RESUMEN
Despite formidable inequities in health care systems, transgender people are accessing clinical services in record numbers and gaining recognition as a patient population. This article examines how transgender people are negotiating their care and, in so doing, challenging patterns of marginalization and exclusion. Interviews with twenty-six transmasculine adults were collected and analyzed in the context of a community-led initiative foregrounding low-income people and people of color in Los Angeles County using a constructivist grounded theory approach. Participants gained agency in clinical settings by compelling care, a grounded theory that explains how patients contest medical authority and shift power through everyday acts to defend themselves and future patients. Histories of mistreatment and unequal social power drive patients to engage with health care providers judiciously and with a sense of social responsibility. In tracing seemingly decentralized acts of self-defense (e.g., vetting providers, disrupting gender norms, directing treatment), the study shows how patients rely on community resources and marshal collective protection. The theory recasts patients as constitutive actors in a changing landscape of care and as integral to, and one of many fronts of, collective struggle. In turn, the study lends theoretical insights to anti-racist understandings of medical mistrust andoffers a depathologized framework toward the development of community-building health equity interventions.
Asunto(s)
Personas Transgénero , Confianza , Adulto , Humanos , Teoría Fundamentada , Atención a la Salud , Identidad de GéneroRESUMEN
Transgender women ("trans women") are disproportionately impacted by HIV; yet there are few interventions tailored for trans women. This study employed qualitative methods to better understand how trans women's social networks and technology-based networking platforms may be leveraged in developing health promotion strategies for this high-priority population. Qualitative data from five focus groups (N = 39) revealed three key themes: (1) Social network structure and composition; (2) Technology use patterns; and (3) Accessing transgender health resources online. Participants used technology to establish affiliation with other trans women, build networks of support, and exchange health information and advice. Policymakers and practitioners can invest in the knowledge and expertise of trans women in using technology to organize health resources and support the development of peer-led, technology-based HIV prevention and care interventions.
Asunto(s)
Infecciones por VIH/tratamiento farmacológico , Infecciones por VIH/prevención & control , Promoción de la Salud/métodos , Red Social , Telemedicina , Personas Transgénero/psicología , Adulto , Femenino , Grupos Focales , Identidad de Género , Humanos , Los Angeles , Masculino , Investigación Cualitativa , TransexualidadRESUMEN
In 2013, the Violence Against Women Act became one of the first federal laws to explicitly prohibit discrimination against transgender people, yet little is known about its impact in practice. This qualitative study draws on in-depth interviews with transgender people working in domestic and sexual violence advocacy organizations. Building on critical and intersectional perspectives, the findings suggest that the persistence of inequities for trans survivors are tied to the reliance on criminal legal responses, contingent access to gender-specific services, compliance-focused approaches to inclusion, operating theories of gender-based violence, and the diversion of responsibility to LGBTQ (lesbian, gay, bisexual, transgender and queer) programs. This study highlights the participants' recommendations for change.
Asunto(s)
Violencia Doméstica/legislación & jurisprudencia , Delitos Sexuales/legislación & jurisprudencia , Personas Transgénero/psicología , Derechos Civiles/legislación & jurisprudencia , Femenino , Humanos , Entrevistas como Asunto , Masculino , Políticas , Investigación Cualitativa , Minorías Sexuales y de Género , Sobrevivientes/psicologíaRESUMEN
Research indicates that sexual minority youth are disproportionately criminalized in the U.S. and subjected to abusive treatment while in correctional facilities. However, the scope and extent of disparities based on sexual orientation remains largely overlooked in the juvenile justice literature. This study, based on a nationally representative federal agency survey conducted in 2012 (N = 8785; 9.9% girls), reveals that 39.4% of girls and 3.2% of boys in juvenile correctional facilities identified as lesbian, gay, or bisexual. These youth, particularly gay and bisexual boys, report higher rates of sexual victimization compared to their heterosexual peers. Sexual minority youth, defined as both lesbian, gay, and bisexual identified youth as well as youth who identified as straight and reported some same-sex attraction, were also 2-3 times more likely than heterosexual youth to report prior episodes of detention lasting a year or more. Implications for future research and public policy are discussed.