A Three Paper Examination of Social Inequity and Health and Illness among Transwomen

Transwomen are among the most vulnerable populations in the United States and are disproportionately at risk for HIV and other negative health outcomes. Research with transwomen has been largely descriptive, documenting the high prevalence of various co-morbidities, ranging from substance use to negative mental health outcomes. In these studies, singular axes of identity have generally been analyzed. For example, studies have found that race is especially salient in the health of transwomen, finding that transwomen of color experience numerous structural inequalities that drive disparities in health. More intersectional research to examine social inequities in health and illness among transwomen is needed to better understand factors situated in the lived experiences of transwomen. This dissertation draws upon quantitative methods to examine disparities in HIV risk behavior and substance use among transwomen at the intersection of race and gender (Paper 1) and sexuality and gender (Paper 2). Qualitatively, this dissertation examines transmisogyny as a form of intersectional stress among transwomen (Paper 3). This first study is a cross-sectional analysis of data from a sample of 149 HIV-negative adult transwomen in San Francisco collected in 2013 from the TEACH 2 study. The second study is a cross-sectional analysis of data from a sample of 259 young transwomen in the San Francisco Bay Area collected in 2012-2014 from the SHINE study. The third study is a secondary analysis of qualitative, in-depth interview data from the Transgender Research Youth Project (TRYP), collected from 34 young transwomen in Chicago and Los Angeles in 2006. Altogether, these studies argue that future transgender research should increasingly take up intersectionality in order to understand the unique social location of transwomen.