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332452
Gender and racial discrimination significantly increases risk for mental health problems among trans*female youth


Tuesday, November 3, 2015

Sean Arayasirikul, PhD Candidate, Center for Public Health Research, San Francisco Department of Public Health, San Francisco, CA
Yea-Hung Chen, MS, Center for Public Health Research, SFDPH, San Francisco, CA
Erin C. Wilson, DrPH, Center for Public Health Research, San Francisco Department of Public Health, San Francisco, CA
H. Fisher Raymond, DrPH, MPH, Center for Public Health Research, San Francisco Department of Public Health, San Francisco, CA
Willi McFarland, MD, PhD, MPH&TM, Center for Public Health Research, San Francisco Department of Public Health, San Francisco, CA
Background: Racial discrimination on top of gender-based stigma may exert a profound effect on HIV risk among trans*female youth. This study was conducted to determine the effect of racial and gender-based discrimination on mental health problems and substance – two key factors that predict engagement in high-risk sexual behaviors.

Methods: This analysis used cross sectional data from 282 trans*female youth ages 16-24 in the San Francisco Bay Area. Odds ratios adjusted for age and race were calculated to assess differences between youths with low versus high levels of exposure to racial discrimination, gender-based discrimination, and both on psychological distress, post-traumatic stress syndrome (PTSD), depression and substance use.

Results: Trans*female youth who experienced high vs. low exposure to gender-related discrimination had significantly increased odds for psychological distress (AOR, 2.29; 95% CI, 1.3-6.9), PTSD (AOR, 2.8; 95% CI, 1.6-5.0), and depression (AOR, 2.3; 95% CI, 1.2-4.3). Those with high exposure to racial discrimination had significantly increased odds for psychological distress (AOR 4.1; 91% CI 1.6-10.7) and PTSD (AOR 2.1; 95% CI 1.1-4.2). Those who experienced high exposure to both had significantly increased odds for psychological distress (AOR 3.4; 91% CI 1.3-9.2) and PTSD (AOR 2.7; 95% CI 1.2-6.3).

Discussion: Trans*female youth with high exposure to both racial and gender-based discrimination had more than twice the odds of exhibiting mental health problems. For trans*female youth, interventions and programs that address the stressors related to racial and gender-based discrimination may have a critical impact on risk for substance use and HIV.

Learning Areas:

Epidemiology
Planning of health education strategies, interventions, and programs
Program planning
Public health or related public policy
Public health or related research
Social and behavioral sciences

Learning Objectives:
Describe the link between mental health problems, substance use and HIV risk trans*female youth. Discuss ways in which trans*female youth face racial and gender-based discrimination. Explain the importance of addressing discrimination-related stressors on HIV risk for trans*female youth.

Keyword(s): Mental Health, Lesbian, Gay, Bisexual and Transgender (LGBT)

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I have been the principal or co-principal of multiple federally funded grants focusing on the social epidemiology of HIV among transgender people, including youth, women and men, for over 13 years. Among my scientific interests has been the development of strategies for preventing HIV among
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.

Back to: 4276.0: HIV Prevention Among Specific Populations