J Health Care Poor Underserved. 2024;35(3):816-836.
In Jamaica and the wider Caribbean, the legal system allows for discrimination based on gender and sexual identity with impunity. This exposes trans people to disparate risks of violence and barriers to accessing social services such as health care. In this paper we assess the social determinants of health in the Jamaican trans population using a modified social-ecological model of transgender stigma and stigma interventions. To conduct this assessment, we situated the findings of the 2021 Jamaican Trans Health Needs Assessment and Trans Health Strategy within the socio-ecological framework with direct application to rights-based health services as well as the Jamaican legal system to develop a model for understanding the socio-legal determinants of health. The social determinants of health identified within the Jamaican trans community are all influenced by a lack of legal protection suggesting a need for legal reform toward nondiscrimination of sexual and gender-diverse populations.
在牙买加和更广泛的加勒比地区，法律体系允许基于性别和性身份的歧视而不受惩罚。这使跨性别者面临不同程度的暴力风险和获得医疗保健等社会服务的障碍。在本文中，我们使用经过修改的跨性别者耻辱和耻辱干预的社会生态模型，评估牙买加跨性别者群体的健康的社会决定因素。为了进行这项评估，我们将 2021 年牙买加跨性别者健康需求评估和跨性别者健康战略的结果置于社会生态框架内，并直接应用于基于权利的健康服务以及牙买加法律体系，以建立一个理解健康的社会法律决定因素的模型。在牙买加跨性别者社区中确定的健康的社会决定因素都受到缺乏法律保护的影响，这表明需要进行法律改革，以实现对性和性别多样化人群的非歧视。
