Hangin' in Harlem: Poverty-class/low-income transfeminine and transmasculine people of color in New York City

Introduction: Public health research has revealed 50% HIV seroprevalence among poverty-class/low-income transfeminine (MTF) people of color, along with vulnerabilities to substance use and depression/suicidality. Much less research has been conducted among poverty-class/low-income transmasculine (FTM) people of color, and there has been no comprehensive public health research specifically focusing on this latter population.

Objective: This paper will present preliminary findings from focus groups conducted among both poverty-class/low-income transfeminine and transmasculine people of color populations. Findings on gender identities, social networks, relationships, abuse/violence, sexual behaviors, substance use, mental health, and HIV risk behaviors will be discussed. The majority of participants is or was affiliated with the Ball community and lived in poverty-class/low-income people of color neighborhoods.

Methods: N=7 transfeminine persons and N=13 transmasculine persons participated in focus groups. Participant observation was also conducted among 300 poverty-class/low-income trans/gender-variant people of color.

Results: Transmasculine people appeared to have slightly more access to resources compared to transfeminine persons. Gender identities appeared to be nuanced and complex. Transfeminine persons were mostly androphilic and transmasculine persons were mostly gynephilic/transgynephilic. For some participants violence was normalized, especially IPV. Substance use was also highly prevalent among some participants. Depression, suicidality, anxiety, and panic attacks were also common. HIV testing was common but some transfeminine persons engaged in unprotected sex with cis-gendered males of unknown HIV status. Participants often accessed healthcare services in Harlem and the South Bronx and preferred accessing healthcare in these socio-geographic enclaves.

Conclusion: Both the social contexts of Ball-affiliation and the neighborhood context of Harlem, where the focus groups were conducted, provided a socio-geographic context that seemed very comfortable for all participants. Certain facets of resource-based social capital such as “thick trust” (Rostila, 2011) were integral in determining the establishment of social ties and networks and consequently where and how healthcare services were provided and accessed.