Situating Racialized Genders: An Analysis of Identity Development, Cultural Influences, and State-level Policy Impact on the Health of Transgender People of Color

Abstract

This research provides an in-depth exploration and definition of the multifaceted experiences of transgender (trans and nonbinary) individuals of color in the United States (US), balancing both a broad legislative analysis and a focused qualitative perspective. This dissertation explores how to more rigorously define the epidemiological concept of “exposure” to impact upon health inequities for individuals who experience oppression on multiple axes (e.g., race and gender). Initially, this research employs a polytomous latent class analysis to classify US states into three categories—Mostly Protective, Mixed, and Mostly Harmful—based on trans rights and structural racism policies. By drawing upon data from the Movement Advancement Project’s Gender Identity Tally and a structural racism legal database, the analysis reveals that even within seemingly inclusive states, protective measures are not uniformly applied, pointing to the necessity of comprehensive, intersectional policy evaluations. These insights underscore the variable impacts of state policies, advocating for more inclusive legislative frameworks that adequately consider the intersecting identities of race and gender. The second study shifts to a qualitative focus, examining the experiences of 8 Black transmasculine individuals in the Black culturally rich and historically significant city of Detroit, Michigan—a pivotal site during the Great Migration – and surrounding counties in Southeastern Michigan. Using Interpretative Phenomenological Analysis and object elicitation, the study investigates how participants, aged 25-35 years, navigate the tapestry of Black gender norms, family belonging, and community interactions in shaping their masculine and Black identities. A key finding is the role of alcohol serving not only as a medium for gender affirmation and personal identity exploration but also as a crucial element in familial and community bonding and coping with structural anti-Black oppression. Amid structural discrimination, alcohol emerges as a tool for coping and solidarity, facilitating connections and collective support within the family and community. Together, these quantitative and qualitative insights offer a holistic view of how historical, cultural, and political determinants intersect with localized, cultural dynamics to influence the well-being and identity development of marginalized communities. The research stresses the importance of crafting policy solutions that are both broad in scope and finely attuned to the specific needs and challenges faced by these communities. By detailing the interplay between legislation and lived experience, the study advocates for interventions and policies that are both inclusive and sensitive to the diverse realities of trans individuals of color, particularly those identifying as Black and transmasculine.Population Health Science