Familial Rejection and Psychological Distress Among Young Transgender Women in Chicago and Boston Público

Abstract

Purpose: The central aim of this analysis is to investigate the association between transphobia, sex work, familial rejection and psychological distress and social support, among young transgender women (YTW) aged 16-29.

Methods: These data were collected via in-person surveys. A total of 300 YTW ages 16-29 were recruited through multiple convenience and referral-based sampling techniques and were enrolled over a period of 36 months. Three surveys were incomplete, thus this analysis examines data from a sample of n=297 YTW. Two outcomes were modeled using multivariate regression: self-reported psychological distress and social support. Key covariates included internalized, perceived, and experienced stigma; history of sex work, and relationship equity. Models controlled for age, race/ethnicity, and education.

Results: Nearly half of the sample reported a history of sex work (n=147), and more than 30% reported having attempted suicide in their lifetime (n=90). In this sample, 39.4% (n=117) reported at least one instance of familial rejection from an immediate family member. Women who reported instances of familial rejection experienced a 6.23 unit increase in psychological distress (95% CI: 2.38, 10.08; p: 0.002).

Conclusion: There are significant gaps in the literature addressing transgender health, and too few studies explore familial rejection and psychological distress among transgender women with a history of sex work. The strong association between familial rejection and experiences of psychological distress and suicidality highlights a need for more research. This finding also suggests a critical gap in education for the families of YTW, which could be addressed through evidence-based public health interventions.

Table of Contents

CHAPTER I: INTRODUCTION ---- 1

OBJECTIVES AND AIMS ---- 4

TRANSPHOBIA - INTERNALIZED STIGMA; PERCEIVED STIGMA; AND EXPERIENCED STIGMA ---- 5

SEX WORK ---- 6

RELATIONSHIP POWER ---- 7

CHAPTER II: MANUSCRIPT ---- 8

INTRODUCTION ---- 12

BACKGROUND ---- 12

DATA & METHODS ---- 14

MEASUREMENTS ---- 17

Relationship Power ---- 17

Psychological Distress ---- 18

Social Support ---- 18

Transphobia ---- 19

RESULTS ---- 24

DISCUSSION ---- 29

CONCLUSION ---- 35

APPENDICES ---- 37

CHAPTER III: RECOMMENDATIONS ---- 42

PUBLIC HEALTH IMPLICATIONS ---- 42

CHAPTER IV: REFERENCES ---- 50

About this Master's Thesis

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School	Rollins School of Public Health
Department	Hubert Department of Global Health
Degree	MPH
Submission	Master's Thesis
Language	English
Research Field	Health Sciences, Public Health Health Sciences, Mental Health Sociology, Theory and Methods
Palabra Clave	Psychological Distress Transgender Familial Rejection
Committee Chair / Thesis Advisor	Stephenson, Robert, Emory University
Committee Members	Miedema, Stephanie Spaid, Emory University
Partnering Agencies	Hospital or other health care provider

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