Housing insecurity and intersecting social determinants of health among transgender people in the USA: A targeted ethnography

Abstract

Background: 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.

Aims: This targeted ethnography explores housing insecurity as a SDOH among transgender people in the U.S.

Methods: In-depth interviews were conducted with transgender people (n?=?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.

Results: 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.

Discussion: Findings support increasing transgender housing security intervention resources that address intersecting and cyclical discrimination, trauma, housing, employment, and health issues.     

Physical child abuse: A dual-component analysis

Previous etiological models of child abuse are reviewed, with particular emphasis on the current social interactional analysis. It is argued that while this model accounts for the documented correlates of abuse, it fails to provide a plausible mechanism for explaining the rapid acceleration from low- to high-intensity punitive behavior characteristic of abusive episodes. Drawing from research on interpersonal aggression by Berkowitz, Zillmann, and other social psychologists, a model is developed in which an arousal-mediated respondent component is added to the current instrumentally based punitive processes. Implications of this improved analysis for treatment and prevention are considered.