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. 2019 Oct;65(4):483-490.
doi: 10.1016/j.jadohealth.2019.04.029. Epub 2019 Jul 11.

Stigma, Gender Affirmation, and Primary Healthcare Use Among Black Transgender Youth

Tamar Goldenberg  1 , Laura Jadwin-Cakmak  2 , Elliot Popoff  2 , Sari L Reisner  3 , Bré A Campbell  4 , Gary W Harper  2
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Free PMC article

Stigma, Gender Affirmation, and Primary Healthcare Use Among Black Transgender Youth

Tamar Goldenberg et al. J Adolesc Health. 2019 Oct.
Free PMC article

Abstract

Purpose: Healthcare access is important for achieving health equity across vulnerable social groups. However, stigma can be a barrier for accessing healthcare among black transgender and gender diverse youth (TGDY) in the U.S. Using a resilience approach, this article examines the role of gender affirmation within healthcare to determine if it can mitigate the negative relationship between stigma and healthcare use.

Methods: Data include responses from 110 black TGDY from 14 U.S. cities. Multiple logistic regression models were fit to determine relationships between stigma in healthcare (anticipated and enacted), gender affirmation in healthcare, and delayed/nonuse of primary care. Interaction terms were included to determine if gender affirmation moderates the relationship between stigma and healthcare nonuse.

Results: In the main effects model, gender affirmation was the only variable statistically associated with healthcare nonuse. The interaction between gender affirmation and enacted stigma was not significant, but gender affirmation moderated the relationship between anticipated stigma and healthcare nonuse. For individuals who did not have their gender affirmation needs met, as anticipated stigma increased, healthcare nonuse also increased; however, this did not occur for those who had their gender affirmation needs met.

Conclusions: Findings suggest that gender affirmation within healthcare is important for increasing access to care among black TGDY. Interventions should consider how to increase gender affirmation among healthcare providers and within healthcare settings. Additional research using an intersectional approach to understand the experiences of black TGDY is needed to highlight the unique healthcare needs of this population.

Keywords: Gender affirmation; Healthcare; Resilience; Stigma; Transgender; Youth.

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Figure 1:
Figure 1:
The role of gender affirmation in healthcare as a moderating factor between anticipated stigma and the predicted probability of delaying or not using primary healthcare among Black transgender youth (n=110)
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