Structural vulnerability as a conceptual framework for transgender health research: findings from a community needs assessment of transgender women of colour in Detroit.
Cult Health Sex
; 25(6): 681-697, 2023 06.
Article
em En
| MEDLINE
| ID: mdl-35736653
ABSTRACT
The concept of structural vulnerability explains how systems of oppression drive health inequities by reducing access to survival resources (e.g. food, housing) for marginalised populations. Indicators of structural vulnerability such as housing instability, violent victimisation and poverty are often interconnected and result from intersectional oppression. We sought to demonstrate the utility of the structural vulnerability framework for transgender health research by examining patterns of structural vulnerability indicators among transgender women of colour in Detroit. We conducted latent class analysis and tested associations between classes and mental health and substance use outcomes. Membership to the Lowest Vulnerability class was negatively associated with post-traumatic stress disorder (PTSD) (aOR = 0.10, 95% CI 0.02-0.59). High Economic Vulnerability membership was associated with daily marijuana use (aOR = 4.61, 95% CI 1.31-16.16). Complex Multi-Vulnerability membership was associated with PTSD (aOR = 9.75, 95% CI 2.55-37.29), anxiety (aOR = 4.12, 95% CI 1.22-13.97), suicidality (aOR = 6.20, 95% CI 1.39-27.70), and club drug use (aOR = 4.75, 95% CI 1.31-17.29). Substantively different findings emerged when testing relationships between each indicator and each outcome, highlighting the value of theoretically grounded quantitative approaches to understanding health inequities. Community-driven interventions and policy changes that reduce structural vulnerability may improve mental health and substance use outcomes among structurally vulnerable trans women of colour.
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Base de dados:
MEDLINE
Assunto principal:
Infecções por HIV
/
Transtornos Relacionados ao Uso de Substâncias
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Pessoas Transgênero
Idioma:
En
Ano de publicação:
2023
Tipo de documento:
Article