Complicating Narratives of Sexual Minority Mental Health: An Intersectional Analysis of Frequent Mental Distress at the Intersection of Sexual Orientation, Gender Identity, and Race/Ethnicity

Walubita, Tubanji; Beccia, Ariel L.; Boama-Nyarko, Esther; Ding, Eric Y.; Ferrucci, Katarina A.; Jesdale, Bill M.

doi:10.1089/lgbt.2021.0099

Cited by 5 publications

(3 citation statements)

References 41 publications

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“…For example, individuals who occupy multiple marginalization groups (i.e. intersections of race/ethnicity, socioeconomic level, education) and have low social and family acceptance [ 80 ] likely experience differential risks for disordered eating regardless of gender identity. Within group differences will be useful to substantiate for informing improved treatment modalities and approaches.…”

Section: Discussionmentioning

confidence: 99%

A scoping review of research literature on eating and body image for transgender and nonbinary youth

Heiden-Rootes,

Linsenmeyer,

Levine

et al. 2023

J Eat Disord

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Background Transgender and nonbinary (TGNB) adolescents and young adults are underrepresented in the literature on eating disorders and body image-related problems, despite increased mental health disparities and emerging research showing high associations between gender dysphoria, body image, and eating disorders among TGNB youth. Aims The scoping review was designed to critically examine the research on TGNB adolescents and young adults who experience eating and body image related problems as well as clinical studies on treatment approaches and effectiveness. Method Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) was used for reporting this scoping review. The electronic databases of MEDLINE and PsychInfo were used for searching subject terms. Inclusion criteria for studies required the quantitative measurement or qualitative exploration of body image or eating for transgender minor children, adolescents, or young adult samples (18 to 25 years old) and address differences in eating/body-related problems by age. The relevant data was extracted and narratively summarized. Results 49 studies were identified, data extracted, and analyzed. Increased prevalence of eating disorders and body image problems were identified for TGNB youth. Body-gender congruence through gender affirming social and medical interventions (e.g., hormone therapy) were noted as significant for alleviating body image problems and facilitating eating disorder treatment. Family and social factors were not well understood in the literature and a need for increased study of TGNB youth from varied racial/ethnic, neurodiverse, and within specific identities (e.g., nonbinary) and families and cultural contexts is still needed. Conclusions Future research should consider the use of developmental and family theories for guiding inclusion of salient social factors influencing eating patterns, body image, and treatment outcomes. In addition, more studies are needed with those from minoritized racial and ethnic groups, neurodiversity, and varied gender identities (e.g., nonbinary and gender queer) for identifying important differences.

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Section: Discussionmentioning

confidence: 99%

A scoping review of research literature on eating and body image for transgender and nonbinary youth

Heiden-Rootes,

Linsenmeyer,

Levine

et al. 2023

J Eat Disord

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show abstract

“…For example, intersections between gender and race and the resultant cisgenderism and racism are likely culprits for the exorbitantly disparate poor health outcomes for Black transgender women and femmes, including being 2.73 times more likely to die than other Black transgender people, 2.38 times more likely than Black cisgender men, and 2.43 times more likely than Black cisgender women (Hughes et al, 2022). Intersectional effects are consistently observed among a number of physical and mental health outcomes (Walubita et al, 2022; Zubizarreta et al, 2022). Within the health care system, this compounded discrimination among individuals with intersecting marginalized identities can further impact health negatively through inequities in health care access and receipt of lower quality treatment (Bosworth et al, 2021).…”

Section: Exclusion and Discrimination Contribute To Lgbtq+ Health Ine...mentioning

confidence: 99%

Changing language, changes lives: Learning the lexicon of LGBTQ+ health equity

Soled

Clark

Altman

et al. 2022

Research in Nursing & Health

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“…18 There are also racial inequities within trans and nonbinary populations, whereby ethnoracial minority trans and nonbinary people disproportionately experience discrimination in healthcare settings, structural barriers to care (e.g., financial and limited providers), and poor health outcomes (e.g., cardiovascular disease and depression). [19][20][21][22][23][24][25][26][27][28] Racial disparities in HIV prevalence among transgender women have been well documented. For example, 2019 National HIV Behavioral Surveillance (NHBS) Data collected across seven US cities revealed that HIV prevalence was highest among Native American (65%), Black (62%), and Hispanic/Latina (35%) transgender women, and lowest among White transgender women (17%).…”

mentioning

confidence: 99%

A Quantitative Intersectionality Analysis of HIV/STI Prevention and Healthcare Access Among Transgender and Nonbinary People

Tordoff,

Fernandez,

Perry

et al. 2023

Epidemiology

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Background: Transgender and nonbinary people experience substantial barriers to accessing healthcare, including prevention of HIV and other sexually transmitted infections (HIV/STI), due to structural inequities. We examined differences in insurance, HIV/STI prevalence, testing, and preexposure prophylaxis use among transgender and nonbinary people living in Washington State by race and ethnicity and gender. Methods: We pooled data from five 2019–2021 Washington State HIV/STI surveillance data sources to obtain a large and diverse sample of 1648 transgender and nonbinary participants. We calculated the risk difference (RD) for each outcome and used Poisson regression to estimate a surrogate measure of additive interaction—attributable proportion (AP)—that measures the proportion of the excess prevalence of the outcome observed at the intersection of gendered and racialized experience, beyond that expected from gender or race and ethnicity alone. Results: Participants reported overall high levels of poverty (29% incomes <$15,000 and 7% unstable housing). Certain groups, especially racial/ethnic minority transgender women, were disproportionately impacted by HIV/STIs (RDs from 20% to 43% and APs from 50% to 85%) and less likely to currently have insurance (RDs from 25% to 39% and APs from 74% to 93%) than that expected based on gendered or racialized experience alone. Conclusions: Our findings highlight the heterogeneity in insurance access, HIV/STI positivity, and prevention utilization within transgender communities. We observed that a large proportion of increased HIV/STI prevalence among racial/ethnic minority transgender women was attributable to the intersection of gender and race and ethnicity. Our findings highlight the importance of trans-inclusive models of HIV/STI prevention that address multilevel barriers rooted in cissexism and structural racism.

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Complicating Narratives of Sexual Minority Mental Health: An Intersectional Analysis of Frequent Mental Distress at the Intersection of Sexual Orientation, Gender Identity, and Race/Ethnicity

Cited by 5 publications

References 41 publications

A scoping review of research literature on eating and body image for transgender and nonbinary youth

A scoping review of research literature on eating and body image for transgender and nonbinary youth

Changing language, changes lives: Learning the lexicon of LGBTQ+ health equity

A Quantitative Intersectionality Analysis of HIV/STI Prevention and Healthcare Access Among Transgender and Nonbinary People

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