Abstract
BackgroundTransgender women sex workers have a high prevalence of depression. Low self-esteem and subsequent involuntary subordination (characterized by feelings of defeat and entrapment) are well-documented risk factors for depression. The object of the present study was to investigate the mediating effect of feelings of entrapment and defeat on the relationship between self-esteem and depression among transgender women sex workers in China.MethodsA cross-sectional study was conducted in Shenyang and Guangzhou in 2017. Participants were 198 transgender women sex workers who completed a structured questionnaire assessing background characteristics, self-esteem, feelings of entrapment and defeat, and depression. Linear regression was used to test the mediation hypotheses.ResultsOf participants, 25.25% exhibited high levels of depression. Self-esteem scores were negatively correlated with depression scores (r = −0.54, p < 0.05, R2adj = 0.23), defeat scores (r = −1.68, p < 0.05, R2adj = 0.31), and entrapment scores (r = −1.67, p < 0.05, R2adj = 0.25). In the mediation hypothesis model, entrapment (r = 0.21, p < 0.05) and defeat (r = 0.08, p < 0.05) had a complete mediating effect on the relationship between self-esteem (Spearman’s r = −0.06, p = 0.36) and depression (R2adj = 0.61).ConclusionFeelings of entrapment and defeat mediated the association between self-esteem and depression. More focus is needed on monitoring feelings of defeat and entrapment among transgender women sex workers to mitigate the risk of depression.
Highlights
Transgender women are individuals whose legal gender identity at birth is male, but who currently identify as female
A survey of transgender women sex workers in Shenyang and Guangzhou, we found that marital status, monthly income, and human immunodeficiency virus (HIV) test results were related to depression
The current study investigated depression among transgender women sex workers in Shenyang and Guangzhou, China, examining the mediating effect of entrapment and defeat on the relationship between self-esteem and depression
Summary
Transgender women are individuals whose legal gender identity at birth is male, but who currently identify as female. Mediating of Self-Esteem and Depression in sex work, while between 54% and 80% of transgender women in Asia are involved in sex work (Cohen et al, 2011; Poteat et al, 2015). Few studies have examined depression among transgender women sex workers, estimates of depression in transgender women are as high as 62% (Hoffman, 2014), substantially higher than the estimated rate of depression in general population (2.06%) (Phillips et al, 2009). The object of the present study was to investigate the mediating effect of feelings of entrapment and defeat on the relationship between self-esteem and depression among transgender women sex workers in China. Self-Esteem Scale Measure The Rosenberg Self-Esteem Scale measures self-esteem status and comprises 10 Likert-type scale items (Mckay et al, 2014) The scale measures both positive and negative reflections of self-esteem.
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