Glick Jennifer L, Lopez Alex, Pollock Miranda, Theall Katherine P
Department of Health Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA.
Global Community Health and Behavioral Sciences, Tulane University School of Public Health and Tropical Medicine, New Orleans, Louisiana, USA.
Int J Transgend Health. 2020 Jul 2;21(3):337-349. doi: 10.1080/26895269.2020.1780661. eCollection 2020.
Housing is an important social determinant of health (SDOH). Transgender people face a unique blend of discrimination and compromised social services, putting them at risk for housing insecurity and associated public health concerns. This targeted ethnography explores housing insecurity as a SDOH among transgender people in the U.S. In-depth interviews were conducted with transgender people ( = 41) throughout the U.S.A., identified through purposive sampling. A semi-structured guide was used to elicit personal stories and peer accounts of insecure housing experiences and coping strategies. Interviews were audio recorded and transcribed. Data was coded, sorted, and analyzed for key themes. Responses revealed pervasive housing insecurity and inter-related challenges. Respondents discussed how intersecting identities create unique constellations of vulnerability, which "intersect like a star." Financial insecurity and interpersonal rejection were lead housing insecurity causes, often resulting in psychological strain, which was sometimes addressed with substances and sexual risk-taking. These factors were cyclically accompanied by financial and employment insecurity and a cascade of unmet social needs. Social support facilitated coping. Findings support increasing transgender housing security intervention resources that address intersecting and cyclical discrimination, trauma, housing, employment, and health issues.
住房是健康的重要社会决定因素（SDOH）。跨性别者面临着独特的歧视和社会服务不足的情况，这使他们面临住房不安全以及相关公共卫生问题的风险。这项有针对性的人种志研究探讨了美国跨性别者中住房不安全作为一种健康的社会决定因素的情况。通过目的抽样在美国各地对41名跨性别者进行了深入访谈。使用半结构化指南来引出关于住房不安全经历和应对策略的个人故事及同伴叙述。访谈进行了录音和转录。对数据进行编码、分类并分析关键主题。回应揭示了普遍存在的住房不安全及相互关联的挑战。受访者讨论了交叉身份如何造成独特的脆弱性组合，这些组合“像星星一样交叉”。经济不安全和人际排斥是导致住房不安全的主要原因，常常导致心理压力，有时人们会通过物质滥用和危险性行为来应对。这些因素又周期性地伴随着经济和就业不安全以及一系列未得到满足的社会需求。社会支持有助于应对。研究结果支持增加跨性别者住房安全干预资源，以解决交叉和周期性的歧视、创伤、住房、就业及健康问题。
