A qualitative study of the ecology of stigma experiences - An application of the ecological model to stigma experiences of trans-women from Ghana. BSGH019

Abstract

Trans-women in Ghana experience stigma from institutions, social groups, and individuals. Yet, studies are needed to provide a comprehensive understanding of the nature of stigma experienced by trans-women, especially in Ghana and West Africa. This study employs an ecological model to qualitatively explore the ecology of stigma experiences of trans-women living in urban slums in Accra, Ghana (N=20). Findings revealed stigma across various ecological levels. At the public policy level, the LGBTQ+ bill emerged as a key driver of stigma. Various subcategories related to this bill included: (a) Restricted freedoms of expression and isolation from harm, (b) LGBTQ+ bill potential for facilitating violence, and (c) fear of arrest and jail time. At the institutional level, trans-women encountered stigma in three areas. The first was in the healthcare sector involving Rude/unwelcoming gestures and behaviors. The second was from law enforcement officers and included (a) harassing attitudes from law officers, and (b) extortion. Community-level stigma encompassed: (a) insults, name-calling, (b) possible harm from gender expression, and (c) fear of attacks. At the interpersonal level, Trans-women experienced: (a) invasion of privacy, (b) leaving home due to safety, (c) threat of bodily harm, and (d) rejection. At the individual/self-stigma level, trans-women experienced (a) self-doubt and internal struggles, and (b) sense of regret and guilt. Findings highlight the unique experiences and pervasive and multi-layered stigma faced by trans-women across different levels of society. Addressing stigma experiences requires a multi-tiered approach that tackles issues from public policy to individual self-acceptance.