Employment, mental health, internalized stigma, and coping with transphobia among transgender individuals.

Abstract

Transgender individuals encounter stigma related to nonconforming gender identity, contributing to elevated symptoms of depression, anxiety, and suicidality. Stigma toward transgender individuals (i.e., transphobia) poses significant barriers to employment and other areas of functioning. Transgender individuals with a history of mental health concerns may encounter double stigma. The present 2-part study was conducted to investigate experiences of double stigma, internalized stigma, and coping strategies for dealing with transphobia. In Study 1, quantitative findings with 55 transgender participants indicated that employed participants reported higher levels of stigma (both internalized and external). Higher levels of coping with stigma were associated with lower levels of stigma (both internalized and external). Higher levels of coping were reported by participants utilizing psychiatric medication, with lower levels of coping with mental health stigma in particular found among those receiving outpatient mental health services. In Study 2, a grounded theory analysis was conducted with 45 of these participants to identify coping strategies that transgender individuals use to deal with transphobia. Coping strategies were categorized into individual factors (gender normative coping, self-affirmative coping, emotional regulation coping, cognitive reframe coping); interpersonal factors (social-relational coping, preventative-preparative coping, disengagement coping); and systemic factors (resource access coping, spiritual and religious coping, and political empowerment coping). Findings of Study 2 also revealed the presence of disclosure strategies-decisions to reveal or conceal one's transgender identity, and anticipatory stigma-expecting and preparing for prejudice and discrimination. Results suggest the need for interventions for transgender individuals to enhance coping with stigma and reduce internalized stigma.

Geographic and Individual Differences in Healthcare Access for U.S. Transgender Adults: A Multilevel Analysis

“…3 Among this sample, mistreatment was significantly associated with avoidance of necessary medical care when sick or injured, as well as routine preventive care. The relationship between mistreatment and healthcare avoidance among transgender people has been confirmed by previous studies 4,5 and literature supports a rejection sensitivity model in which stigmatized individuals nervously anticipate (hypervigilance), routinely observe (perceived stigma), and ultimately, anxiously react to rejection (e.g., healthcare avoidance). 6 While healthcare avoidance may be initially protective against the psychological distress associated with stigmatizing healthcare encounters, avoiding healthcare can have serious adverse health consequences, including delaying care to the point that one experiences a medical emergency.…”

“…4,5,9,25,36,51,54,59,60 Our findings uniquely demonstrate that, in addition to individual-level demographic and behavioral factors, the social climate of a state as measured through partisan voting practices is a strong indicator of experiencing care refusal among U.S. transgender individuals. By identifying areas where access to care barriers exist, these findings pave the way for the development of targeted public health research, programming, and intervention efforts aimed at achieving transgender health equity.…”

Cultura y valores en el proceso de discriminación de las personas transgénero

“…Debido a los diversos factores culturales, socio-políticos y religiosos asociados a la sexualidad y las normas de género que históricamente han llevado a la negación de su existencia, la población transgénero se encuentra en situación de vulnerabilidad social (Barrón López et al, 2008), siendo sistemáticamente discriminada y excluida desde muy temprana edad de sus ámbitos familiares y educativos, así como del mercado laboral formal y del sistema de salud (FH, 2012;Mizock & Mueser, 2014). Así, como la misma APA pág.…”

Health Disparities, Risk Behaviors and Healthcare Utilization Among Transgender Women in Los Angeles County: A Comparison from 1998–1999 to 2015–2016

“…Among transgender women, experiences of harassment and abuse are associated with anxiety, depression, PTSD, and suicidality (47–50). These mental health correlates have been reported as significant barriers to employment and general functioning among transgender individuals (6, 51); thus, placing transgender individuals at increased risk of poverty (3, 8) and its associated detrimental health consequences. Given these results, the cyclical and syndemic nature of structural and interpersonal barriers to adequate health and wellbeing among transgender women is immense.…”