Experiences of violence and mental health outcomes among Asian American transgender adults in the United States

Abstract

Purpose We addressed prevalence and factors associated with mental health outcomes (suicidal behavior and psychological distress) among Asian Americans (AA), who identify as transgender, a key group among sexual and gender minorities that is overlooked and understudied. Methods We used data from 2015 United States Transgender Survey during 2019–2020 with our population as census defined AA. Outcomes included suicidal ideation, suicidal thoughts, and serious psychological distress (SPD). Independent variables included any abuse, partner abuse, bathroom-related abuse, and additional covariates. Adjusted odds ratio and 95% confidence interval (aOR; 95% CI) for each outcome are adjusted for age, marital status, citizenship status, education level, employment status, as well as poverty status. Results Nearly 67% reported experiencing any abuse, 52% reported abuse from romantic/sexual partner(s), while 29% reported harassment/abuse when trying to use bathrooms. Moreover, 82% reported suicidal thoughts, 40% reported suicidal attempts, and 39% had SPD. Results demonstrated that any abuse/violence had higher odds of suicidal thoughts (adjusted odds ratio [aOR] = 2.67, 95% confidence interval (CI):[1.98–3.58], suicidal attempts (aOR = 2.83, 95% CI:[2.18–3.68]), and SPD (aOR = 1.56, 95% CI:[1.20, 2.04]). Abuse from romantic/sexual partners had higher odds of suicidal thoughts (aOR = 2.47, 95% CI:[1.76–3.47]), suicidal attempts (aOR = 2.17, 95% CI:[1.68–2.80]), and SPD (aOR = 2.72, 95% CI:[2.03–3.63]). Experience of harassment/abuse during bathroom use had increased odds of suicidal attempts (aOR = 1.81, 95% CI:[1.41–2.31]). Conclusion Exposure to violence is common among AA transgender individuals and related to negative mental health outcomes. Initiatives to reduce exposure to abuse and providing resources for trauma-informed care are imperative to improve health outcomes.

“Being Trans Intersects with My Cultural Identity”: Social Determinants of Mental Health Among Asian Transgender People

“…All mental health variables were assessed using one-item questions except for the 10-item Kessler Psychological Distress (K10) Scale. The K10 demonstrated high internal consistency in the overall sample, and we used this scale to identify if participants had low or moderate (0-11), high (12)(13)(14)(15)(16)(17)(18)(19), or very high ( ‡ 20) psychological distress. 27 Participants were asked about their experiences accessing gender-affirming care and general health services.…”

“…[3][4][5] Moreover, existing (limited) studies that have looked at mental health differences across ethnic/racial groups of transgender people often housed Asian within the broader ethnic minority groups, 14,15 except for one recent U.S. study that explored the relationships between violence exposures and mental health outcomes for Asian transgender people. 16 While research on transgender people in Asia is beginning to flourish, 9,17,18 there needs to be careful consideration when extrapolating these findings to Asian transgender people in Western countries such as Aotearoa/New Zealand which have unique migration contexts.…”

A global cautionary tale: discrimination and violence against trans women worsen despite investments in public resources and improvements in health insurance access and utilization of health care

“…Violence against trans persons of color is particularly high; the HRC report noted that fatal violence disproportionately affected Black trans women. Becerra et al, reported that a majority of their study population of Asian-American transgender persons reported experiencing any form of abuse/violence (66.9%), 52.4% reported abuse/violence from romantic/sexual partner (52.4%), and 29.5% reported harassment/abuse when trying to use a bathroom [36].…”

Alcohol and Cannabis Use Trajectories and Outcomes in a Sample of Hispanic, White, and Asian Sexual and Gender Minority Emerging Adults

“…First, few studies use longitudinal data (e.g., tracking substance use from adolescence into emerging adulthood, when substance use typically peaks [ 14 , 15 , 16 ]). Second, few studies with disaggregated SGM samples have included Asian American and Pacific Islander SGM populations, who tend to be underrepresented in SGM research more generally [ 17 , 18 ]. Another gap in the extant literature relates to limited understanding of how substance use may differentially affect multiple domains of outcomes across SGM individuals with different racial/ethnic identities.…”