*Note* This scheduling program was not designed by folks who do a lot with APA Style and unfortunately it defaults to listing authors in alphabetical order. We cannot fix this for this online schedule, but the author orders are posted in the order submitted in the printed program available via pdf here.
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Saturday, March 7 • 3:45pm - 5:00pm
Reduced Access to Gender Affirmation is Associated with Increased Drug, Alcohol, and Hormone Abuse among Transgender Women

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Transgender women are highly marginalized in the U.S., experiencing pervasive stigma and discrimination and reporting disproportionate levels of depression, trauma, and substance abuse. The Model of Gender Affirmation provides a framework for conceptualizing health disparities among trans women of color and theorizes that the high levels of substance abuse and misuse of hormones observed among transgender women can be partly accounted for by psychiatric distress that results from social oppression and a low levels of interpersonal and internalized affirmation of their gender identity. The current study represents the first quantitative exploration of the Model of Gender Affirmation, utilizing data from a cross-sectional study of 150 adult transgender women in the San Francisco Bay Area. We examined multivariable relationships between social oppression, psychiatric distress, external and internal gender affirmation, and substance abuse using generalized structural equation modeling (GSEM). Our analysis revealed a significant direct effect of social oppression on both psychiatric distress and external gender affirmation, such that increased levels of reported social oppression led to higher levels of psychiatric distress and decreased levels of external gender affirmation. Psychiatric distress in turn had significant direct effects on internalized gender affirmation as well as the number of drugs used and the number of alcoholic drinks consumed in the past 30 days. Internalized gender affirmation was significantly associated with the number of drugs used, number of alcoholic drinks consumed, as well as hormone misuse (i.e. using more hormones than prescribed) in the past 30 days. This study provides quantitative support for the Model of Gender Affirmation in that gender affirmation processes (both internal and external) mediated the relationships between social oppression and substance misuse in this sample of transgender women. Interventions aimed at improving mental health and decreasing substance abuse among transgender women should consider strategies to increase their access to gender affirmation.

Saturday March 7, 2015 3:45pm - 5:00pm PST