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

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.

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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.

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Correspondence to Brandon J. Hill.

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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.

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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.

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

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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

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Keywords

  • Transgender
  • Transgender health
  • Transgender rights
  • Transition-related health care
  • Transgender victimization