Abstract
Latina transgender women (LTW) are disproportionately vulnerable to depression, although the role of immigration/documentation status (legal authority to live/work in the U.S.) in depression has not been explored. LTW in Washington, DC were recruited into a cross-sectional study via convenience sampling. Most were Spanish-speaking Central American immigrants. Participants completed rapid HIV tests, and a Spanish-language survey assessing recent depressive symptoms (PHQ-2), sociodemographics, and factors from the minority stress framework: structural stressors (documentation status, stable housing), social stressors (discrimination, fear of deportation, violence) and coping resources (social support, resilience). Among immigrant LTW (n = 38), 24 were undocumented. Among the undocumented, the average PHQ-2 score was 2.7, and among the documented, the average PHQ-2 score was 1.4 (p < 0.05). Undocumented LTW were significantly more likely to experience employment discrimination, recent unstable housing, and fear of deportation. Bivariate and multiple linear regressions were performed to assess the relationship between documentation status and other correlates of past two week depressive symptoms. In multivariate analysis, PHQ-2 scores were inversely associated with being documented (p < 0.01), having an income above the federal poverty level, higher friends’ social support, and increased resiliency. Documentation status is an important correlate of depressive symptoms among LTW that should be considered within the context of health interventions.
Highlights
Transgender people living in the U.S experience disproportionately elevated rates of depression, with prevalence as high as 44.1% [1] to 62.0% [2]
Guided by the minority stress framework, we identified documentation status as a structural stressor associated with depressive symptoms [4]
Consistent with the minority stress framework, our study found resilience to be a protective factor against depressive symptoms for immigrant
Summary
Transgender people living in the U.S experience disproportionately elevated rates of depression, with prevalence as high as 44.1% [1] to 62.0% [2]. A recent systematic review on the mental health of transgender and gender non-conforming people found consistently high levels of depressive symptoms across studies [3]. The review was guided by the minority stress framework, which posits that social and environmental stressors disproportionately impact sexual and gender minority populations because of intersecting identity-based oppression; these stressors, in turn, cause poor mental health [4,5]. These stressors can occur across levels of the socioecological framework, from distal (e.g., structural and institutional polices) to proximal (e.g., internal coping) [4]. Public Health 2018, 15, 1246; doi:10.3390/ijerph15061246 www.mdpi.com/journal/ijerph
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