Featured Investigator: Scout, MA, PhD

August 2022: Scout, MA, PhD
Executive Director
National LGBT Cancer Network

Scout is the Executive Director of the National LGBT Cancer Network and the principal investigator of both the CDC-funded LGBTQ tobacco-related cancer disparity network and Out: The National Cancer Survey. He spends much of his time providing technical assistance for tobacco and cancer focusing agencies expanding their reach and engagement with LGBTQ+ populations. Scout has a long history in health policy analysis and a particular interest in expanding LGBTQ+ surveillance and research. He has faculty appointments at both Brown University and Boston Universities’ Schools of Public Health. He is a member of the NIH Council of Councils, the Co-Chair of the NIH Sexual and Gender Minority Research Office Work Group, on the Advisory Panel for NIH’s All of Us initiative, and a U.S. Pharmacopeial Convention delegate. His work has won him recognition from the U.S. House of Representatives, two state governments, and many city governments. Scout is an openly transgender father of three, a vegetarian, an avid hiker, and runner.

Q: What are your current research interests?
A: Experiences of SGM people with cancer and their caregivers; tobacco use among SGM people.

Q: Tell us about your career path – how did you end up where you are now?
A: I always presumed I’d get a PhD, but then that started to float away until a health researcher named Judy Bradford took me aside and told me she really thought I should get one, specializing in queer health. With Judy’s pushing I got back into school at 30 and pursued a masters in sociology then enrolled in Columbia’s School of Public Health to get my PhD. Judy was faculty at the school and was trying to start an SGM research nexxus. During that program I came out publicly as trans, which unexpectedly made me even more valuable due to the lack of trans researchers. My thesis was on Social Determinants of Transgender Health and I still remember what a profound experience it was getting people’s life stories. I heard from people who were homeless in Times Square as young teens, who had friends violently murdered, who lived high and much more often, who struggled deeply with addictions, depression, and the persistent violence against them. Every single trans person had their education interrupted, which left me feeling even more amazed I was getting a PhD.

When I graduated I was one of two openly trans PhD level health researchers I knew, which is a lonely place to be. But Judy continued helping me land well, pulling me into one of the biggest SGM health centers in the country to be the head of trans research. But to be honest, while she was a staunch ally, the rest of the environment was at times quite chilly. Nonetheless I continued stepping ahead, doing a large national tobacco study and building my connections as Judy pulled me into more and more national queer health planning efforts. Soon I was the Science Director for the National LGBT Health Coalition and meeting with heads of different HHS OpDivs to get community health priorities moving. A key thing this work taught me was how policy shapes the ability of researchers to be able to conduct good SGM science. For many years, the researchers around me had to use coded words to get NIH studies about queers funded. They endured a brisk change of political winds everytime the President changed. They had to deal with their lives and or research being mocked by right wing trolls, including one time when there was a full scale witchhunt of queer researchers that to be honest, drove many away from the field. Because of this persistent headwind, I leaned into policy more and more, including pushing HHS’s Office of Minority Health to include SGM issues in cultural competency standards, a multi-year push to get SGM acknowledged as a health disparity population by NIH, then another to get an office of SGM health opened at NIH.

Ultimately all those things were achieved, which makes me very proud. But I continue to push on what is now my longest term professional goal, getting enough SGM data for us to write compelling needs statements for our research project. Our communities data gaps have too often left us unable to be as competitive as researchers in other topics, and with highly competitive paylines this is one of the biggest barriers to getting more SGM research. En route to this goal, I’ve continued to speak up about the needs of our research community frequently.

For most of this time, I was funded primarily by CDC to run a tobacco and cancer disparity network but since we don’t get public health interventions without identifying problems via data, then researching what interventions work, I’ve continued to focus on opened that research pipeline wider. I worked with a few amazing students to publish the first analysis of NIH funding, a process that’s now become an annual activity of the SGMRO. I continued to listen to my research colleagues about what was slowing them down and speaking up about it to NIH leadership. While the head of NIH didn’t answer many of my early letters, eventually he started to meet with me and others we would assemble; by the time he retired I had been pulled in to many official advisory committess and we were on first name basis, as I still am with the current Interim Director. I am now ending my term as a member of the Council of Councils and as Co-Chair of the SGMRO Work Group. I am still on the advisory committee for what I admit is probably my favorite study, All of Us. I like to think of All of Us as research 2.0, where underrepresented people make up a majority of the study population and diversity is seen as a strength of the data collected.

Meanwhile on the career side, except for a two year gap I’ve now run the CDC funded tobacco and cancer disparity network for over a dozen years. I love how that work lets me provide technical assistance to states and federal entities looking to do better work on SGM health. For the last few years I’ve now moved into being the Executive Director of the National LGBT Cancer Network. I love the team we’ve assembled to do that work, and I find it interesting to learn about industry (i.e. pharmaceutical) options for getting research funded. My most recent research project is Out: The National Cancer Survey, where we had 2,700 queer cancer survivors tell us about what worked and what went wrong. Now that dataset is available for researchers to use and at least a dozen nationwide are doing different types of secondary analyses. What’s next for me on the research front? Two things: I want to run a similar study of cancer caregivers and we’ve started a new mentorship program, Cancer Leaders Like Us, which I hope can help pave the way to get more queer and minoritized researchers into the field. The other day I gave a career talk to an NIH group of fellows, and as I started one of the participants admitted they were almost crying, simply because they don’t see senior people like me in the field very much. So I’m reminded on a very frequent basis how lucky I am to have come so far, and the responsibility that confers to do my level best to clear the path for other unrecognized and undervalued people to follow.

Q: What organizational challenges have you faced?
A: Just as I’ve had so many amazing mentors, I also had plenty of people who did not help clear a path, for example the CEO I worked under for nearly a decade who could not bear to look at me. Most notably, the other CEO who fired me from the SGM project I brought to his organization, only to hire a non SGM person to lead it instead. The brutal truth is that firing was not long ago, and to my shocked surprise, despite a robust network of colleagues who thought very highly of me, I endured two years of unemployment. Well meaning colleagues would convey they couldn’t imagine me in a non-queer position despite my depth of expertise in several other topic areas. Others were outright uncomfortable with a trans person. At the same time, the District of Columbia was doing resume testing and found nearly 80% of employers wouldn’t even get back to a trans guy like me for an entry level position, much less a senior public health position. My academic based research colleagues were honestly facing some similar battles, some of the most senior SGM health researchers I knew were getting less secure in career choices the more senior they became. Only the (male) HIV researchers seemed to be building status and security. And at the same time I was unemployed I was on NIH advisory committees peopled with deans and chancellors, trust me the imposter syndrome struggle was real.

Q: What advice do you have for trainees and researchers who want to work in this area or are interested in applying for NIH funding? 
A: While on the NIH advisory committee for diversifying the pipeline of researchers I learned that most minoritized researchers fall out of the NIH funding stream by applying once, getting turned down (as is usual), then not applying again. So my biggest piece of advice is to prepare for that hurdle, be persistent about reaching out to find mentors who can help you get over it. We need you to get past that breakpoint. Beyond that? In my early career, staying debt-free allowed me to make choices that really helped me. Through my whole career, mentors have been a lifeline. No matter how senior you are, be persistent about finding and nurturing them. Also, mentor back, no matter how junior you are, you are still more senior than some people, especially those from the most underrepresented groups among us. Also, back up and look at how policy affects your research. Become involved in efforts to change policies to help level the research playing field. Beyond that, the most valuable asset I’ve ever built in my life are my friends. Both personal and professional, cultivate a group of strong people around you. Actively curate that group to inspire you. Remember, research shows us as we never want to be at the front or back of our “herd”… so building a friend group that inspires you to do more to keep up is one of the easiest ways to both excel yourself and have the social support you need to weather adverse events. 

Q: Do you have any specific advice for working with and involving SGM populations in research?
A: Whether you are SGM yourself or someone who is using your access and priviledge to move into this field, try to involve as many other SGM people as possible in the framing and execution of your research. Remember whenever you work with an underrepresented population that will create some tension – we have systemically been denied opportunities for generations. Build the concept of “giving back” into your research, employ us, mentor us, co-author with us, dig deeper to find some of us who are struggling and give us a chance, remember peer reviewed journals are not accessibly to most of us so create community-friendly summaries. Make sure every time you ask demographics SGM is included. Remember every time to erase or suppress our data, that action is contributing to ongoing disparities. By definition researchers have reached a position that many underrepresented population members can not attain, so be conscious of your priviledge and make sure you are not just taking from our communities, but giving too.  

Q: Who inspires you?
A: Sidney Poitier epitomizes for me a man who faced a hostile world with unparalleled composure and grace. Every single (honestly mostly BIPOC) ally researcher who’s reached out to include us inspires me. Every single Black trans woman out there inspires me with their daily fight to survive and thrive.

Q: Any final words of wisdom?
A: Nope.