Intercategorical and Intracategorical Experiences of Discrimination and HIV Prevalence Among Transgender Women in San Francisco, CA: A Quantitative Intersectionality Analysis

Author:

Wesson Paul1,Vittinghoff Eric1,Turner Caitlin1,Arayasirikul Sean1,McFarland Willi1,Wilson Erin1

Affiliation:

1. Paul Wesson, Eric Vittinghoff, and Caitlin Turner are with the Department of Epidemiology and Biostatistics, University of California, San Francisco. Sean Arayasirikul, Willi McFarland, and Erin Wilson are with the Center for Public Health Research, San Francisco Department of Public Health.

Abstract

Objectives. To examine differences in HIV prevalence and experiences of discrimination within the trans women community in California’s San Francisco Bay Area. Methods. Intersectional positions were constructed on the basis of race/ethnicity (non-Hispanic White, non-Hispanic Black, Latina) and gender identity (female identifying, transgender identifying). We used baseline data from the Trans*National study (2016–2017) to construct regression models that estimated racial/ethnic differences in the attribution of discrimination experienced and, along with surrogate measures for intersectionality, estimated risk among those who were dually marginalized (racial/ethnic minority and transgender identifying). Margins plots were used to visually compare absolute risk across all intersectional positions. Results. Black and Latina trans women were more likely to be HIV positive than non-Hispanic White trans women. In several of the study domains, we estimated a lower risk of reporting discrimination among dually marginalized trans women than among White female-identifying trans women. Conclusions. Quantitative intersectionality methods highlight the diversity of experiences within the trans women community and reveal potential measurement challenges. Despite facing multiple forms of systemic marginalization, racial/ethnic minority trans women report less discrimination than White trans women. Subjective reporting of discrimination likely undercounts risks among racial/ethnic minorities.

Publisher

American Public Health Association

Subject

Public Health, Environmental and Occupational Health

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