Social Support Among Young Transgender Women

Background and Purpose: Research indicates that young transgender women experience poorer mental health than their lesbian, gay, and bisexual peers. Social support, a term generally used to describe the benefits gained from social relationships, has been linked to improved health and mental health outcomes (Cohen and Willis, 1985; Cobb, 1976; Turner and Marino, 1994). Social support may be especially important for helping young transgender women to cope with experiences of discrimination and victimization, and may be a correlate of improved mental health.  Research with transgender women has tended to rely on small sample sizes or has analyzed transgender women along with young men who have sex with men, which limits identification of the unique mental health challenges and social support dynamics within this population. In contrast, the present study examines the correlates and importance of social support in a sample of 264 diverse transgender women aged 16-29 years old.

Methods: Baseline data from Project LifeSkills, a randomized control trial of an HIV-prevention intervention for young transgender women, was analyzed to examine sociodemographic differences in social support and the association between social support and mental health. The data set is useful for conducting non-experimental analysis of these factors because of the size of the sample (n=264), the availability of relevant variables, and the dearth of other samples of young transgender women. Participants were recruited via online, venue- and event-based sampling conducted in Chicago (n=133) and Boston (n=131). Participants completed a close-ended survey on social support, depression, HIV-status, and sociodemographic factors. Bivariate and multivariate ordinary least squares (OLS) regression was conducted to examine how baseline social support varied among study participants and the association between social support (using the six-item Medical Outcomes Study Modified Social Support Survey, α=.947) and depression (using the six-item depression dimension of Brief Symptom Inventory 18 Test, α=.918) at baseline.

Results: Participants range in age from 16-29 (M=23.30, S.D.=3.46); 47.3% identify as Black/African American, 25.4% as White, 12.1% as Latina and 15.2% as Asian American/Pacific Islander, American Indian, and Native Hawaiian. African American participants reported significantly higher levels of social support than did white participants (β=.53; SE=.22, p<.05), and young women experiencing homelessness reported lower levels of social support than did housed participants (β=-.52; SE=.20, p<.01). There were no other significant sociodemographic differences in social support. Social support at baseline was negatively associated with depression in bivariate analyses (β=-1.52; SE=.58, p<.05), but was marginally significant after controlling for important covariates (β=-.1.03; SE=.60, p<.10).

Conclusions and Implications: This analysis identified several sociodemographic differences in levels of social support among this population and a marginal association between social support and depression. Further research is necessary to explore whether the higher levels of support reported by African American transgender women is due to greater access or more need for support. This cross-sectional data does not allow establishment of a causal relationship between these variables, and suggests the merits of future experimental and longitudinal research on the benefits of social support for transgendered young adults’ mental health.