Online Program

Social and economic marginalization as determinant of health and well-being among transgender young adults in the Detroit Metro Area

Monday, November 2, 2015

Laura Jadwin-Cakmak, MPH, Center for Sexuality and Health Disparities, University of Michigan School of Public Health, Ann Arbor, MI
José A. Bauermeister, MPH, PhD, Department of Health Behavior and Health Education, University of Michigan, Ann Arbor, MI
Sari Reisner, ScD, Epidemiology/ The Fenway Institute, Harvard School of Public Health/ Fenway Health, Boston, MA

Emily Pingel, MPH, Center for Sexuality and Health Disparities (SexLab), University of Michigan School of Public Health, Ann Arbor, MI
Gary W. Harper, PhD, MPH, Department of Health Behavior and Health Education, University of Michigan School of Public Health, Ann Arbor, MI
Transgender populations in the U.S. are overburdened by preventable inequities in poor health and social well-being. Most transgender research focuses on individual-level correlates affecting the community’s health, ignoring the multi-level socioecological determinants (e.g., economic marginalization) influencing health behaviors and outcomes in transgender young adults. This study explored the prevalence of indicators of socioeconomic status among a sample of transgender youth (N=30) using quantitative data collected in 2012 for a cross-sectional observational study examining the structural and psychosocial vulnerabilities experienced by a convenience sample of sexual minority young men and transgender young adults (ages 18-29) in the Detroit Metro Area.

A majority (70%; N=21) of the sample reported past year income below the Federal Poverty Line; more than one third (36.6%; N=11) had spent at least one night homeless or transient in the past 30 days; 64.4% (N=19) were unemployed; and two-thirds (66.6%; N=20) had engaged in transactional sex in their lifetime. Economic status was salient in multiple aspects of participants’ lives. The top two reasons chosen for delaying needed medical care in the previous year were cost and transportation. When asked about their hopes and dreams for the future, goals identified as most important included being financially secure and owning a home.

Social and economic factors are key determinants of health for transgender young adults. Local- and national-level programmatic and policy interventions are recommended to alleviate the economic stress experienced by many transgender young adults and improve their health and social well-being.

Learning Areas:

Advocacy for health and health education
Program planning
Public health or related public policy
Public health or related research
Social and behavioral sciences

Learning Objectives:
Describe the connection between socioeconomic marginalization on the health and well-being of transgender young adults. Identify the importance of considering structural-level factors such as socioeconomic status when proposing interventions aimed at improving health behaviors and health outcomes among transgender young adults. Describe programmatic and policy changes that can be made to alleviate the economic marginalization experienced by many transgender young adults.

Keyword(s): Lesbian, Gay, Bisexual and Transgender (LGBT), Health Disparities/Inequities

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I have been the Project Director of multiple federally funded grants focusing on the health and well-being of LGBT populations, including a current study to assess the engagement of gender minority youth in the HIV continuum of care. My scientific interests include understanding and addressing the social and structural factors impacting health.
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.

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