IDEAS home Printed from https://ideas.repec.org/a/plo/pone00/0269776.html
   My bibliography  Save this article

Barriers to accessing and engaging in healthcare as potential modifiers in the association between polyvictimization and mental health among Black transgender women

Author

Listed:
  • Athena D F Sherman
  • Monique S Balthazar
  • Gaea Daniel
  • Kalisha Bonds Johnson
  • Meredith Klepper
  • Kristen D Clark
  • Glenda N Baguso
  • Ethan Cicero
  • Kisha Allure
  • Whitney Wharton
  • Tonia Poteat

Abstract

Background: Black transgender women endure pervasive polyvictimization (experiencing multiple forms of violence throughout the lifespan). Polyvictimization is associated with poor mental health. Black transgender women also face barriers in access to healthcare, but the extent that such barriers modify the association between polyvictimization and poor mental health has not been described using convergent mixed-methods analysis. Methods: This convergent mixed-methods secondary analysis employs an intersectional lens and integrates two inter-related datasets to describe barriers to healthcare and the extent that such barriers modify the association between polyvictimization and mental health among Black transgender women. Investigators used survey data (n = 151 participants) and qualitative interview data (n = 19 participants) collected from Black transgender women (age 18 years and older) in Baltimore, MD and Washington, DC between 2016 and 2018. Analyses include thematic content analysis, bivariate analysis, joint display, and multivariate linear regression analysis examining mediation and moderation. Results: Joint display illuminated three domains to describe how barriers to healthcare present among Black transgender women–Affordability, Accessibility, and Rapport and Continuity. Independent t-tests revealed significantly higher polyvictimization, Post Traumatic Stress Disorder (PTSD), and depression scores among participants who reported at least one barrier to healthcare (BHI) compared to those who reported no barriers. BHI significantly moderated and partially mediated the association between polyvictimization and PTSD symptom severity and BHI fully mediated the association between polyvictimization and depressive symptom severity–when accounting for age and location. Discussion: Findings highlight the importance of access to healthcare in modifying the association between polyvictimization and PTSD and depression symptom severity among Black transgender women. Findings call for immediate interventions aimed at reducing barriers to healthcare and improved training for clinical providers serving Black transgender women.

Suggested Citation

  • Athena D F Sherman & Monique S Balthazar & Gaea Daniel & Kalisha Bonds Johnson & Meredith Klepper & Kristen D Clark & Glenda N Baguso & Ethan Cicero & Kisha Allure & Whitney Wharton & Tonia Poteat, 2022. "Barriers to accessing and engaging in healthcare as potential modifiers in the association between polyvictimization and mental health among Black transgender women," PLOS ONE, Public Library of Science, vol. 17(6), pages 1-25, June.
    • Handle: RePEc:plo:pone00:0269776
    DOI: 10.1371/journal.pone.0269776
    as

    Download full text from publisher

    File URL: https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0269776
    Download Restriction: no
    File URL: https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0269776&type=printable
    Download Restriction: no
    File URL: https://libkey.io/10.1371/journal.pone.0269776?utm_source=ideas
    LibKey link: if access is restricted and if your library uses this service, LibKey will redirect you to where you can use your library subscription to access this item
    ---><---

    References listed on IDEAS

    as
    1. Poteat, Tonia & German, Danielle & Kerrigan, Deanna, 2013. "Managing uncertainty: A grounded theory of stigma in transgender health care encounters," Social Science & Medicine, Elsevier, vol. 84(C), pages 22-29.
    2. Sanchez, N.F. & Sanchez, J.P. & Danoff, A., 2009. "Health care utilization, barriers to care, and hormone usage among male-to-female transgender persons in New York City," American Journal of Public Health, American Public Health Association, vol. 99(4), pages 713-719.
    Full references (including those not matched with items on IDEAS)

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. White Hughto, Jaclyn M. & Reisner, Sari L. & Pachankis, John E., 2015. "Transgender stigma and health: A critical review of stigma determinants, mechanisms, and interventions," Social Science & Medicine, Elsevier, vol. 147(C), pages 222-231.
    2. Wall, Catherine S.J. & Patev, Alison J. & Benotsch, Eric G., 2023. "Trans broken arm syndrome: A mixed-methods exploration of gender-related medical misattribution and invasive questioning," Social Science & Medicine, Elsevier, vol. 320(C).
    3. Theo Beltran & Amani M. Allen & Jess Lin & Caitlin Turner & Emily J. Ozer & Erin C. Wilson, 2019. "Intersectional Discrimination Is Associated with Housing Instability among Trans Women Living in the San Francisco Bay Area," IJERPH, MDPI, vol. 16(22), pages 1-11, November.
    4. Linander, Ida & Alm, Erika & Hammarström, Anne & Harryson, Lisa, 2017. "Negotiating the (bio)medical gaze – Experiences of trans-specific healthcare in Sweden," Social Science & Medicine, Elsevier, vol. 174(C), pages 9-16.
    5. Bhattacharya, Shamayeta & Ghosh, Debarchana, 2020. "Studying physical and mental health status among hijra, kothi and transgender community in Kolkata, India," Social Science & Medicine, Elsevier, vol. 265(C).
    6. Erin Ziegler & Ruta Valaitis & Nancy Carter & Cathy Risdon & Jennifer Yost, 2020. "Primary Care for Transgender Individuals: A Review of the Literature Reflecting a Canadian Perspective," SAGE Open, , vol. 10(3), pages 21582440209, September.
    7. Naima Mohammadi, 2018. "Life experiences of sexual minorities in Iran: limitations, adaptations and challenges," Quality & Quantity: International Journal of Methodology, Springer, vol. 52(2), pages 719-737, March.
    8. Joseph G. L. Lee & Adam O. Goldstein & Leah M. Ranney & Jeff Crist & Anna McCullough, 2011. "High Tobacco Use among Lesbian, Gay, and Bisexual Populations in West Virginian Bars and Community Festivals," IJERPH, MDPI, vol. 8(7), pages 1-12, July.
    9. Randi Beth Singer & Amy K Johnson & Natasha Crooks & Douglas Bruce & Linda Wesp & Alexa Karczmar & Lucy Mkandawire-Valhmu & Susan Sherman, 2021. "“Feeling Safe, Feeling Seen, Feeling Free”: Combating stigma and creating culturally safe care for sex workers in Chicago," PLOS ONE, Public Library of Science, vol. 16(6), pages 1-15, June.
    10. Phillips II, Gregory & McCuskey, David J. & Felt, Dylan & Raman, Anand B. & Hayford, Christina S. & Pickett, Jim & Shenkman, Julia & Lindeman, Peter T. & Mustanski, Brian, 2020. "Geospatial perspectives on health: The PrEP4Love campaign and the role of local context in health promotion messaging," Social Science & Medicine, Elsevier, vol. 265(C).
    11. C. Riley Hostetter & Jarrod Call & Donald R. Gerke & Brendon T. Holloway & N. Eugene Walls & Jennifer C. Greenfield, 2022. "“We Are Doing the Absolute Most That We Can, and No One Is Listening”: Barriers and Facilitators to Health Literacy within Transgender and Nonbinary Communities," IJERPH, MDPI, vol. 19(3), pages 1-16, January.
    12. Long, Amanda & Jennings, Jacky & Bademosi, Kehinde & Chandran, Aruna & Sawyer, Simone & Schumacher, Christina & Greenbaum, Adena & Fields, Errol L., 2022. "Storytelling to improve healthcare worker understanding, beliefs, and practices related to LGBTQ + patients: A program evaluation," Evaluation and Program Planning, Elsevier, vol. 90(C).
    13. Woodgate, Roberta L. & Zurba, Melanie & Tennent, Pauline & Cochrane, Carla & Payne, Mike & Mignone, Javier, 2017. "“People try and label me as someone I'm not”: The social ecology of Indigenous people living with HIV, stigma, and discrimination in Manitoba, Canada," Social Science & Medicine, Elsevier, vol. 194(C), pages 17-24.
    14. Vaitses Fontanari, Anna Martha & Zanella, Gabriel Ibarra & Feijó, Marina & Churchill, Siobhan & Rodrigues Lobato, Maria Inês & Costa, Angelo Brandelli, 2019. "HIV-related care for transgender people: A systematic review of studies from around the world," Social Science & Medicine, Elsevier, vol. 230(C), pages 280-294.
    15. Natalie Ingraham & Lindsey Fox & Andres Leon Gonzalez & Aerin Riegelsberger, 2022. "“I just felt supported”: Transgender and non-binary patient perspectives on receiving transition-related healthcare in family planning clinics," PLOS ONE, Public Library of Science, vol. 17(7), pages 1-11, July.
    16. Smith-Johnson, Madeline & Alexander, Katherine, 2025. "Gender affirming medical care access: The role of healthcare stereotype threat and social support in a national probability sample of transgender adults," Social Science & Medicine, Elsevier, vol. 373(C).
    17. Clark, Kirsty A. & White Hughto, Jaclyn M. & Pachankis, John E., 2017. "“What's the right thing to do?” Correctional healthcare providers' knowledge, attitudes and experiences caring for transgender inmates," Social Science & Medicine, Elsevier, vol. 193(C), pages 80-89.
    18. Wang, Thelma, 2024. "Sex reconfigured: DIY hormone therapy and vernacular endocrinology in transfeminine communities in China," Social Science & Medicine, Elsevier, vol. 353(C).
    19. Nicole A. Francisco, 2021. "Bodies in Confinement: Negotiating Queer, Gender Nonconforming, and Transwomen’s Gender and Sexuality behind Bars," Laws, MDPI, vol. 10(2), pages 1-17, June.
    20. shuster, stef m., 2019. "Performing informed consent in transgender medicine," Social Science & Medicine, Elsevier, vol. 226(C), pages 190-197.

    More about this item

    Statistics

    Access and download statistics

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:plo:pone00:0269776. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: plosone (email available below). General contact details of provider: https://journals.plos.org/plosone/ .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.