Food Insecurity Among Transgender and Gender Nonconforming Individuals in the Southeast United States: A Qualitative Study

Abstract

Purpose: Transgender and gender nonconforming (TGNC) people experience high rates of poverty, joblessness, and homelessness, which drive risk for food insecurity. TGNC people also face discrimination due to transphobia and cissexism, which may contribute to these drivers. Minimal empirical evidence describes experiences with food insecurity among TGNC people. This project investigated food insecurity among TGNC people and how these experiences relate to their physical and mental health. Methods: Semistructured telephone interviews were conducted with 20 TGNC people residing in the Southeast United States (U.S.), recruited through social media. Interviews were transcribed and qualitatively coded. Results: TGNC people reported living in extreme poverty. They described how the conservative sociopolitical climate of the Southeast United States made it difficult to find and maintain employment, which was a primary driver of food insecurity. Participants experienced discomfort seeking food assistance due to discrimination and concern for reducing emergency food availability for people in greater need. Stress from unemployment and underemployment, inadequate food supplies, and discrimination was reported as a contributor to poor physical and mental health, and weakened support systems. Conclusion: Poverty and food insecurity erode TGNC people's physical and mental health and support systems. TGNC people faced substantial barriers—including unemployment and underemployment and multilevel discrimination—which prevented them from affording adequate food. Public health solutions include implementing employment nondiscrimination policy to protect TGNC people in the workplace and building relationships between local food pantries and LGBT organizations to create safer environments for all persons in need of food assistance.

Sexual orientation disparities in food insecurity and food assistance use in U.S. adult women: National Health and Nutrition Examination Survey, 2005–2014

“…To our knowledge, no studies have explicitly investigated the experiences of SMW who access food pantries. However, in a recent qualitative study of food insecure transgender and gender non-conforming (TGNC) individuals, respondents were less likely to seek food assistance in their local communities due to fear of gender- and sexual orientation-based stigma and discrimination from religiously-affiliated food pantries [ 42 ]. One solution is the rise of LGBT-specific food pantries sponsored by community-based organizations in major metropolitan areas.…”

Food insecurity and food pantry use among transgender and gender non-conforming people in the Southeast United States

“…From January to February 2019, TGNC people living in the Southeast U.S. were recruited online via targeted Facebook advertisements to complete an online survey. This recruitment approach is an evidence-based method documented to successfully recruit stigmatized groups into research projects [18][19][20][21].…”

Sexual orientation disparities in food insecurity and food assistance resource use in U.S. adult women: National Health and Nutrition Examination Survey, 2005-2014

“…Summary statistics were calculated to describe demographic, socioeconomic, and psychosocial factors. Age was recoded into four categories representing respondents across emerging (18)(19)(20)(21)(22)(23)(24)(25), young (26)(27)(28)(29)(30)(31)(32)(33)(34)(35), middle (36)(37)(38)(39)(40)(41)(42)(43)(44)(45), mid-late (46-59) stages of adulthood. NHANES' original variable structure was retained for race/ethnicity categories (non-Hispanic white, non-Hispanic black, Mexican American, other Hispanic, and other race including multiracial).…”

“…It is concerning that SMW are more likely to use emergency food assistance, but not more likely to use SNAP, despite evidencing disparities in food insecurity. SNAP participation reduces food insecurity [36,37]; as such, increasing SMW's SNAP participation may alleviate disparities. One explanation for SMW's underutilization of SNAP is that SMW women may earn too much to qualify for SNAP, but not enough to afford food.…”