Showing papers on "Transgender published in 2013"

Stigma, mental health, and resilience in an online sample of the US transgender population.

Abstract: Objectives. We assessed the association between minority stress, mental health, and potential ameliorating factors in a large, community-based, geographically diverse sample of the US transgender population.Methods. In 2003, we recruited through the Internet a sample of 1093 male-to-female and female-to-male transgender persons, stratified by gender. Participants completed an online survey that included standardized measures of mental health. Guided by the minority stress model, we evaluated associations between stigma and mental health and tested whether indicators of resilience (family support, peer support, identity pride) moderated these associations.Results. Respondents had a high prevalence of clinical depression (44.1%), anxiety (33.2%), and somatization (27.5%). Social stigma was positively associated with psychological distress. Peer support (from other transgender people) moderated this relationship. We found few differences by gender identity.Conclusions. Our findings support the minority stres...

Experiences of Transgender-Related Discrimination and Implications for Health: Results From the Virginia Transgender Health Initiative Study

Abstract: Objectives. We examined relationships between social determinants of health and experiences of transgender-related discrimination reported by transgender people in Virginia.Methods. In 2005 through 2006, 387 self-identified transgender people completed a statewide health needs assessment; 350 who completed eligibility questions were included in this examination of factors associated with experiences of discrimination in health care, employment, or housing. We fit multivariate logistic regression models using generalized estimating equations to adjust for survey modality (online vs paper).Results. Of participants, 41% (n = 143) reported experiences of transgender-related discrimination. Factors associated with transgender-related discrimination were geographic context, gender (female-to male spectrum vs male-to-female spectrum), low socioeconomic status, being a racial/ethnic minority, not having health insurance, gender transition indicators (younger age at first transgender awareness), health care needed...

Anxiety and Depression in Transgender Individuals: The Roles of Transition Status, Loss, Social Support, and Coping.

Abstract: Objective The purpose of the current study was to examine facilitative and avoidant coping as mediators between distress and transition status, social support, and loss. Method A total of 351 transgender individuals (n = 226 transgender women and n = 125 transgender men) participated in this study. Participants completed measures on transgender identity, family history of mental health concerns, perceptions of loss, coping, depression, and anxiety. Results The rates of depressive symptoms (51.4% for transgender women; 48.3% for transgender men) and anxiety (40.4% for transgender women; 47.5% for transgender men) within the current study far surpass the rates of those for the general population. Structural equation modeling (SEM) was used to analyze the data-2 separate models were hypothesized, based on reports of anxiety or depression. The SEM results suggest that the processes for transgender women and transgender men are primarily similar for depression and anxiety; avoidant coping served as a mediator between transition status and both distress variables. Social support was directly related to distress variables, as well as indirectly related through avoidant coping. Conclusion Results suggest the need for practitioners to focus on interventions that reduce avoidant coping strategies, while simultaneously increasing social support, in order to improve mental health for transgender individuals. Individuals who are in the beginning stages of their transition will use different coping strategies than those who are in later stages; interventions should be adjusted on the basis of the transition status of transgender clients.

Heterosexuals’ Attitudes Toward Transgender People: Findings from a National Probability Sample of U.S. Adults

Abstract: Using data from a national probability sample of heterosexual U.S. adults (N = 2,281), the present study describes the distribution and correlates of men’s and women’s attitudes toward transgender people. Feeling thermometer ratings of transgender people were strongly correlated with attitudes toward gay men, lesbians, and bisexuals, but were significantly less favorable. Attitudes toward transgender people were more negative among heterosexual men than women. Negative attitudes were associated with endorsement of a binary conception of gender; higher levels of psychological authoritarianism, political conservatism, and anti-egalitarianism, and (for women) religiosity; and lack of personal contact with sexual minorities. In regression analysis, sexual prejudice accounted for much of the variance in transgender attitudes, but respondent gender, educational level, authoritarianism, anti-egalitarianism, and (for women) religiosity remained significant predictors with sexual prejudice statistically controlled. Implications and directions for future research on attitudes toward transgender people are discussed.

Gender Affirmation: A Framework for Conceptualizing Risk Behavior Among Transgender Women of Color

Abstract: Experiences of stigma, discrimination, and violence as well as extreme health disparities and high rates of sexual risk behavior and substance use have been well-documented among transgender women of color. Using an intersectional approach and integrating prominent theories from stigma, eating disorders, and HIV-related research, this article offers a new framework for conceptualizing risk behavior among transgender women of color, specifically sexual risk behavior and risky body modification practices. This framework is centered on the concept of ‘gender affirmation,’ the process by which individuals are affirmed in their gender identity through social interactions. Qualitative data from 22 interviews with transgender women of color from the San Francisco Bay Area in the United States are analyzed and discussed in the context of the gender affirmation framework.

“Once You’ve Blended the Cake, You Can’t Take the Parts Back to the Main Ingredients”: Black Gay and Bisexual Men’s Descriptions and Experiences of Intersectionality

Abstract: Although Black gay and bisexual men have written eloquently about the intersections of race, gender, and sexual identity in anthologies such as Brother to Brother and In the Life, empirical studies of intersectionality with men, and Black gay and bisexual men in particular are rare. This qualitative study examined descriptions and experiences of intersectionality in individual interviews with 12 U.S. Black self-identified gay (n = 9) and bisexual (n =3) men in Washington, DC. Participants ranged in age from 21 and 44 (M = 36.33) and were predominantly highly educated and middle income. Research questions were: (1) How do participants describe and experience intersections of race, gender, and sexual identity?; (2) How do social processes shape their social identities?; (3) What are their challenges due to intersections of race, gender, and sexual identity?; and (4) What are the perceived benefits of these intersections? Analyses highlighted four key themes: (1) explicit and implicit descriptions of intersectionality; (2) the primacy of identities as Black and/or Black men first; (3) challenges such as negative stereotypes, racial microaggressions in mainstream and White LGB communities, heterosexism in Black communities, and gender role pressures to act “masculine”; and (4) perceived benefits such as psychological growth, liberation from traditional gender role or heteronormative expectations, and the freedom that being outsiders or “never being comfortable” confers in terms of exploring new opportunities and experiences. These findings imply that intersectionality can be expanded to incorporate the strengths/assets of intersectional identities in addition to oppression based on interlocking social identities.

(De)Subjugated Knowledges: An Introduction to Transgender Studies

Abstract: In , I found myself standing in line for my turn at the microphone in the Proshansky Auditorium of the Graduate Center of the City University of New York. I was attending a conference called “Lesbian and Gay History,” organized by the Center for Lesbian and Gay Studies (CLAGS). I had just attended a panel discussion on “Gender and the Homosexual Role,” moderated by Randolph Trumbach, whose speakers consisted of Will Roscoe, Martha Vicinus, George Chauncey, Ramon Gutierrez, Elizabeth Kennedy, and Martin Manalansan. I had heard a great many interesting things about fairies and berdaches (as two-spirit Native Americans were still being called), Corn Mothers and molly-houses, passionate female friendships, butch-femme dyads, and the Southeast Asian gay diaspora, but I was nevertheless standing in line to register a protest. Each of the panelists was an intellectual star in his or her own right, but they were not, I thought, taken collectively, a very genderdiverse lot. From my perspective, with a recently claimed transsexual identity, they all looked pretty much the same: like nontransgender people. A new wave of transgender scholarship, part of a broader queer intellectual movement was, by that point in time, already a few years old. Why were there no transgender speakers on the panel? Why was the entire discussion of “gender diversity” subsumed within a discussion of sexual desire-as if the only reason to express gender was to signal the mode of one’s attractions and availabilities to potential sex partners?

A longitudinal study of predictors of suicide attempts among lesbian, gay, bisexual, and transgender youth.

Abstract: This short-term prospective study examined general and lesbian, gay, bisexual, and transgender (LGBT)-specific risk and protective factors for suicide attempts in an ethnically diverse sample of LGBT youth (N = 237, 47.7 % male). A structured psychiatric interview assessed clinical depression and conduct disorder symptoms, as well as past and prospective suicide attempts over a 1-year follow-up period (91 % retention). Participants completed questionnaires measuring general risk factors for suicide attempts, including hopelessness, impulsiveness, and perceived social support. They also completed measures of LGBT-specific suicide risk factors, including gender nonconformity, age of first same-sex attraction, and LGBT victimization. Correlation and multivariate regression analyses were conducted to examine the relations between predictors and suicide attempt, and to identify mediators. Of nine variables examined, seven were related to lifetime history of attempted suicide: hopelessness, depression symptoms, conduct disorder symptoms, impulsivity, victimization, age of first same-sex attraction, and low family support. Depressive symptoms and hopelessness mediated the relation between multiple risk and resilience factors and suicide attempts. Suicide attempt history was the strongest predictor of prospective suicide attempts. Participants who previously attempted suicide (31.6 % of the sample) had more than 10 times greater odds of making another attempt in the 1-year follow-up period than were those who had made no previous attempt. These results highlight the need for suicide prevention programs for LGBT youth and suggest the importance of addressing depression and hopelessness as proximal determinants and family support and victimization, which have more distal effects.

Transgender Youth of Color and Resilience: Negotiating Oppression and Finding Support

Abstract: This qualitative study explored the resilience of 13 transgender youth of color in the southeastern region of the U.S. The definition of resilience framing this study was a participant’s ability to “bounce back” from challenging experiences as transgender youth of color. Using a phenomenological research tradition and a feminist, intersectionality (intercategorical) theoretical framework, the research question guiding the study was: “What are the daily lived experiences of resilience transgender youth of color describe as they negotiate intersections of transprejudice and racism?” The researchers’ individuated findings included five major domains of the essence of participants’ daily lived experiences of resilience despite experiencing racism and transprejudice: (1) evolving, simultaneous self-definition of racial/ethnic and gender identities, (2) being aware of adultism experiences, (3) self-advocacy in educational systems, (4) finding one’s place in the LGBTQQ (lesbian, gay, bisexual, transgender, queer, questioning) youth community, and (5) use of social media to affirm one’s identities as a transgender youth of color. Implications for practice, research, and advocacy, in addition to the study’s limitations are discussed.

The Effect of Negative School Climate on Academic Outcomes for LGBT Youth and the Role of In-School Supports

Abstract: For many lesbian, gay, bisexual, and transgender (LGBT) youth, intolerance and prejudice make school a hostile and dangerous place. This study examined simultaneously the effects of a negative school climate on achievement and the role that school-based supports—safe school policies, supportive school personnel, and gay–straight alliance (GSA) clubs—may have in offsetting these effects. Data were drawn from a survey of a diverse sample of 5,730 LGBT youths who had attended secondary schools in the United States. Results from structural equation modeling showed that victimization contributed to lower academic outcomes and lower self-esteem; however, school-based supports contributed to lower victimization and better academic outcomes. Moderating effects of supports on esteem and academic outcomes were also examined through hierarchical linear regression. Results suggested that a hostile school climate has serious ramifications for LGBT students but institutional supports can play a significant role in maki...

Approaches to Research on Intersectionality: Perspectives on Gender, LGBT, and Racial/Ethnic Identities

Abstract: Intersectionality theories, or the recognition of multiple interlocking identities, defined by relative sociocultural power and privilege, constitute a vital step forward in research across multiple domains of inquiry. This special issue, which extends Shields (2008) contribution in Sex Roles, provides an opportunity to reflect on past, present, and future promise in intersectionality scholarship. To provide a common ground for this work, each paper in this special issue addresses the intersections of gender; lesbian, gay, bisexual, and transgender (LGBT); and racial/ethnic identities and related experiences. In this introduction, we (1) provide an overview of definitions and conceptualizations of intersectionality, (2) discuss the various approaches utilized in this issue to conceptualize and assess gender, LGBT, and racial/ethnic identities, (3) describe how these conceptualizations and assessments were translated into analyses of intersectionality, and (4) close with a discussion of some additional approaches and considerations intended to advance intersectionality research.

Association for Lesbian, Gay, Bisexual, and Transgender Issues in Counseling Competencies for Counseling with Lesbian, Gay, Bisexual, Queer, Questioning, Intersex, and Ally Individuals

Abstract: This document is intended to provide counseling and related professionals with competencies for working with lesbian, gay, bisexual, queer, intersex, questioning and ally (LGBQIQA) individuals, gro...

An Argument for Separate Analyses of Attitudes Toward Lesbian, Gay, Bisexual Men, Bisexual Women, MtF and FtM Transgender Individuals

Abstract: While past research has certainly investigated a variety of correlates of U.S. attitudes toward lesbians, gays, bisexual men, bisexual women, male-to-female (MtF) and female-to-male (FtM) transgender (LGBT) individuals, there are no U.S. quantitative studies that could be located that examined attitudes toward each of these groups separately. This is especially important because efforts to combat prejudices are likely to be most successful if they are based in research that explores how attitudes are both similar and different across specified targets of prejudice. Toward that goal, this essay underscores the significance of examining U.S. attitudes toward LGBT individuals as separate constructs. Both the gender and sexual orientation of the target of prejudice and the gender and sexual orientation of the respondent are highlighted as important constructs that should be considered when investigating U.S. attitudes toward LGBT individuals. First, I review previous U.S. studies that have examined attitudes toward LGBT individuals. Second, I offer arguments for how the intersections of gender and sexual orientation may affect attitudes toward LGBT individuals. Third, I discuss future considerations in studies of attitudes toward LGBT individuals in the context of multiple intersectionalities. I suggest that U.S. initiatives to reduce sexual stigma, gender nonconformity stigma, and transgender stigma should be grounded in research that highlights prejudicial attitudes as they vary by the target of prejudice and the respondents’ characteristics.

A two-question method for assessing gender categories in the social and medical sciences.

Abstract: Three studies (N = 990) assessed the statistical reliability of two methods of determining gender identity that can capture transgender spectrum identities (i.e., current gender identities different from birth-assigned gender categories). Study 1 evaluated a single question with four response options (female, male, transgender, other) on university students. The missing data rate was higher than the valid response rates for transgender and other options using this method. Study 2 evaluated a method of asking two separate questions (i.e., one for current identity and another for birth-assigned category), with response options specific to each. Results showed no missing data and two times the transgender spectrum response rate compared to Study 1. Study 3 showed that the two-question method also worked in community samples, producing near-zero missing data. The two-question method also identified cisgender identities (same birth-assigned and current gender identity), making it a dynamic and desirable measurement tool for the social and medical sciences.

The impact of anticipated HIV stigma on delays in HIV testing behaviors: findings from a community-based sample of men who have sex with men and transgender women in New York City.

Abstract: Treatment as prevention (TaSP) is a critical component of biomedical interventions to prevent HIV transmission However, its success is predicated on testing and identifying undiagnosed individuals to ensure linkage and retention in HIV care Research has examined the impact of HIV-associated stigma on HIV-positive individuals, but little work has explored how anticipated HIV stigma–the expectation of rejection or discrimination against by others in the event of seroconversion—may serve as a barrier to HIV testing behaviors This study examined the association between anticipated stigma and HIV testing behaviors among a sample of 305 men who have sex with men (MSM) and transgender women living in New York City Participants' mean age was 330; 655% were racial/ethnic minority; and 502% earned <$20,000 per year Overall, 32% of participants had not had an HIV test in the past 6 months Anticipated stigma was negatively associated with risk perception In multivariate models, anticipated stigma, risk perception, and younger age were significant predictors of HIV testing behaviors Anti-HIV stigma campaigns targeting HIV-negative individuals may have the potential to significantly impact social norms around HIV testing and other biomedical strategies, such pre-exposure prophylaxis, at a critical moment for the redefinition of HIV prevention

We are despised in the hospitals: sex workers experiences of accessing health care in four African countries.

Abstract: Sex workers in east and southern Africa are exposed to multiple occupational health and safety risks. Detailed understanding of barriers to accessing care would optimise design of improved services for this population. In this study, trained sex workers conducted 55 in-depth interviews and 12 focus group discussions with 106 female, 26 male and 4 transgender sex workers across 6 urban sites in Kenya, Zimbabwe, Uganda and South Africa. Data were analysed thematically, following an interpretive framework. Participants cited numerous unmet health needs, including diagnosis and treatment for sexually transmitted infections and insufficient access to condoms and lubricant. Denial of treatment for injuries following physical assault or rape and general hostility from public-sector providers was common. Resources permitting, many sex workers attended private services, citing higher quality and respect for dignity and confidentiality. Sex workers in southern Africa accessed specialised sex worker clinics, reporting mostly positive experiences. Across sites, participants called for additional targeted services, but also sensitisation and training of public-sector providers. Criminalisation of sex workers and associated stigmatisation, particularly of transgender and male sex workers, hinder HIV-prevention efforts and render access to mainstream healthcare precarious. Alongside law reform, sex worker-led peer outreach work should be strengthened and calls by sex workers for additional targeted services heeded.

The Interplay between Online and Offline Explorations of Identity, Relationships, and Sex: A Mixed-Methods Study with LGBT Youth

Abstract: Although the Internet is commonly used by lesbian, gay, bisexual, and transgender (LGBT) youth to explore aspects of sexual health, little is known about how this usage relates to offline explorations and experiences. This study used a mixed-methods approach to investigate the interplay between online and offline explorations of multiple dimensions of sexual health, which include sexually transmitted infections, sexual identities, romantic relationships, and sexual behaviors. A diverse community sample of 32 LGBT youth (ages 16-24) completed semi-structured interviews, which were transcribed and then qualitatively coded to identify themes. Results indicated that, although many participants evaluated online sexual health resources with caution, they frequently used the Internet to compensate for perceived limitations in offline resources and relationships. Some participants turned to the Internet to find friends and romantic partners, citing the relative difficulty of establishing offline contact with LGBT peers. Further, participants perceived the Internet as an efficient way to discover offline LGBT events and services relevant to sexual health. These results suggest that LGBT youth are motivated to fill gaps in their offline sexual health resources (e.g., books and personal communications) with online information. The Internet is a setting that can be harnessed to provide support for the successful development of sexual health.

Gay--Straight Alliances Are Associated with Student Health: A Multischool Comparison of LGBTQ and Heterosexual Youth.

Abstract: Few studies have examined school-based factors associated with variability in the victimization and health of lesbian, gay, bisexual, transgender, and questioning (LGBTQ) youth. Among 15,965 students in 45 Wisconsin schools, we identified differences based on Gay–Straight Alliance (GSA) presence. Youth in schools with GSAs reported less truancy, smoking, drinking, suicide attempts, and sex with casual partners than those in schools without GSAs, with this difference being more sizable for LGBTQ than heterosexual youth. GSA-based differences were greatest for sexual minority girls on reported sex while using drugs. GSA effects were nonsignificant for general or homophobic victimization, grades, and school belonging. Findings suggest that GSAs could contribute to attenuating a range of health risks, particularly for LGBTQ youth.

Transgender patient perceptions of stigma in health care contexts.

Abstract: Objectives:Transgender individuals, or those who cross or transcend sex categories, commonly experience stigma and discrimination Anecdotal evidence indicates that this transphobia manifests in health care settings, but few studies address the forms of mistreatment experienced in this context This

The Daily Heterosexist Experiences Questionnaire: Measuring Minority Stress Among Lesbian, Gay, Bisexual, and Transgender Adults

Abstract: The authors conducted a three-phase, mixed-methods study to develop a self-report measure assessing the unique aspects of minority stress for lesbian, gay, bisexual, and transgender adults. The Daily Heterosexist Experiences Questionnaire has 50 items and nine subscales with acceptable internal reliability, and construct and concurrent validity. Mean sexual orientation and gender differences were found.

LGBT Sexuality and Families at the Start of the Twenty-First Century

Abstract: Since the start of the twenty-first century, the literature on same-sex couple relationships and families headed by single parents who identify as lesbian or gay has grown exponentially, and research published in the past 10 to 15 years tackles many new questions about sexual minority families. This review concentrates on four topics that have dominated the sociological arena: who counts as family and how/whether changing definitions of family incorporate households formed by lesbian, gay, bisexual, and transgender (LGBT) people; the biological, social, and legal obstacles that influence family formation for this population; the outcomes for youth raised with lesbian or gay parents; and family dynamics, relationship quality, and relationship dissolution in same-sex couple and transgender partner households. We conclude with future directions for the sociological study of LGBT sexuality and families.

Office-Based Care for Lesbian, Gay, Bisexual, Transgender, and Questioning Youth

Abstract: American Academy of Pediatrics issued its last statement on ho- mosexuality and adolescents in 2004.This technical report reflects the rapidly expanding medical and psychosocial literature about sexual minority youth. Pediatricians should be aware that some youth in their care may have concerns or questions about their sexual orientation or that of siblings, friends, parents, relatives, or others and should pro- vide factual, current, nonjudgmental information in a confidential man- ner. Although most lesbian, gay, bisexual, transgender, and questioning (LGBTQ) youth are quite resilient and emerge from adolescence as healthy adults, the effects of homophobia and heterosexism can con- tribute to increased mental health issues for sexual minority youth. LGBTQ and MSM/WSW (men having sex with men and women having sex with women) adolescents, in comparison with heterosexual ado- lescents, have higher rates of depression and suicidal ideation, higher rates of substance abuse, and more risky sexual behaviors. Obtaining a comprehensive, confidential, developmentally appropriate adoles- cent psychosocial history allows for the discovery of strengths and assets as well as risks. Pediatricians should have offices that are teen-friendly and welcoming to sexual minority youth. This includes having supportive, engaging office staff members who ensure that there are no barriers to care. For transgender youth, pediatricians should provide the opportunity to acknowledge and affirm their feel- ings of gender dysphoria and desires to transition to the opposite gen- der. Referral of transgender youth to a qualified mental health professional is critical to assist with the dysphoria, to educate them, and to assess their readiness for transition. With appropriate assis- tance and care, sexual minority youth should live healthy, productive lives while transitioning through adolescence and young adulthood. Pediatrics 2013;132:e297-e313

Seeking Support: Transgender Client Experiences with Mental Health Services

Abstract: Mental health research and practice has traditionally maintained a view of transgender people through the narrow lens of gender identity disorder. Recently, broader understandings of gender have influenced affirmative therapy with transgender clients. The purpose of the present research is to critically review historical views of transgender clients and to highlight experiences of transgender clients in therapy. Feminist phenomenology informed in-depth interviews with seven people who self-identify as transgender. Four themes emerged: the purposes transgender clients sought therapy, problems in practice, therapist reputation, and transgender affirmative therapy. Transgender affirmative practice and training implications are discussed.

Putting the “T” in “Resource”: The Benefits of LGBT-Related School Resources for Transgender Youth

Abstract: This study examines the availability and effectiveness of lesbian, gay, bisexual, and transgender (LGBT)-related school resources for a national sample of transgender youth (N = 409), as compared to a national sample of LGB cisgender (non-transgender) youth (N = 6,444). All four examined resources—gay–straight alliances (GSAs), supportive educators, LGBT-inclusive curricula, and comprehensive anti-bullying/anti-harassment policies which include specific protections for LGBT students—were related to decreased absenteeism. Three of the four resources (except for comprehensive anti-bullying/anti-harassment policies) were related to lower levels of victimization. The results indicated that the resources provided benefits for transgender and cisgender LGB students alike, yet the positive effects of policies and GSAs were even stronger for transgender youth.

Transgender Emotional and Coping Processes Facilitative and Avoidant Coping Throughout Gender Transitioning

Abstract: Eighteen transgender-identified individuals participated in semi-structured interviews regarding emotional and coping processes throughout their gender transition. The authors used grounded theory to conceptualize and analyze the data. There were three distinct phases through which the participants described emotional and coping experiences: (a) pretransition, (b) during the transition, and (c) posttransition. Five separate themes emerged, including descriptions of coping mechanisms, emotional hardship, lack of support, positive social support, and affirmative emotional experiences. The authors developed a model to describe the role of coping mechanisms and support experienced throughout the transition process. As participants continued through their transitions, emotional hardships lessened and they used facilitative coping mechanisms that in turn led to affirmative emotional experiences. The results of this study are indicative of the importance of guiding transgender individuals through facilitative co...

Perceptions of Campus Climate by Sexual Minorities

Abstract: Previous research has indicated that students who identify as lesbian, gay, bisexual, or transgender (LGBT) often have negative experiences on university campuses due to their sexual orientation or gender identity. Direct and indirect experiences contribute to an overall perception of the campus climate. This study used an online survey to assess students' perceptions of campus climate, their experiences confronting bias, support of family members and friends, and whether they had considered leaving campus. Multiple regression analysis indicated that perceptions of poorer campus climate were predicted by greater unfair treatment by instructors, more impact from anti-lesbian, gay, bisexual, transgender, or queer (LGBTQ) bias on friends’ and families’ emotional support, and having hidden one's LGBT identity from other students. Cluster analyses revealed four groups of participants distinguished by openness about their sexual orientation and negative experiences, with one group appearing to be at risk for po...