Transgender stigma and health: A critical review of stigma determinants, mechanisms, and interventions

Abstract

Rationale Transgender people in the United States experience widespread prejudice, discrimination, violence, and other forms of stigma. Objective This critical review aims to integrate the literature on stigma towards transgender people in the US. Results This review demonstrates that transgender stigma limits opportunities and access to resources in a number of critical domains (e.g., employment, healthcare), persistently affecting the physical and mental health of transgender people. The applied social ecological model employed here elucidates that transgender stigma operates at multiple levels (i.e., individual, interpersonal, structural) to impact health. Stigma prevention and coping interventions hold promise for reducing stigma and its adverse health-related effects in transgender populations. Conclusion Additional research is needed to document the causal relationship between stigma and adverse health as well as the mediators and moderators of stigma in US transgender populations. Multi-level interventions to prevent stigma towards transgender people are warranted.

A comparison of health disparities among transgender adults in Colorado (USA) by race and income

“…Transgender individuals face a variety of risks for discrimination, harassment, and violence that impact their psychosocial well-being and physical health (Bockting, Miner, Swinburne Romine, Hamilton, & Coleman, 2013;Edelman et al, 2015;Grant et al, 2011;Kosenko, Rintamaki, Raney, & Maness, 2013;White Hughto, Reisner, & Pachankis, 2015). However, few studies have thoroughly examined the general physical and mental health of transgender adults (Coulter, Kenst, Bowen, & Scout, 2014;Grant et al 2011; Institute of Medicine [IOM], 2011; MacCarthy, Reisner, Nunn, Perez-Brumer, & Operario, 2014).…”

Factors Associated with Medical Doctors' Intentions to Discriminate Against Transgender Patients in Kuala Lumpur, Malaysia

“…Stigma is a multilevel phenomenon that affects transgender experience at the structural, interpersonal, and individual levels. 1,2 This study used a nuanced scale that distinguishes between multiple stigma-related constructs at the interpersonal level, which is critical to identifying specific intervention targets that are highly associated with healthcare providers' intentions to discriminate against transgender people. Our findings suggest opportunities for intervention in at least two settings: early medical education and continuing medical education (CME) for healthcare providers.…”

“…The implementation of a CME session based on the theory underlying the contact hypothesis 33 -bringing transgender people to present to physicians or a community physician who specializes in transgender-specific care-could reduce feelings of shame and fear among physicians about transgender people. 2 Integration of the basic tenets of medicine-the Hippocratic oath and the duty to provide nondiscriminatory care to all of their patients 49 -within these CME sessions may address the belief among some physicians that transgender people are not as equally deserving of good care as other patients.…”

“…W orldwide, transgender people face systematic oppression and devaluation as a result of stigma, 1,2 which is a social process involving social devaluation and discrediting of individuals whose assigned sex at birth (i.e., male or female) differs from their current gender identity or expression. 3 The total worldwide population of transgender people is unclear; however, estimates suggest that worldwide 0.5%-1.3% of birth-assigned males and 0.4%-1.2% of birth-assigned females identify as transgender.…”

“…For example, transgender individuals report significant verbal and physical harassment from cisgender (i.e., non-transgender) individuals. 2,4,7 Transgender people who face discrimination from others are at an increased risk of poor health outcomes, including depression, suicidality, substance use, and HIV. [8][9][10][11] Although discrimination against transgender people is an issue across the globe, Malaysia is unique in that it has a sizable transgender population.…”