Correlates of discrimination: Understanding sexual health and well-being among transgender female youth in Northern California

Objective: This study examines the extent to which ethnoracial-based and gender-based discrimination are associated with sexual health and feminization outcomes among transgender female youth.

Methods: We used preliminary baseline data collected from the Shine Study, a respondent-driven sample survey of youth (ages 16-24) who self-identified as transgender female. We initially calculated Pearson product-moment and Spearman rho correlations to assess relationships between discrimination type and sexual health, as well as between feminization procedures. Next, partial correlations were computed to assess the role of social support type and insurance status as correlation influences.

Results: The sample (N=239) was ethnoracially diverse (Asian=6%, Black=13%, Latino=31%, White=34%, Multiracial=10%), with a mean age of 21. Significant relationships were seen between ethnoracial-based discrimination and ever having done sex work (p=0.019), as well as inverse relationships between current hormone use (p=0.002) and having had feminization surgery (p=0.005). With respect to gender-based discrimination, significant relationships were seen between ever having done sex work (p<0.001), drug use during sex (p=0.037), and total instances of unprotected anal intercourse (p=0.019). While 79% of the sample reported having insurance, no significant associations were seen when controlling for insurance status. Further, 30% of the sample reported receiving most support from their friends, followed by parents (16%) and chosen family (14%); however, controlling for support type did not reveal significant correlations.  

Conclusion: The effects of ethnoracial-based and gender-based discrimination type can vary greatly among health outcomes of transgender female youth. Devising strategies specific to these differences may help in reducing health disparities among the population.