when personnel change.