Stigma, social and structural vulnerability, and mental health among transgender women: A partial least square path modeling analysis

Introduction Existing literature suggests that transgender women (TW) may be at high risk for adverse mental health due to stress attributed combined experiences of stigma and complex social structural vulnerabilities. Little research has examined how these co-occurring relate health. We aimed test a theoretically driven conceptual model relationships between stigma, vulnerabilities, inform future intervention tailoring. Design/Methods Partial least square path modeling followed by response-based unit segmentation was used identify homogenous clusters in diverse community sample United States (US)-based TW (N = 1418; 46.2% White non-Hispanic). This approach associations latent constructs (polyvictimization discrimination), vulnerabilities (housing food insecurity, unemployment, sex work, support, substance use), (post-traumatic psychological distress). Results The final defined the relationship variables interest within vulnerability, Six were identified this framework which racism, ethnicism, geography related inequities among TW. Conclusion Our findings around impact reflect existing literature, unfortunately shows us little change occurred last decade color Southern US; however, strength our evidence (related sampling structure size) type analyses (accounting predictors health, i.e., reflecting real-world patients) is novel necessary addition literature. Findings suggest interventions designed offset negative effects must include anti-racist approaches with components reduce or eliminate barriers resources contribute Herein we provide detailed recommendations guide primary, secondary, tertiary prevention efforts. Clinical Relevance study demonstrated importance considering during clinical care design who are experiencing post-traumatic disorder distress. Specifically, should take an would benefit from incorporating support-building activities.