Psychosocial Disparities Among Racial/Ethnic Minority Transgender Young Adults and Young Men Who Have Sex with Men Living in Detroit

Purpose: Transgender populations in the United States experience unique inequities in health and social well-being; however, they continue to be categorized with men who have sex with men (MSM) in HIV surveillance. To illustrate the differences in the lived realities of young MSM and transgender youth, we compare psychosocial outcomes across a sample of transgender and MSM youth from Detroit. Methods: Data for this study come from a community-based cross-sectional survey of young adults (ages 18-29) living in Detroit who identify as transgender and/or as cisgender young men who have sex with men (YMSM). Using participants' geographic location within the city of Detroit, we matched transgender participants (N=26) to YMSM (N=123) living in the same area, and compared the prevalence in risk and resilience indicators across the two groups. Results: Transgender participants were more likely than YMSM to experience socioeconomic vulnerability across several indicators, including lower educational attainment and workforce participation, greater residential instability, and higher lifetime experiences of transactional sex. Transgender participants were more likely than YMSM to report poorer health status, higher symptoms of depression and anxiety, and greater experiences of daily hassles and gender-related discrimination. Transgender participants did not differ from YMSM peers on health-promotive factors, including self-esteem, coping mastery, purpose in life, or social support. Conclusions: Our findings underscore the importance of addressing the social and economic inequities experienced by transgender young adults. Local- and national-level programmatic and policy interventions are recommended to alleviate the psychosocial vulnerability experienced by transgender young adults and to improve their health and social well-being.