TransConnect: A mixed methods study of pathways to health for Black and Latinx transgender women who have survived violence
Embargo until
2020-05-01
Date
2019-04-25
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Publisher
Johns Hopkins University
Abstract
Background: Transgender women are disproportionately affected by violence and accompanying adverse mental health. Widespread stigma has led to delays in help-seeking and modifiable factors to improve outcomes for transgender women have yet to be fully understood. This mixed methods study investigates the influence of transgender community connection (TCC) on mental health and help-seeking post-violence for Black and Latinx transgender women (BLTW).
Methods: Phase I consisted of secondary data analysis using multiple linear regression (N=197 BLTW). Phase II collected quantitative and qualitative data from 19 Black transgender women (BTW). Phase II interviews were transcribed, coded, and analyzed using thematic content analysis guided by principals of narrative analysis. All findings were then integrated and interpreted.
Results: In both phases, there was a nearly universal exposure to polyvictimization, which was significantly associated with increased symptoms of depression and post-traumatic stress disorder (PTSD). Among Phase II participants, experiences of violence and the help-seeking process were influenced by stigmas related to race and gender expression. In both phases, emotional TCC was not significantly associated with PTSD and did not moderate the relationship between polyvictimization and mental health in Phase I; however, in Phase II, was significantly associated (r=-.473; p<.05) with depression symptoms. In Phase II, behavioral participation with trans* community members was commonly reported as an informal source of support and helped connect participants to formal sources of care post-violence. Additionally, trans* and LGBTQ+ serving institutions were noted as common sources of help but had negative factors including risk of loss of confidentiality and discrimination.
Discussion: These findings highlight the association of polyvictimization and mental health for BLTW and support current research on the cumulative effects of violence. It is unclear whether emotional TCC plays a significant role in the relationship between polyvictimization and mental health; however, behavioral participation with trans* community members or organizations was noted as instrumental to seeking and receiving support post-exposure to violence. Service providers and nurses who work with trans* people should assess for polyvictimization not only as part of their routine risk assessments for mental health disorder, but also consider the impact of polyvictimization when developing person-centered health interventions.
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Keywords
MTF, gender minority, social support, discrimination, help-seeking, polyvictimization, depression, PTSD, community connection