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Transgender women of color: discrimination and depression symptoms

Kevin Jefferson (Doctoral Student, based at Rollins School of Public Health, Emory Universty, Atlanta, Georgia, USA)
Torsten B. Neilands (Professor, based at Center for AIDS Prevention Studies, University of California, San Francisco, California, USA)
Jae Sevelius (Assistant Professor, based at Center for AIDS Prevention Studies, University of California, San Francisco, California, USA)

Ethnicity and Inequalities in Health and Social Care

ISSN: 1757-0980

Article publication date: 29 November 2013




Trans women of color contend with multiple marginalizations; the purpose of this study is to examine associations between experiencing discriminatory (racist/transphobic) events and depression symptoms. It uses a categorical measure of combined discrimination, and examines a protective association of transgender identity on depression symptoms.


Data from a subset of trans women of color participants in the Sheroes study were analyzed with linear and logistic regression. Associations of depression symptoms with racist and transphobic events, combined discrimination, coping self-efficacy, and transgender identity were assessed with odds ratios.


Exposure to discriminatory events and combined discrimination positively associated with depression symptom odds. Increased transgender identity associated with increased coping self-efficacy, which negatively associated with depression symptom odds.

Research limitations/implications

Cross-sectional study data prohibits inferring causality; results support conducting longitudinal research on discrimination's health effects, and research on transgender identity. Results also support operationalizing intersectionality in health research. The study's categorical approach to combined discrimination may be replicable in studies with hard to reach populations and small sample sizes.

Practical implications

Health programs could pursue psychosocial interventions and anti-discrimination campaigns. Interventions might advocate increasing participants’ coping self-efficacy while providing space to explore and develop social identity.

Social implications

There is a need for policy and health programs to center trans women of color concerns.


This study examines combined discrimination and identity in relation to depression symptoms among trans women of color, an underserved population.



The authors wish to thank Louis Graham for reviewing draft manuscripts, Jamison Green for offering input on policy interventions, Sunho Jung for sharing MATLAB codes used in regularized exploratory factor analysis, Angel Ventura for recruiting and interviewing participants, and Sheroes participants for sharing their time and stories. Sheroes is supported by NIH/NIMH grant No. K08MH085566 (Sevelius, PI). This analysis of Sheroes data was supported by an internship grant to Kevin Jefferson from the University of Michigan School of Public Health department of Health Behavior and Health Education. This grant provided funding for the corresponding author to travel and live in San Francisco while beginning work on this analysis.


Jefferson, K., B. Neilands, T. and Sevelius, J. (2013), "Transgender women of color: discrimination and depression symptoms", Ethnicity and Inequalities in Health and Social Care, Vol. 6 No. 4, pp. 121-136.



Emerald Group Publishing Limited

Copyright © 2013, Emerald Group Publishing Limited

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