Skip to main content

Advertisement

SpringerLink
Log in

Exploring Transgender Legal Name Change as a Potential Structural Intervention for Mitigating Social Determinants of Health Among Transgender Women of Color

  • Published:
Sexuality Research and Social Policy Aims and scope Submit manuscript

Abstract

The purpose of this exploratory study was to examine the effects of legal name change on socioeconomic factors, general and transgender-related health care access and utilization, and transgender-related victimization in a sample of young transgender women (transwomen) of color. A cross-sectional group comparison approach was used to assess the potential effects of legal name change. A convenience sample of young transwomen enrolled in a no-cost legal name change clinic were recruited to complete a 30-min interviewer-guided telephone survey including sociodemographic and socioeconomic factors, health and well-being, health care utilization, transgender transition-related health care, and transgender-related victimization. Sixty-five transgender women of color (37 = pre-name change group, 28 = post-name change group) completed the survey. Results indicated that the transwomen in the post-name change group were significantly older than the pre-name change group. In age-adjusted analyses, the post-name change group was significantly more likely to have a higher monthly income and stable housing than the pre-name change group. No significant differences were observed for general health care utilization; however, a significantly greater percentage of transwomen in the pre-name change group reported postponing medical care due to their gender identity. In addition, a significantly larger proportion of transwomen in the pre-name change group reported using non-prescribed hormones injected by friends and experiencing verbal harassment by family and friends compared to transwomen in the post-name change group. Findings suggest that legal name change may be an important structural intervention for low-income transwomen of color, providing increased socioeconomic stability and improved access to primary and transition-related health care.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  • Adimora, A. A., & Auerbach, J. D. (2010). Structural interventions for HIV prevention in the United States. Journal of Acquired Immune Deficiency Syndromes, 55, 132–135.

    Article  Google Scholar 

  • Agresti, A. (1996). An introduction to categorical data analysis. New York: Wiley.

    Google Scholar 

  • Auerbach, J. D., Parkhurst, J. O., & Cáceres, C. F. (2011). Addressing social drivers of HIV/AIDS for the long term response: Conceptual and methodological considerations. Global Public Health, 6, 293–309.

    Article  Google Scholar 

  • Bauer, G. R., Scheim, A. I., Deutsch, M. B., & Massarella, C. (2014). Reported emergency department avoidance, use, and experiences of transgender persons in Ontario, Canada: Results from a respondent-driven sampling survey. Annals of Emergency Medicine, 63, 713–720.

    Article  PubMed  Google Scholar 

  • Bockting, W. O., Miner, M. H., Romine, R. E. S., Hamilton, A., & Coleman. (2013). Stigma, mental health, and resilience in an online sample of the US transgender population. American Journal of Public Health, 103, 943–951.

    Article  PubMed  PubMed Central  Google Scholar 

  • Bradford, J., Reisner, S. L., Honnold, J. A., & Xavier, J. (2013). Experiences of transgender related discrimination and implications for health: Results from the Virginia Transgender Health Initiative Study. American Journal of Public Health, 103, 1820–1829.

    Article  PubMed  PubMed Central  Google Scholar 

  • Brown, T. N. T., & Herman, J. L. (2016). Voter ID laws and their added costs for transgender voters. UCLA School of Law: The Williams Institute.

    Google Scholar 

  • Card, J. J., Lessard, L., & Benner, T. (2007). PASHA: Facilitating the replication and use of effective adolescent pregnancy and STI/HIV prevention programs. Journal of Adolescent Health, 40, 275.

    Article  PubMed  Google Scholar 

  • Centers for Disease Control and Prevention. (2005). Update: Syringe exchange programs—United States, 2002. Morbidity and Mortality Weekly Report, 54, 673–676.

    Google Scholar 

  • Clements-Nolle, K., Marx, R., & Katz, M. (2006). Attempted suicide among transgender persons: The influence of gender-based discrimination and victimization. Journal of Homosexuality, 51, 53–69.

    Article  PubMed  Google Scholar 

  • Conron, K. J., Scott, G., Stowell, G. S., & Landers, S. J. (2012). Transgender health in Massachusetts: Results from a household probability sample of adults. American Journal of Public Health, 102, 118–122.

    Article  PubMed  PubMed Central  Google Scholar 

  • Couch, M., Pitts, M., Croy, S., Mulcare, H., & Mitchell, A. (2008). Transgender people and the amendment of formal documentation: Matters of recognition and citizenship. Health Sociology Review, 17, 280–289.

    Article  Google Scholar 

  • Crosby, R. A., Salazar, L. F., & Hill, B. J. (2016). Gender affirmation and resiliency among black transgender women with and without HIV infection. Transgender Health, 1, 86–93.

    Article  PubMed  PubMed Central  Google Scholar 

  • DeNavas-Walt, C., Proctor, B., & Smith, J. (2013). Income, poverty, and health insurance coverage in the United States: 2010. 2011. Washington, DC: US Government Printing Office.

    Google Scholar 

  • Derogatis, L. R. M. N. (1983). The Brief Symptom Inventory: An introductory report. Psychological Medicine, 13, 595–605.

    Article  PubMed  Google Scholar 

  • Garofalo, R., Deleon, J., Osmer, E., Doll, M., & Harper, G. W. (2006). Overlooked, misunderstood and at-risk: Exploring the lives and HIV risk of ethnic minority male-to female transgender youth. Journal of Adolescent Health, 38, 230–236.

    Article  PubMed  Google Scholar 

  • Haas, A. P., Eliason, M., & Mays, V. M. (2010). Suicide and suicide risk in lesbian, gay, bisexual, and transgender populations: Review and recommendations. Journal of Homosexuality, 58, 10–51.

    Article  Google Scholar 

  • Hill, B. J., Rosentel, K., Bak, T., Silverman, M., Crosby, R., Salazar, L., & Kipke, M. (2017). Exploring individual and structural factors associated with employment among young transgender women of color using a no-cost transgender legal resource center. Transgender Health, 2(1), 29–34.

  • Institute of Medicine. (2011). The health of lesbian, gay, bisexual, and transgender people: Building a foundation for better understanding. Washington, DC: National Academies Press.

    Google Scholar 

  • Jordan, W., Edwards, D. G. F., Grace, L., & Reynolds. (2007). Male-to-female transgender and transsexual clients of HIV service programs in Los Angeles County, California. American Journal of Public Health, 97, 1030–1033.

    Article  Google Scholar 

  • Kim, T. J., & von dem Knesebeck, O. (2015). Is an insecure job better for health than having no job at all? A systematic review of studies investigating the health-related risks of both job insecurity and unemployment. BMC Public Health, 15, 985.

    Article  PubMed  PubMed Central  Google Scholar 

  • Liebetrau, A. M. (1983). Measures of association. Thousand Oaks: Sage.

    Book  Google Scholar 

  • McClelland, G. H., & Judd, C. M. (1993). Statistical difficulties of detecting interactions and moderator effects. Psychological Bulletin, 114, 376.

    Article  PubMed  Google Scholar 

  • Nadal, K. L., Skolnik, A., & Wong, Y. (2012). Interpersonal and systemic microaggressions toward transgender people: Implications for counseling. Journal of LGBT Issues in Counseling, 6, 55–82.

    Article  Google Scholar 

  • Namaste, V. K. (1999). HIV/AIDS and female-to-male transsexuals and transvestites: Results from a needs assessment in Quebec. International Journal of Transgenderism, 3, 2.

    Google Scholar 

  • Nuttbrock, L., Rosenblum, A., & Blumenstein, R. (2002). Transgender identity affirmation and mental health. International Journal of Transgenderism, 6, 97–103.

    Google Scholar 

  • Reisner, S. L., White, J. M., Bradford, J. B., & Mimiaga, M. J. (2014). Transgender health disparities: Comparing full cohort and nested matched-pair study designs in a community health center. LGBT Health, 1, 177–184.

    Article  PubMed  PubMed Central  Google Scholar 

  • Rood, B. A., Reisner, S. L., Surace, F. I., Puckett, J. A., Maroney, M. R., & Pantalone, D. W. (2016). Expecting rejection: Understanding the minority stress experiences of transgender and gender-nonconforming individuals. Transgender Health, 1, 151–164.

    Article  PubMed  PubMed Central  Google Scholar 

  • Rosenberg, M. (1965). Society and the adolescent self-image. Princeton: Princeton University Press.

    Book  Google Scholar 

  • 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, 99, 713–719.

    Article  PubMed  PubMed Central  Google Scholar 

  • Santelli, J., Ott, M. A., Lyon, M., Rogers, J., Summers, D., & Schleifer, R. (2006). Abstinence and abstinence-only education: A review of US policies and programs. Journal of Adolescent Health, 38, 72–81.

    Article  PubMed  Google Scholar 

  • Sevelius, J. M., Patouhas, E., Keatley, J. G., & Johnson, M. O. (2014). Barriers and facilitators to engagement and retention in care among transgender women living with human immunodeficiency virus. Annals of Behavioral Medicine, 47, 5–16.

    Article  PubMed  PubMed Central  Google Scholar 

  • Stroumsa, D. (2014). The state of transgender health care: Policy, law, and medical frameworks. American Journal of Public Health, 104, 31–38.

    Article  Google Scholar 

  • Su, D., Irwin, J. A., Fisher, C., Ramos, A., Kelley, M., & Mendoza, D. A. R. (2016). Mental health disparities within the LGBT population: A comparison between transgender and nontransgender individuals. Transgender Health, 1, 12–20.

    Article  PubMed  PubMed Central  Google Scholar 

  • Transgender Legal Defense, & Education Fund. (2014). Name change project overwhelmingly young transgender women of color living in poverty. New York: Transgender Legal Defense & Education Fund.

    Google Scholar 

  • Wolitski, R. J., Kidder, D. P., Pals, S. L., Royal, S., Aidala, A., & Stall, R. (2010). Randomized trial of the effects of housing assistance on the health and risk behaviors of homeless and unstably housed people living with HIV. AIDS and Behavior, 14, 493–503.

    Article  PubMed  Google Scholar 

Download references

Acknowledgement

We would like to acknowledge and thank all of our participants and the staff at the Transgender Legal Defense & Education Fund, Inc. for their dedicated support.

Author information

Authors and Affiliations

  1. Department of Obstetrics and Gynecology, Center for Interdisciplinary Inquiry and Innovation in Sexual and Reproductive Health (Ci3), University of Chicago, 6030 S. Ellis Ave, Edelstone 266, Chicago, IL, 60637, USA

    Brandon J. Hill, Alida Bouris, Rayna Brown, Trevor Bak, Kris Rosentel & Alicia VandeVusse

  2. Department of Obstetrics and Gynecology, Section of Family Planning and Contraceptive Research, University of Chicago, 5841 S Maryland Ave, Chicago, IL, 60637, USA

    Brandon J. Hill

  3. The Kinsey Institute for Research in Sex, Gender, and Reproduction, Indiana University, 1165 E. Third St., Morrison Hall 313, Bloomington, IN, 47405, USA

    Brandon J. Hill & Richard Crosby

  4. College of Public Health, University of Kentucky, 111 Washington Ave, Lexington, KY, 40536, USA

    Richard Crosby

  5. School of Social Service Administration, University of Chicago, 969 E. 60th St, Chicago, IL, 60637, USA

    Alida Bouris & Kris Rosentel

  6. Chicago Center for HIV Elimination, University of Chicago, 5837 S. Maryland Ave, Chicago, IL, 60637, USA

    Alida Bouris

  7. Transgender Legal Defense & Education Fund, Inc., 20 West 20th St., Suite 705, New York, NY, 10011, USA

    Michael Silverman

  8. School of Public Health, Georgia State University, 33 Gilmer St. SE, Atlanta, GA, 30303, USA

    Laura Salazar

Authors
  1. Brandon J. Hill
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Richard Crosby
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Alida Bouris
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Rayna Brown
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Trevor Bak
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Kris Rosentel
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Alicia VandeVusse
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Michael Silverman
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. Laura Salazar
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Brandon J. Hill.

Ethics declarations

Funding

This research was supported by the National Center for Advancing Translational Sciences of the National Institutes of Health, grant number UL1-TR000430 and The University of Chicago, Medicine and Biological Sciences Office of Diversity and Inclusion, B.J. Hill & M. Silverman (PIs). The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health or The University of Chicago Office of Diversity and Inclusion.

Conflict of Interest

The authors declare that they have no conflict of interests.

Ethical Approval

All procedures performed in this study involving human participants were in accordance with the ethical standards of the institutional research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed Consent

Informed consent was obtained from all individual participants included in the study.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Hill, B.J., Crosby, R., Bouris, A. et al. Exploring Transgender Legal Name Change as a Potential Structural Intervention for Mitigating Social Determinants of Health Among Transgender Women of Color. Sex Res Soc Policy 15, 25–33 (2018). https://doi.org/10.1007/s13178-017-0289-6

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s13178-017-0289-6

Keywords

Search

Navigation