Gender affirmation: a framework for conceptualizing risk behavior among transgender women of color.
Open accessAbstract
Experiences of stigma, discrimination, and violence as well as extreme health disparities and high rates of sexual risk behavior and substance use have been well-documented among transgender women of color. Using an intersectional approach and integrating prominent theories from stigma, eating disorders, and HIV-related research, this article offers a new framework for conceptualizing risk behavior among transgender women of color, specifically sexual risk behavior and risky body modification practices. This framework is centered on the concept of 'gender affirmation,' the process by which individuals are affirmed in their gender identity through social interactions. Qualitative data from 22 interviews with transgender women of color from the San Francisco Bay Area in the United States are analyzed and discussed in the context of the gender affirmation framework.
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Transgender persons often experience high rates of stigma and socioeconomic and structural barriers to care that negatively affect health care usage and increase susceptibility to HIV and STIs.
“Transgender persons often experience high rates of stigma and socioeconomic and structural barriers to care that negatively affect health care usage and increase susceptibility to HIV and STIs (326–332).”
From Sexually Transmitted Infections Treatment Guidelines, 2021 (2021) · cites this paper as [331]
The Introduction links stigma and social and economic inequality to HIV risk among transgender women, especially women of color. The Discussion reports barriers to obtaining health care, particularly transition-related care, in the study sample. The claim extends these points to all transgender persons, and the cited passages do not specifically address STI susceptibility. Page numbers were not available in our copy. (LLM, conf=0.86)
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The Biological Contributions to Gender Identity and Gender Diversity: Bringing Data to the Table
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Gaither, T. W., Awad, M. A., Osterberg, E. C., Murphy, G. P., Romero, A., Bowers, M. L., & Breyer, B. N. (2017) · The Journal of Urology · doi:10.1016/j.juro.2017.10.013 · Cited by 149 · see citing works
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Invalidation experiences among non-binary adolescents
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Current trends in the study of gender norms and health behaviors
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Minority stressors and psychological distress in transgender individuals.
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González, C. A., Gallego, J. D., & Bockting, W. O. (2017) · The Journal of Primary Prevention · doi:10.1007/s10935-017-0469-4 · Cited by 132 · see citing works
Barriers and Facilitators to Oral PrEP Use Among Transgender Women in New York City
Rael, C. T., Martinez, M., Giguere, R., Bockting, W. O., MacCrate, C., Mellman, W., Valente, P. K., Greene, G. J., Sherman, S. G., Footer, K. H. A., et al. (2018) · AIDS and Behavior · doi:10.1007/s10461-018-2102-9 · Cited by 127 · see citing works
Stigma, Gender Affirmation, and Primary Healthcare Use Among Black Transgender Youth
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Predictors and Mental Health Benefits of Chosen Name Use Among Transgender Youth
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Alpert, A., CichoskiKelly, E. M., & Fox, A. D. (2017) · Journal of Homosexuality · doi:10.1080/00918369.2017.1321376 · Cited by 107 · see citing works
Facial Feminization Surgery: The Ethics of Gatekeeping in Transgender Health
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HIV Prevention Among Transgender Populations: Knowledge Gaps and Evidence for Action
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Challenges and opportunities for gender-affirming healthcare for transgender women in prison
Sevelius, J. M., & Jenness, V. (2017) · International Journal of Prisoner Health · doi:10.1108/ijph-08-2016-0046 · Cited by 103 · see citing works
Bakko, M., & Kattari, S. K. (2020) · Journal of General Internal Medicine · doi:10.1007/s11606-020-05724-2 · Cited by 103 · see citing works
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Gordon, A. R., Austin, S. B., Krieger, N., White Hughto, J. M., & Reisner, S. L. (2016) · Social Science & Medicine · doi:10.1016/j.socscimed.2016.07.038 · Cited by 97 · see citing works
Gender euphoria: a grounded theory exploration of experiencing gender affirmation
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“Prior research has shown that many trans individuals face stigma (Bockting, Miner, Swinburne Romine, Hamilton, & Coleman, 2013; Logie, James, Tharao, & Loutfy, 2012; Sevelius, 2013)—stigma which can contribute to violence (Lombardi, Wilchins, Priesing, & Malouf, 2001; Mogul, Ritchie, & Whitlock, 2011; Perry & Dyck, 20…”
A Content Analysis of Literature on Trans People and Issues
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Coverage for Gender-Affirming Care: Making Health Insurance Work for Transgender Americans
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the Adolescent Medicine Trials Network for HIV/AIDS Interventions, Gamarel, K. E., Nelson, K. M., Stephenson, R. B., Rivera, O. J. S., Chiaramonte, D. M., & Miller, R. L. (2017) · AIDS and Behavior · doi:10.1007/s10461-017-2005-1 · Cited by 92 · see citing works
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Characterizing the HIV Prevention and Care Continua in a Sample of Transgender Youth in the U.S.
Reisner, S. L., Jadwin-Cakmak, L. A., Hughto, J. M. W., Martinez, M., Salomon, L., & Harper, G. W. (2017) · AIDS and Behavior · doi:10.1007/s10461-017-1938-8 · Cited by 90 · see citing works
Lagos, D. (2018) · Demography · doi:10.1007/s13524-018-0714-3 · Cited by 90 · see citing works
Sevelius, J. M., Poteat, T., Luhur, W., Reisner, S. L., & Meyer, I. H. (2020) · JAIDS Journal of Acquired Immune Deficiency Syndromes · doi:10.1097/qai.0000000000002403 · Cited by 89 · see citing works
HIV and stigma in the healthcare setting
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Pega, F., & Veale, J. F. (2015) · American Journal of Public Health · doi:10.2105/ajph.2014.302373 · Cited by 87 · see citing works
Gender Identity Disparities in Bathroom Safety and Wellbeing among High School Students
Wernick, L. J., Kulick, A., & Chin, M. (2017) · Journal of Youth and Adolescence · doi:10.1007/s10964-017-0652-1 · Cited by 87 · see citing works
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Radix, A. E., Sevelius, J. M., & Deutsch, M. B. (2016) · Journal of the International AIDS Society · doi:10.7448/ias.19.3.20810 · Cited by 80 · see citing works
Correlates of antiretroviral adherence and viral load among transgender women living with HIV
Sevelius, J. M., Saberi, P., & Johnson, M. O. (2014) · AIDS Care · doi:10.1080/09540121.2014.896451 · Cited by 79 · see citing works
Dhanani, L. Y., & Totton, R. R. (2023) · Sexuality Research and Social Policy · doi:10.1007/s13178-023-00810-6 · Cited by 78 · see citing works
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IL-10 Synergizes with Multiple Cytokines in Enhancing HIV Production in Cells of Monocytic Lineage
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Distinguishing and Addressing Gender Minority Stress and Borderline Personality Symptoms
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State of the Science: LGBTQ-Affirmative Psychotherapy
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In the name of brevity: The problem with binary HIV risk categories
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- Authors
- Sevelius, J. M.
- Affiliations
- University of California, San Francisco (US)
- Corresponding author
- Sevelius, Jae M.
- ORCID
- Sevelius, Jae M.
- Venue
- Sex Roles
- Published
- 2012-09-30
- Volume
- 68
- Issue
- 11-12
- Pages
- 675-689
- ISSN
- 0360-0025 (ISSN-L)
- 1573-2762
- PMC
- PMC3667985
- OpenAlex
- W1987404283
- Cited by
- 572
- References
- 64
- Citations by year
- 2026: 39 · 2025: 53 · 2024: 52 · 2023: 63 · 2022: 51 · 2021: 62 · 2020: 58 · 2019: 46 · 2018: 32 · 2017: 36 · 2016: 37 · 2015: 22 · 2014: 9 · 2013: 5
- FWCI
- 17.20
- Type
- journal article
- Language
- en
- Open access
- green
- europepmc.org
- Licence
- www.springer.com/tdm (tdm)
- Locations
- Sex Roles (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- eScholarship (California Digital Library) (submittedVersion)
- Funders
- National Institute of Mental Health (K08MH085566)
- Topics
- Social Sciences › Psychology › Social Psychology › LGBTQ Health, Identity, and Policy
- Health Sciences › Medicine › Infectious Diseases › HIV/AIDS Research and Interventions
- Social Sciences › Gender Studies › Gender and Feminist Studies
- Keywords
- gender affirmation, transgender women of color, sexual risk behavior, intersectionality, stigma, discrimination, HIV, eating disorders, substance use, health disparities, gender identity
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Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
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