Perceived Barriers to HIV Prevention Services for Transgender Youth

Fisher, Celia B.; Fried, Adam L.; Desmond, Margaret; Macapagal, Kathryn; Mustanski, Brian

doi:10.1089/lgbt.2017.0098

Cited by 59 publications

(62 citation statements)

References 45 publications

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“…When faced with experiences of constant discrimination and violence, TGD individuals feel exhausted, develop a concern about their safety, and may begin to anticipate rejection or avoid settings where they either have or could encounter marginalization (Puckett, Cleary, Rossman, Mustanski, & Newcomb, ; Rood et al, ). For instance, many TGD youth fear stigma from their medical providers (Fisher, Fried, Desmond, Macapagal, & Mustanski, ) and TGD individuals who encounter discrimination in health care settings may be more likely to avoid or delay seeking treatment (Glick et al, ). This prior research shows that discrimination has implications for many aspects of TGD people's lives.…”

Section: Discrimination and Psychological Distressmentioning

confidence: 99%

Coping with discrimination: The insidious effects of gender minority stigma on depression and anxiety in transgender individuals

et al. 2019

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Objectives We examined types of discrimination encountered by transgender and gender diverse (TGD) individuals and the associations with symptoms of depression and anxiety, as well as the mediating and moderating effects of coping responses. Method This online study included 695 TGD individuals ages 16 years and over (M = 25.52; standard deviation = 9.68). Results Most participants (76.1%) reported discrimination over the past year. Greater exposure to discrimination was associated with more symptoms of depression and anxiety. These associations were mediated by coping via detachment and via internalization, although a direct effect remained. Conclusions Many TGD people will encounter discrimination and this is associated with greater psychological distress. Engagement in the internalization of blame or detachment partially explains the association between discrimination and mental health issues. These findings elucidate possible avenues for interventions to bolster adaptive coping responses for TGD people and highlight that actions to decrease discrimination are urgently needed.

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Section: Discrimination and Psychological Distressmentioning

confidence: 99%

Coping with discrimination: The insidious effects of gender minority stigma on depression and anxiety in transgender individuals

et al. 2019

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“…Adults with nonbinary identities report difficulty accessing affirming health care, even in clinics designed to provide care for transgender patients . Among transgender and gender nonconforming youth, nonbinary youth are less likely to be out to their primary parent or guardian than transgender peers with binary identities . The few studies that have examined mental health among youth with nonbinary identities have shown high rates of attempted suicide, low mental health scores, and high rates of self‐harm .…”

Section: School Experiences For Tng Youthmentioning

confidence: 99%

At the Margins: Comparing School Experiences of Nonbinary and Binary‐Identified Transgender Youth

Allen

Andert²,

Botsford³

et al. 2020

Journal of School Health

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BACKGROUND Transgender, nonbinary, and gender nonconforming (TNG) young people are a diverse group, including young people with gender identities beyond the gender binary. Whereas nonbinary youth experience disparities in victimization and mental health, school belonging, support, and resources have not been well described. METHODSWe conducted an online survey of TNG young people (ages 12-22) in Wisconsin to assess school belonging, safety, support, and resources. We compared responses among participants with nonbinary versus binary identities using mulvariate analysis of variance, multivariate analysis of covariance, chi-square and logistic regression analysis. RESULTSA total of 287 TNG young people met inclusion criteria (average age 18.2 ± 2.5 years). More than 40% of participants identified as nonbinary. Nonbinary participants were less likely to be out to teachers, but more likely to utilize supportive staff as a resource compared to binary-identified TNG peers. There were no significant differences in school safety and belonging.CONCLUSIONS Most school experiences do not vary significantly between TNG young people with binary versus nonbinary gender identities, though nonbinary young people are less likely to be out at school. Future research should examine factors that impact whether nonbinary young people share their gender identity and access school support services.Citation: Allen BJ, Andert B, Botsford J, Budge SL, Rehm JL. At the margins: comparing school experiences of nonbinary and binary-identified transgender youth.T ransgender, nonbinary, and gender nonconforming (TNG) people have been increasingly recognized as a diverse group including individuals that span geography and culture. 1-3 Day-to-day stress related to discrimination, internalized and externalized transphobia, and victimization, well-outlined in the Intersectional Ecological Model of LGBTQ health, is a widely accepted explanation for mental health and a Assistant Professor, (bjallen@pediatrics.wisc.edu), Indicates CHES continuing education hours are available. Also available at http://www.ashaweb.org/continuing_education.html physical health as well as socioeconomic disparities seen in TNG populations. 4 For most young people, school experiences are central in the day-to-day structure of their lives and social relationships; therefore, experiences of discrimination, safety, and belonging at school are critical to understand in assessing how these environments impact the wellness of TNG young people.

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“…Half (50%) of the participants identified as transgender women, 38% as cisgender men, and 12% as transgender men. Participant median age was 26 years (range [18][19][20][21][22][23][24][25][26][27][28][29].…”

Section: Resultsmentioning

confidence: 99%

“…This setting allowed providers to address barriers to PrEP access that have been previously described, such as high cost and provider hesitation to discuss PrEP and/or gender identity. [16][17][18] Despite providing services in a setting specifically designed for LGBTQ youth, both retention and adherence were suboptimal. This is consistent with other studies of PrEP adherence among transgender women 19 and young men who have sex with men 5,6 in which a majority of participants did not have evidence of highly protective drug levels over time.…”

Section: Discussionmentioning

confidence: 99%

Outcomes of a PrEP Demonstration Project with LGBTQ Youth in a Community-Based Clinic Setting with Integrated Gender-Affirming Care

et al. 2020

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Lesbian, gay, bisexual, transgender, and queer/questioning (LGBTQ) youth are disproportionately affected by HIV, and young transgender women (YTW) are especially impacted. The purpose of this small demonstration project was to measure pre-exposure prophylaxis (PrEP) adherence in a community-based clinic for LGBTQ youth in which PrEP services are integrated with gender-affirming care. Of the 50 enrolled participants, 38 had a serum drug assay performed after three or more months and 26% of those had laboratory evidence of highly protective levels of medication. Low adherence highlights the need for culturally tailored follow-up efforts and assistance with the structural barriers to health experienced by LGBTQ youth, especially YTW.

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Perceived Barriers to HIV Prevention Services for Transgender Youth

Abstract: Transgender youth may not discuss their GSM identity or sexual health with PCPs because they anticipate GSM stigma and fear being "outed" to parents. PCPs should receive transgender-inclusive training to adequately address youths' sexual health needs and privacy concerns.

Cited by 59 publications

References 45 publications

Coping with discrimination: The insidious effects of gender minority stigma on depression and anxiety in transgender individuals

Coping with discrimination: The insidious effects of gender minority stigma on depression and anxiety in transgender individuals

At the Margins: Comparing School Experiences of Nonbinary and Binary‐Identified Transgender Youth

Outcomes of a PrEP Demonstration Project with LGBTQ Youth in a Community-Based Clinic Setting with Integrated Gender-Affirming Care

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