Structural vulnerability as a conceptual framework for transgender health research

Findings from a community needs assessment of transgender women of colour in Detroit

Bibliographic Data

ID15098289
AuthorsWesley M Correll-King (0000-0002-4135-1603, University of Michigan, corresponding author), Laura Jadwin-Cakmak (0000-0001-5744-9632, University of Michigan), Racquelle Trammell (University of Michigan), Kristi E Gamarel (0000-0001-9405-7515, University of Michigan)
Year2023
Volume25
Issue6
Pages681-697
Publication date2023-06-01
Peer ReviewedYes
Open AccessNo
TypeARTICLE
VenueCulture Health & Sexuality (JOURNAL)
Journal identifiersISSN: 1369-1058 • E-ISSN: 1464-5351
PublisherInforma UK Limited (PUBLISHER • GB)
DOI10.1080/13691058.2022.2086709
PMID35736653
OpenAlexW4283330791
LanguageEN
Citations received7
References cited62

The concept of structural vulnerability explains how systems of oppression drive health inequities by reducing access to survival resources (e.g. food, housing) for marginalised populations. Indicators of structural vulnerability such as housing instability, violent victimisation and poverty are often interconnected and result from intersectional oppression. We sought to demonstrate the utility of the structural vulnerability framework for transgender health research by examining patterns of structural vulnerability indicators among transgender women of colour in Detroit. We conducted latent class analysis and tested associations between classes and mental health and substance use outcomes. Membership to the Lowest Vulnerability class was negatively associated with post-traumatic stress disorder (PTSD) (aOR = 0.10, 95% CI: 0.02-0.59). High Economic Vulnerability membership was associated with daily marijuana use (aOR = 4.61, 95% CI: 1.31-16.16). Complex Multi-Vulnerability membership was associated with PTSD (aOR = 9.75, 95% CI: 2.55-37.29), anxiety (aOR = 4.12, 95% CI: 1.22-13.97), suicidality (aOR = 6.20, 95% CI: 1.39-27.70), and club drug use (aOR = 4.75, 95% CI: 1.31-17.29). Substantively different findings emerged when testing relationships between each indicator and each outcome, highlighting the value of theoretically grounded quantitative approaches to understanding health inequities. Community-driven interventions and policy changes that reduce structural vulnerability may improve mental health and substance use outcomes among structurally vulnerable trans women of colour

Computer security · Environmental health · Health equity · Mental health · Oppression · Political science · Poverty · Psychiatry · Psychological intervention · Public health · Transgender · Vulnerability (computing · Clinical Psychology · Food Security and Health in Diverse Populations · Homelessness and Social Issues · LGBTQ Health, Identity, and Policy · Medicine · Nursing · Psychology