Latinx Trans and Gender Diverse Southerners Experiences with Violence and Service Utilization

Background/Purpose: There is research dearth on the violent experiences among trans and gender diverse (TGD) Latinx individuals living in the Southern U.S. We explored the experiences of TGD Latinx Southerners with transprejudice and anti-trans violence, the services they commonly access, and their experiences with these services. We used the Socioecological Model of Anti-Trans Stigma (Hughto et al., 2015) to describe individual, interpersonal, and structural experiences.

Methods: We used 2015 U.S. Transgender Survey data (James et al., 2016). Sociodemographic predictor variables included gender identity, citizenship status, health insurance coverage, and age. Dependent variables included experiences with physical and sexual violence, intimate partner violence (IPV), services accessed in the past year (health care, domestic violence shelter, legal services), and anti-trans stigma and transprejudice experiences in these services. For our analyses, we (1) calculated frequencies/percentages of various types of violence in the past year, followed by two separate chi-square analyses for the association of each type of violence with gender identity and citizenship status; (2) calculated frequency/percentage of using each type of service, followed by chi-square analysis to examine whether experiences of violence in the past year were associated with rates of using services; (3) calculated frequencies/percentages of various types of experiences in service settings, among those who had experienced any violence in the past year; (4) ran three logistic regression models for demographic characteristics and documentation alignment’s association with experiencing verbal mistreatment in health care, being refused treatment, and any form of negative health care experience in the past year.

Results: Of 547 Latinx respondents, 53.7% experienced verbal harassment of any type in the past year, 57.5% any form of violence in the past year, and nearly half nonphysical or severe IPV across the life course. There were differences by gender in terms of verbal harassment, with the highest rates among genderqueer/non-binary AFAB (63.9%). The relationship between citizenship and experiencing violence was not significant. Regarding services used in the past year, 80% utilized health care, <20% went to court or used legal services, and <2% visited a domestic violence shelter, despite the notable rates of IPV. Among those who had experienced any form of violence in the past year, less than half reported being treated respectfully by a doctor. Finally, regarding predictors of negative health care experiences, age squared was statistically significantly associated with odds of verbal mistreatment in health care (AOR=9.95x10^-1, p<.05), with an increase in verbal mistreatment through the mid-30s, followed by a rapid decline. Those with only some IDs displaying their correct name had 2.93 greater odds of being refused care and 2.84 greater odds of experiencing any type of negative treatment in health care compared to those with all or none of their IDs displaying their correct name.

Conclusions/Implications: Health care interventions must address the violent experiences of TGD Latinx individuals. Given that most of the sample had experienced violence in the past year and accessed health care services in the same time frame, health care programs and providers have a unique position for prevention and intervention.