For the purpose of this research on Kenyan queer womxn and trans men and how they make decisions regarding sexual health and service utilisation, recruitment, and data collection using online spaces was successful.
Respondents for the survey were identified and recruited more rapidly than anticipated, which is due to several factors: the existing, trusting relationships the researcher had with key people in the population to be studied; buy-in from influential and well-connected community members who identified as LGBTQI+ people themselves; interest and enthusiasm for the topic at hand; the timing of the survey immediately following a high-profile court case, and thorough online safety precautions. Concerns around stigma and violence were mitigated by participants completing the survey or participating in interviews online, hence lowering barriers to participation, such as fear of being seen with the researcher or other queer womxn and trans men.
Some of the positive outcomes of the survey had not been anticipated in the original study design. Additionally, concerns around safety and security during qualitative data collection mitigated by using video conferencing tools. Although this was initially done due to the COVID-19 pandemic, it proved to be an effective and safe way to collect sensitive data. It also reduced the need for finding safe places and reduces the time needed for interviews, as commuters were not needed.
Disadvantages, such as low response rates, the inability to walk participants through the survey, posing an annoyance and low external validity, as described by Kılınç and Fırat (2017), were not found. A low response rate was not a concern in this case. It is unknown whether people who received the link multiple times from various sources may have felt bothered by it; if so, it was not brought to the researchers’ attention. Generalisability is certainly a concern for the outcomes of this research, which is amplified by how little is known about the population in general. Future research needs to be conducted in order to be able to make more generalised conclusions. Not being able to explain survey questions in more depth to participants was also a disadvantage in this study.
The confluence of factors – trusting relationships, timing, focus on safety and security – worked well for this research. It might work well in other settings, where data collection with marginalised communities might not be possible, and sampling might be difficult, or participants could be at risk. Including key community members in data collection efforts proved to be important and effective, underscoring the need to do community-participatory research when designing research projects centred around marginalised communities. While the timing of the research and the High Court ruling was serendipitous, other events or developments that can galvanise interest can be purposively addressed in the design of research.
More in-depth research is needed
While the findings of this research are an important start to getting a better understanding and more knowledge of the needs of sexual and gender minorities in Kenya, and specifically queer womxn and trans men, more exploration is needed, with special attention to a broader representation in the sampling, as well as a reduction of the bias that could have been introduced by using the described snowballing techniques. Continuous efforts need to be made to include sexual and gender minorities in research efforts. While efforts for improvement are ongoing, recent developments to exclude and even erase sexual and gender minorities from data scans in federal programs in countries, as is the case in the United States, need to be vigilantly monitored, as ‘data sets that do not include sexual orientation and gender identity information are inadequate and incomplete’ (Loewy, 2017, p. 2).
Continuous efforts need to be made globally to advocate for the inclusion of sexual and gender minorities and other hard to reach populations in research to better understand needs, barriers and other factors that could influence health and well-being, as well as the careful design of interventions to address inequities so that ‘no-one should be left behind’.
Appendix 1: Risk self-assessment
In this survey, you will be asked personal questions about your sex life, your mental and emotional health, about alcohol or drugs use, and about potentially criminal behaviour, because some same-sex activities are illegal in Kenya.
All information you give is confidential. Note: If you are visually impaired, the use of reading apps or assistive devices can cause a lack of privacy. Some of these topics could make you feel uneasy or bring up negative emotions. Some questions you can skip if they are unsettling to you. Other questions need to be answered. If they make you uncomfortable, you can stop taking part at any time. Before you get started with the survey, please answer the questions below and carefully read through the tips to keep you safe online.
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Yes
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No
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I don’t know
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Do you think answering questions about sexuality, sexual health, drug and alcohol use and mental health could cause you any kind of stress?
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Have you been advised by a healthcare professional to refrain from discussing emotional issues you are dealing/have dealt with?
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Do you think you could be physically harmed if anybody found out that you participated in this research?
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Do you think you could be emotionally harmed if anybody found out that you participated in this research?
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Do you think you can face any legal consequences if anybody found out that you participated in this research?
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If participants indicated ‘yes’ or ‘I don’t know’ in any of the questions above:
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Yes
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No
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You said this research may put you at risk. Do you still want to participate?
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Finally, if any issues come up during the survey, you can either contact the researcher via email or one of the following organisations for assistance.
If you have questions about HIV testing, treatment, and other concerns, please get in touch with LVCT Health or their one2one hotline (800 720 121 or 1190, both toll-free) for sexual health questions. For questions around abortion, safe sex, and birth control, please get in touch with Marie Stopes Kenya. For mental health and problems with drugs and alcohol, please head to this sexual and gender minority specialised online counselling service. In case of any legal issues you may face in your private life, the National Gay and Lesbian Human Rights Commission provide legal help to sexual and gender minority people.
Appendix 2: Staying safe online information
We want you to stay safe while participating in this study. If you keep your devices safe, there will be minimal risk that someone finds out you took part and could ‘out’ you against your will. Here are some tips.
Passwords and PINs
Passwords and pin numbers are really important your safety, especially when you are sharing devices. Make sure all your devices have random passwords with letters, numbers, and special characters. Sentences work well, too. The more difficult, the better. Use a different password for every device and each platform/e-mail address/website you use. That will make it easier for you to keep your privacy, even when your computer is hacked or your phone is stolen.
Make sure you log out of accounts when you are done with your session.
Software like 'KeePass’ make it easier for you to have and store complicated passwords.
Clearing your browser history
Clearing your browser history is especially important when other people use the same devices as you, but you should regularly do it if you visit websites etc. that could tell people about your sexual orientation or gender identity. To check how to clear your browsers history, click here.
Using VPNs
If you are worried about anyone tracking you online, you can use a 'VPN' (Virtual Private Network). A VPN helps you get your information safely to and from your computer (encryption), and it hides your real location, so you can't be traced, allowing you to surf anonymously.
To use a VPN, download the Psiphon app to your iPhone or Android smartphone, click ‘connect’ and nobody will be able to tell where you are browsing from. On a desktop, apps like betternet work the same way.
Shared devices
Staying safe when sharing devices with friends, colleagues, family, or at an internet café can be a problem. Make sure nobody can watch your screen. Clear your browsing history when you are done, and don’t forget to log out of any social media sites or accounts you may have used.
Malware and hacker protection
Hackers can attack your computer and steal your information. Make sure that you have an antivirus programme installed, a firewall activated, and never open email attachments from people you don't know and trust. If your phone or computer are acting strangely, the battery dies more quickly than usual, and they get very hot, someone may be monitoring your device.
If you want to know more about staying safe online, have a look at Tactical Tech’s ‘Security in a Box’ information.