Challenging Norms: The Impact of Transgender and Gender-Diverse Realities on Work and School Participation

Author:

Becerra-Culqui Tracy1,Swiatek Daniel2,Dizon Bernadine3,Getahun Darios4,Silverberg Michael5,Zhang Qi6,Im Theresa7,Goodman Michael8

Affiliation:

1. Tracy Becerra-Culqui, PhD, MPH, OT/L, is Assistant Professor, Department of Occupational Therapy, California State University Dominguez Hills, Carson; tbecerraculqui@csudh.edu

2. Daniel Swiatek, OTD, OTR/L, is Assistant Professor, Department of Occupational Therapy, California State University Dominguez Hills, Carson.

3. Bernadine Dizon, MPH, is Research Associate IV, Department of Research and Evaluation, Kaiser Permanente Southern California, Pasadena.

4. Darios Getahun, MD, PhD, MPH, is Research Scientist II, Department of Research and Evaluation, Kaiser Permanente Southern California, Pasadena, and Associate Professor, Department of Health Systems Science, Kaiser Permanente Bernard J. Tyson School of Medicine, Pasadena, CA.

5. Michael Silverberg, PhD, MPH, is Research Scientist, Division of Research, Kaiser Permanente Northern California, Oakland, and Professor, Department of Health Systems Science, Kaiser Permanente Bernard J. Tyson School of Medicine, Pasadena, CA.

6. Qi Zhang, MSPH, is PhD Student, Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA.

7. Theresa Im, MPH, is Research Project Manager, Department of Research and Evaluation, Kaiser Permanente Southern California, Pasadena.

8. Michael Goodman, MD, MPH, is Professor, Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA.

Abstract

Abstract Importance: Disruption in school and the workplace are health concerns for transgender people. Objective: To evaluate transgender individuals’ thoughts and comfort with how others perceive their gender identity (social affirmation) and its association with outness in the workplace and mistreatment at work or school. Design: Cross-sectional survey. Participants: Survey respondents older than age 18 yr from the Study of Transition, Outcomes & Gender cohort (N = 696; n = 350 assigned male at birth, n = 346 assigned female at birth [AFAB]). Outcomes and Measures: Ever “out” to employer and treated unfairly at work or school or fired from job. Predictors were high social affirmation and comfort with how others perceive own gender identity. Descriptive statistics and logistic regression were used for analyses. Results: Individuals reporting high social affirmation were less likely to experience mistreatment at work or school than those with low social affirmation (odds ratio [OR] = 0.57, 95% confidence interval [CI] [0.38, 0.86]). Individuals AFAB who felt comfortable with how others perceived their gender identity were less likely to be out to their employers than individuals AFAB who did not (OR = 0.45; 95% CI [0.20, 0.97]). Conclusions and Relevance: Individuals with high social affirmation were less likely to experience work or school mistreatment, and feeling comfortable with how others perceive their gender identity did not signify the need to be out. Plain-Language Summary: Occupational therapy practitioners can play a pivotal role when working with transgender individuals by assisting in creating new routines for self-presentation at work or school, navigating social environments, and providing guidance in self-advocacy skills. Individuals assigned male at birth may be in greater need because they report lower levels of social affirmation and acceptance at school and work than individuals assigned female at birth.

Publisher

AOTA Press

Reference46 articles.

1. AOTA 2020 Occupational Therapy Code of Ethics;American Occupational Therapy Association;American Journal of Occupational Therapy,2020

2. Occupational therapy practice framework: Domain and process (4th ed.);American Occupational Therapy Association;American Journal of Occupational Therapy,2020

3. Policy E.15: Affirming gender diversity and identity,2021

4. Key terms and concepts in understanding gender diversity and sexual orientation among students;American Psychological Association,2015

5. The impact of positive school climate on suicidality and mental health among LGBTQ adolescents: A systematic review;Ancheta;Journal of School Nursing,2021

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