Intersectional Discrimination Is Associated with Housing Instability among Trans Women Living in the San Francisco Bay Area

Abstract

Trans women face numerous structural barriers to health due to discrimination. Housing instability is an important structural determinant of poor health outcomes among trans women. The purpose of this study was to determine if experiences of intersectional anti-trans and racial discrimination are associated with poor housing outcomes among trans women in the San Francisco Bay Area. A secondary analysis of baseline data from the Trans *National study (n = 629) at the San Francisco Department of Public Health (2016–2018) was conducted. Multivariable logistic regression was used to analyze the association between discrimination as an ordered categorical variable (zero, one to two, or three or more experiences) and housing status adjusting for age, years lived in the Bay Area, and gender identity. We found that the odds of housing instability increased by 1.25 for every categorical unit increase (1–2, or 3+) in reported experiences of intersectional (both anti-trans and racial) discrimination for trans women (95% CI = 1.01–1.54, p-value < 0.05). Intersectional anti-trans and racial discrimination is associated with increased housing instability among trans women, giving some insight that policies and programs are needed to identify and address racism and anti-trans stigma towards trans women. Efforts to address intersectional discrimination may positively impact housing stability, with potential for ancillary effects on increasing the health and wellness of trans women who face multiple disparities.

“You’re so powerless”: Takatāpui/LGBTIQ+ people’s experiences before becoming homeless in Aotearoa New Zealand

“…This was primarily experienced in childhood, and had flow-on effects throughout their lives. Such findings align with international literature which indicates that people who identify as LGBTIQ+ and have experienced homelessness have also experienced a great deal of instability (particularly housing instability) throughout their lives [ 76 – 78 ]. Krause et al [ 78 ] found that instability for LGBTIQ+ youth was rooted in early life experiences; this aligns with the findings presented in this paper showing numerous and wide-ranging instabilities experienced in childhood.…”

“…Krause et al [ 78 ] found that instability for LGBTIQ+ youth was rooted in early life experiences; this aligns with the findings presented in this paper showing numerous and wide-ranging instabilities experienced in childhood. Furthermore, the international literature shows that instability is worsened for those who hold multiple stigmatised identities, and that those who experience it face greater level of discrimination on the basis of LGBTIQ+ identity [ 76 , 77 ]. These findings, along with the corresponding international literature, show that there are a number of common experiences amongst LGBTIQ+ people prior to them experiencing homelessness.…”

Association of Documentation of Legal Residency Status with Nonprescribed Hormone Use Among Hispanic/Latina Trans Women in San Francisco

“…The primary aim of the Trans National cohort study was to assess HIV incidence among trans women living in four cities around the world, and the methods are explained elsewhere. 23,24 Respondent-Driven Sampling was used to obtain a diverse sample of hard-to-reach adult trans women from the community in San Francisco in 2016. Eligibility criteria were (1) 18 years and older, (2) resident of San Francisco by self-reporting living in San Francisco, (3) assigned male sex at birth and identified as a gender other than man (e.g., female, trans woman, woman, nonbinary, gender queer), and (4) spoke English or Spanish.…”

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

“…The diversity of the trans women community necessitates an intersectional approach to address the complexity of the lived experiences of trans women. The benefits of an intersectionality framework and approach for public health policies have been previously described [24,25]. In particular, a focus on the specific intersection of race and gender is crucial to understanding both antitrans and racial discrimination and designing programs and resources that are effective among trans women who are marginalized at the intersection of race and gender [24].…”