Introduction

Young transgender women are significantly negatively impacted by suicidality, HIV, difficult gender and sexual identity development in unaccepting environments, residential instability, joblessness, survival sex work, and a host of other challenges (Grossman and D’augelli 2006; Herbst et al. 2008; Kellogg et al. 2001; Mallon and DeCrescenzo 2006; Mayer et al. 2008; Melendez et al. 2006; Operario et al. 2008; Sanchez et al. 2009; Wilson et al. 2009). These inequities are intensified for young transgender women of color (Clements-Nolle et al. 2001; Garofalo et al. 2006, 2007; Nemoto et al. 2004, 2005a, b, 2006; Sausa et al. 2007), who may, as Crenshaw’s intersectionality (1991) suggests, experience them in disparate ways due to their positions at the intersection of multiple marginalized identities. Though disproportionately burdened by these negative psychosocial and sexual health outcomes, there is a paucity of research on the lived experience of black transgender women that could shed light on the fundamental causes of their vulnerabilities. This study adds young black transgender women’s voices to the gender, sexuality, and social determinants literature on institutional violence, discrimination, and physical and verbal harassment (VDH). Through these voices, we explore the processes by which multiple axes of structural marginality influence various psychosocial health outcomes in this community.

Many health outcomes faced disproportionately by transgender women are closely associated with exposure to VDH (Bockting et al. 1998; Lang et al. 2003; Semple et al. 2010). For example, previous studies have found that high rates of discrimination and victimization predicted unsafe sexual practices among transgender women (Brennan et al. 2012; Garofalo et al. 2007). Singer and colleagues (2006) describe many of the structural features of VDH, and argue that multiple inequalities contribute to the syndemic of “substance abuse, violence, and AIDS” (SAVA) among socially marginalized groups. While such studies provide directions for our analysis, few studies have specifically examined the structural issues contributing to vulnerabilities among black transgender women, and there have been no such studies in Detroit, Michigan, which has a higher percentage of black residents than any other large city in the United States (US; Census Bureau 2010).

Drawing on qualitative interview data with black transgender women in Detroit, our research aims to expand understanding of the relationships among VDH, social stress, and social support in this population. Research on stress and resilience highlights social support as key to buffering against stress by moderating its negative effects (Cohen 2004; Hirsch and DuBois 1992; House et al. 1988; Rhodes et al. 1994). The aforementioned study on transwomen and sexual practices found that lack of social support was an independent predictor of unsafe sexual practices among transgender women (Garofalo et al. 2007). In these studies, social support appears as a factor with consistent protective effects.

However, many studies assess VDH and social support acontextually and do not locate these experiences within particular settings or situations. In order to successfully intervene, we need situational information about the particular forms VDH takes in specific circumstances for black transgender women. Additionally, VDH and social support are often considered independently and do not take into account ways in which any single factor can simultaneously provide support and be a source of stress, or how effective (or not) some forms of support are in an environment of VDH. This study contributes to filling this knowledge gap.

Institutional VDH

For our purposes, it is useful to distinguish three levels at which VDH occurs: interpersonal, institutional, and structural. Interpersonal VDH often occurs within institutional settings. Lesbian, gay, bisexual, and transgender (LGBT) communities face extreme social, legal, and institutional discrimination in the US, and youth are particularly vulnerable (Hatzenbuehler et al. 2009, 2010; Munoz-Plaza et al. 2002). Researchers have identified lack of institutional support—in educational systems, in criminal justice systems, and in faith-based institutions—as a factor contributing to social isolation and emotional stress of LGBT youth (Mercier and Berger 1989). Below, we draw heavily on studies and scholarship by Munoz-Plaza et al. (2002), Marksamer (2008), Dowshen et al. (2011), and others to provide background on transgender youth experiences in schools, the juvenile justice system, and churches.

Schools

Many studies have documented high rates of VDH perpetrated against LGBT students in US school settings (Russo 2006). In 2001, the Gay, Lesbian, and Straight Education Network (GLSEN) conducted a School Climate Survey and found that 82 % of LGBT students reported being the victim of sexual, physical, or verbal harassment; over 90 % indicated that they regularly heard anti-LGBT comments at school; and nearly 25 % heard these comments from school personnel (Bauer 2002). Transgender youth have a particularly difficult time in school (Bochenek and Brown 2001). In most recent studies (Kosciw and Diaz 2006; Kosciw et al. 2009), 90 % of transgender students across the US reported feeling unsafe at school and 55 % reported they had experienced physical harassment because of their gender expression.

Violence and harassment negatively affect young people’s mental health and considerably decrease performance and likelihood of success at school (Marksamer 2008). There is a dearth of information on who primary perpetrators of harassment are, what precipitates violence and harassment for LGBT and ethnic minority subpopulations, and rules and regulations at the school level that institutionalize VDH in predominantly black schools. This study captures some of these stories. As Marksamer (2008), p.74 observes, “unsafe, disrespected, and basically unwelcome, some transgender youth simply stop going to school, further increasing the likelihood of juvenile court intervention.” Structurally, then, VDH in schools is connected with the juvenile justice system.

Juvenile Justice System

Transgender youth are overrepresented in the juvenile justice system (Woronoff et al. 2006), and juvenile justice personnel often lack an understanding of gender and sexuality that would enable them to meet the needs of transgender youth. Unfortunately, as Marksamer (2008, p.72) describes, “the juvenile justice system is hostile and unapologetically punitive toward these youth.” Black transgender youth may be in an even more precarious situation: though African-Americans made up 16 % of the total US youth population, they accounted for 30 % of referrals to juvenile court, 34 % of youth formally processed by the juvenile court, 30 % of adjudicated youth, and 35 % of youth judicially waived to criminal court (Hsia et al. 2004; Poe-Yamagata and Jones 2000).

Juvenile courts are increasingly incarcerating more young people in overcrowded and unsafe prison-like facilities (Conward 2000; Snyder and Sickmund 2006). The harmful effects of some interactions with the juvenile justice system are long lasting: “sex offender registration, preclusion from public housing, ineligibility for student loans or military service, and limited educational and employment opportunities” (Marksamer 2008, p. 75). Less is known about unstandardized and prohibited practices of criminal justice system personnel targeting transgender women. This study includes a focus on black transgender women’s contacts with police officers.

Church

Religion plays an important role in many black communities and in the lives of some young people. Various aspects of religiosity have been conceptualized and operationalized in different ways, including as individual and collective beliefs, worship practices, and traditions used as coping strategies (Rew and Wong 2006). Religiosity has been found to be related to mental and sexual health outcomes (Brown et al. 2001; Scott et al. 2006; Sinha et al. 2007; Turner-Musa and Lipscomb 2007) and is typically theorized to be protective (Cotton and Berry 2007; Cotton et al. 2006), as religious beliefs and practices have been identified as important components of resilience to stress (Golub et al. 2010). Employing religious beliefs and practices to cope with stressful life events has been shown to be associated with higher self-esteem, better life satisfaction, improved cognitive functioning, and less depressive symptoms (Pargament et al. 2004; Park 2006; Yakushko 2005). Nevertheless, these associations may not be generalizable to LGBT youth given doctrines that view homosexuality and transgenderism as sinful, resulting in feelings of alienation, shame, and fear. Some research on ethnic minority populations has also suggested that regardless of a specific individual’s experience in faith-based institutions, religiosity in the larger society can reinforce the stigmatization of sexual minorities, resulting in discrimination in a range of institutional settings, such as health care (Varas-Díaz et al. 2013).

In the most recent study on religion and young transgender women with a predominately African-American sample, Dowshen et al. (2011) found that formal religious practices were significantly negatively associated with sexual risk of HIV. Nevertheless, the authors (Dowshen et al. 2011, p. 411) also comment on the potential negative effects of religious engagement, noting that “many LGBT youth feel isolated from religious institutions whose beliefs are in conflict with their gender or sexual identity.” More research is needed to better understand how the benefits of religiosity or spirituality and the oppressive forces of some religious institutions interact, especially among black gender and sexually marginalized groups, given the unique significance of the church in some black communities.

Amplifying Voices of Black Transwomen

To better determine when, where, and how to intervene to prevent VDH and its deleterious sequelae among young black transgender women, qualitative data on the relationships between contexts, actions, and interpretations are needed (Flyvbjerg 2002). These data will improve our understanding of the broad range of contingencies bearing on specific experiences of VDH and the situations in which they tend to emerge. In this analysis, narrative data directed us to focus attention on the interface between individuals and institutions as a particularly salient conditioning factor in the course of VDH. In this project, we sought to empower marginalized youth of color to share their stories and voices, and to provide venues to amplify these voices into public policy circles through participatory research.

Narrative can be a means by which to examine how different situations impact those at various intersections of race, gender, and sexuality (Graham et al. 2011). Narrative methods place a premium on “perspectivalism,” the idea that a group’s position or standpoint influences how they see truth and reality (Delgado and Stefancic 2011). Storytelling is central to many ethnic minorities’ cultural experience, including African–Americans’ traditional use of storytelling as a tool for nuanced communication and dissemination of vital information. In our study, narrative methods allowed for the collection of data from black transgender women using techniques that were akin to their daily practices of narrative production.

The purpose of this exploratory study is to richly describe young black transgender women’s experiences in community institutions and social structures, and to develop contextualized explanations for particular experiences of VDH. Specifically, this study seeks to better understand the policies, practices, and attitudes in educational systems, criminal justice systems, faith-based institutions, and black transgender communities that contribute to VDH, and psychosocial vulnerabilities, and sources of resilience for black transwomen in Detroit. Drawing on our findings and relevant literature, we offer policy and practice implications for educators, officers, clergy, and community leaders to decrease VDH and cultural orientation incongruence and enhance social support.

Methods

Detroit Youth Passages (DYP) is an ethnographic project that examines the relationships between structural conditions and sexual vulnerabilities (Lopez et al. 2012). DYP is a partnership between the University of Michigan School of Public Health and three community-based organizations and the youth communities they serve, including the Ruth Ellis Center (REC) and young transgender women. REC provides residential and drop-in programs for LGBTQ youth. This study was approved by the University of Michigan Social and Behavioral Sciences Institutional Review Board (IRB).

Design and Sampling

Researchers used an oral narrative approach to collect 10 life histories, during Fall 2011, of black transwomen between 18 and 24 years of age residing in Detroit, Michigan. In our approach to narrative research, participants are minimally prompted on a subject or topic that is likely to highlight a host of intersectional issues, such as ways in which gender and sexuality interact with social structures. In oral narrative, stories are simultaneously told, revised, and positioned. The life history interview is not a quest for a universal narrative “truth,” but rather a means to encourage self-reflection and foster rich descriptions of the life conditions and experiences in which participants are deeply invested.

In this study, we found it useful for the interviewer to simply invite transwomen to “tell me the story of your life,” which resulted in eloquent, meaningful, and complexly positioned representations of self and society that, we believe, provide rich contextual data on individual experiences of VDH. In telling their stories, many participants gravitated toward narratives of VDH, resulting trauma and pre-disposing conditions, and individual circumstances that shaped their experiences. While these narratives demonstrate the profound effect of social and structural inequalities, they also illustrate inspiring processes of resilience. As young black transwomen, their life histories represent counter-narratives to privileged and majoritarian, dominant narratives that serve to subjugate communities at the social margins (Solorzano and Yosso 2002).

Inclusion criteria were: self-reported assignment of male sex at birth; self-identification as black, African-American or mixed-race (including black); self-identification as a gender different from that which is socially associated with male sex assigned at birth (e.g., male-to-female transgender); age between 18 and 24 years, inclusive; and current residence in Detroit or surrounding metropolitan area. The project employed a snowball and chain sampling strategy. A project coordinator, a well-known black transgender community leader who was connected to diverse networks of transwomen, assisted with initial recruitment by introducing a co-investigator and research assistant to a few community members apparently fitting the inclusion criteria. Potential participants were then screened, and if eligible and consented to participate, were scheduled for an interview. The sample was fairly homogenous with respect to several constructs: almost all participants had experienced residential instability at some point in their lives; all participants either had participated in sex work or knew someone who had; most participants had inconsistent or no sources of income; and nearly all participants identified as “transwomen,” as opposed to “women” unqualified or some other local terms (e.g., “Gurls”) the research team identified through participant observation during earlier phases of the project.

Procedures and Data Collection

All interviews took place at REC in private interview rooms, were audio recorded, and transcribed verbatim. The interview process included a brief introduction, ice-breaker question, and the prompt: “tell me the story of your life.” Interviewers asked follow-up questions and probed if necessary to expound on certain elements of stories, but as much as possible, allowed participants to share their stories uninterrupted and held most questions until the end or to encourage further elaboration along the way. A co-investigator and research assistant conducted all interviews, were experienced in oral narrative methods and trained in the use of the interview guide.

Participant experiences, attitudes, beliefs, actions, thoughts, and feelings were elicited. Interview transcripts were imported into NVivo 9 software (QSR International; Melbourne, Australia). Our interpretations were also informed by several months of participant observation with black transwomen and key informants conducted prior to the life history interviews, most of whom were identified through our volunteer work and research collaboration with the REC. These ethnographic observations informed our decisions regarding probing and follow-up questions during the life history interviews, and sharpened our analysis of patterns in the narratives.

Analytic Process

Grounded theory seeks to generate explanations of phenomena based on rich, contextualized data (Strauss and Corbin 1990). We conducted a modified grounded theory analysis (LaRossa 2005; Ridge et al. 1997; Utrata 2011) focused on two elements of Clandinin and Connelly’s (2000) three-dimensional narrative inquiry space: the personal and social (the interaction), which represents the core phenomena (in this case, experiences of VDH); and place (situation), which highlights intervening conditions. Primary actors, challenges, actions taken, and consequences are explored in each setting (Yussen and Ozcan 1996). Data were used to generate an explanation of how and why themes in relationships between young black transgender women and social structures have manifested, and how they are related to VDH.

Life history transcripts were initially memoed and open coded to isolate narrative segments related to VDH within the interviews and arrange them by social structure. As analysis proceeded, segments were iteratively grouped within five emergent categories (schools, criminal justice system, churches, broader society, and transgender community) based on similarities in content, interpreted meaning, and phrasing. The properties within each of these categories were named and summarized using participant words and language, creating sub-categories of specific manifestations (Conrad 1978). More weight was given to segments that had more context, were more descriptive, and exemplified the majority of segments in the group with greater intensity. Based on these procedures, a provisional codebook was created.

A small subset of the interviews were used to develop the codebook that was then discussed with the research team. One other member of the team then coded all interviews independently, using the codebook. Discrepancies in the initial double coded interviews and definitions, inclusion, and exclusion criteria were rectified through joint analysis, discussion, and consensus at regular team meetings. Salient themes centered on black transwomen’s vulnerabilities and resilience in community institutions and social structures, which served as core phenomena of interest for axial coding. Axial coding (Strauss and Corbin 1998) was performed and codes were sorted and sequenced centering on four elements: causal conditions that led to VDH or mitigated it through social support; actions taken in response to experience of VDH or support; intervening conditions or the broad and specific situational factors that structure actions taken; and consequences that result from experience of VDH or support.

We focus on the intervening conditions or situations as units of analysis (Clarke2005) in order to identify policies, practices, and attitudes that shape the lives of black transwomen. A conditional matrix was created to summarize the consequences related to VDH and their antecedents for each community institutional and social setting: schools, criminal justice system, churches, broader society, and transgender community. To improve the internal validity of the findings, member checking was used (Schwartz-Shea 2006); during dissemination meetings, black transwomen at REC were provided with a summary of the findings and were invited to provide feedback regarding the degree to which findings resonated with them. Their feedback informed analysis and interpretation of the data. Findings are presented not as a chronology, as is standard for most narrative studies, but instead are organized by community institution or social structure.

Findings

Experiences in institutions and interactions with peers in transgender and broader communities provided black transgender youth with influential messages about the acceptability of their gender identities and sexualities. Policies, practices, and attitudes in educational systems, criminal justice systems, faith-based institutions, society generally, and transgender communities, influenced participants’ gender identity development, social support, and psychosocial wellbeing (Table 1). Beliefs and actions targeting participants in community social structures served to either limit or facilitate participants’ access to instrumental, informational, and emotional support over the course of their gender transition. Below, we present results, discuss their implications, and situate our findings within the broader literature.

Table 1 Summary of findings
Full size table

Schools

Some of the most striking instances of the social enforcement or regulation of gender expectations occurred at school. One theme in the narratives was the role of school administrators in maintaining heteronormative expressions of gender and sexuality, and punishing children who did not conform as expected. Darla and Berta, respectively, shared memories of, “being sent home from school in grade school for, like, claiming I was a girl” and a principal that called her “gay,” “a fag,” and “a sissy.” Similarly, Carley described being sent home for wearing a skirt to school, under the pretense that it was unsafe for her given the harassment she might face for her gender expression.

But when I first stepped in Nomfield High School with a skirt on… I went to detention and, um, they made me go home early, you know what I’m saying. I thought they was going [to] like kick me out… or, um, make me change my clothes. But they made me leave early and then like when I got there like the next day they, um, told me…they don’t want to see me get hurt or anything. – Carley

Transphobic and homonegative responses of school administrators and officials to transgender identity declarations and expressions had three primary effects. First, they directly contradicted the presumed responsibility of school staff to create safe learning environments free of VDH, and instead made these environments feel dangerous and judgmental. Second, they signaled to students that it is acceptable to treat and regard transgender and gay students with contempt. As Darla quipped, “I seen other people get picked on that was not upfront, open with it. They would. So, that showed me [how I would be treated].” And third, it harmed transgender students’ mental and emotional health. As Berta says, she “got teased, picked on and did a lot of – went through a lot mentally.” Additionally, staff use of terms like “claiming” in reference to a student’s articulation of her gender identity deprives students of the power of self-determination, the ability to name themselves, and to explore their gender and sexual identities. “Claiming” suggests the student is mistaken, that her declaration is unproven or not within her rights to self-determination, and her identity can therefore be called into question and serve as the basis for punishment.

In the face of such pervasive forms of gender enforcement, some participants developed tactics to face bullying and violence at school. A primary strategy described by our participants involved the development of tough exterior facades and a no-tolerance approach to disrespect—enforced using threats and violence—in an attempt to survive and foster respect. During their discussions of school experiences, two participants described this strategy as follows:

…if you could stand your grounds, it was cool with the hood… everybody [says], ‘I don’t understand how you made it over there.’ Easy. I did what I had to do. I didn’t let nobody punk me. I didn’t let nobody do none of that. I did what I had to do. – Dina

I had to let them know. I felt like everybody, like, if you looked at me wrong, we was fighting, like, I felt like I had to start off like doing it like that so you would let people know, and then it worked. It did get to the point where, you know, guys didn’t say nothing no more. – Eboni

These patterns of aggressive self-protection mirror those of other recent studies and highlight the ways in which the school environment is culturally incongruent with the cultural orientations of young transgender women, particularly by viewing transgender identity as both a deviant violation worthy of punishment (i.e., being sent home) and a safety concern, rather than an identity to be celebrated and one that contributes to the diversity of the student body.

Not only does being sent home for wearing a skirt deny students education solely on the basis of being transgender, in this case, it does so under the ironic rationale that administrators are guaranteeing the student’s safety. This approach to maintaining school safety suggests that there is something inevitably unsafe about existing in the world as transgender, rather than locating the root of the school’s safety concerns in the institutional environment that refuses to make safe space for transgender students. In reference to their interactions with other students, many participants described being, at times, accepted and even cool as a “gay boy.” Participants’ school experiences may reflect increased peer acceptance of gay identities and effeminate expressions in the context of gay identities. However, while participants were able to recount both negative and positive experiences in schools, narratives on the whole depict schools as unsafe spaces for youth to transition or to express femininities beyond the bounds of a stereotyped gay male.

For our study participants, lack of acceptance in their transitioning process jeopardized their educational achievement, despite the fact that they held a strong belief in the importance of education:

I went through the process of coming out [as gay first] when I was in the eighth grade, and it was, ugh, it was really something else. And when I got in ninth grade, I dropped out of school be—I tried. You know, I tried to go to school but I was just so vulnerable at the time and really insecure, and I just was not ready to face the world… and the opinions of me. – Adina.

As with other narratives, Adina’s story described a gradual gender transitioning process that resulted in an increasing sense of conflict with the normative environment at her school. Ultimately, this conflict led her to drop out of school. Almost all participants came-out as gay prior to coming out as transgender, and while some discussed positive experiences of being accepted by peers, the support they received was not sufficient to counter the VDH and confluence of other factors to prevent school dropout as their transitioning proceeded.

Criminal (In)justice System

Participants described a tumultuous relationship with law enforcement and correctional facilities. They shared experiences of homonegativity, transphobia, white-on-black racism, and physical assaults by law enforcement officers, indicating significant and highly problematic dysfunctions in these social services. Participants who sold sex felt it was particularly difficult to seek assistance from or trust the police. All participants who engaged in sex work described being introduced to sex work by older transwomen, which suggests a generational dimension to sex work in transgender communities.

We use the term “sex work” here to refer to a general pattern of sexual-economic exchange, but are aware of some of its problematic associations, including its tendency to emphasize more formalized exchange relationships and to suggest a stable form of sex work identity that does not apply in all cases. Nevertheless, some of our participants did use the term “sex work” to describe their transactions or occupation, and hence we retain such language here. Participants described choosing a particular method of sex work (street based vs. industry/internet) based on their perceptions of differences related to safety and stigma. Many of the transwomen in our sample described sex work in terms that parallel definitions in the literature of “survival sex work.”

Survival sex work grows out of economic desperation and increases likelihood of both arrest and assault (Welfare 2006). Some black transgender women’s reliance on survival sex work is tied both to the historic dire economic situation of black communities and the commodification, objectification, and eroticization of black and transgender bodies. Comparative ethnographic studies have shown that the social configuration of sex work in a given instance is a close reflection of social hierarchies, where street-based sex workers are more exposed to VDH by the authorities (Bernstein 2010). For black transgender women, targeting and arrests are often intensified by existing racial hierarchies and their resulting disparities. Police frequently target and arrest residentially unstable transwomen for sex work and other “crimes” born of economic desperation (e.g., loitering, trespassing), and in many cases wrongly so (Marksamer 2008).

Though they felt that they and their communities were over-policed, participants described feeling that police were unwilling to take issues of assault or safety seriously if transgender women were victims or sex work was involved. Indeed, recent homicides of transgender women in Detroit have provoked a heightened sense among black transgender women that law enforcement is unlikely to follow up appropriately or guarantee their safety. During the time period in which the authors were in the field collecting data (2011–2012), two black transgender women were murdered in Detroit. These murders were distinguished not only in the extreme violence and brutality that characterized them, but also for the misunderstanding of the police and media in their portrayal.

Reports described the clothing of both victims, noting that Coko Williams, killed in 2012, was “a person dressed in women’s clothing” (Anderson 2012) and that Shelley Hilliard, killed in 2011, was “wearing a silver dress” (Satyanarayana 2011). Despite having no record of the work history of the victim, the media highlighted an interview describing Coko’s murder as possibly stemming from “a transaction gone bad” in which someone “just happen[ed] to figure out it’s a man, and you know, of course something is going to happen” (Dewey 2012). Authorities were often described by participants in our study as blaming transwomen for the assaults they experienced and disregarding participants’ safety:

They told my friend, ‘Well, you shouldn’t have been out here and maybe they wouldn’t have been cheating you or trying to rob you.’ So it was like, so who do they take to jail? Boy with a gun or, uh, somebody who out here selling their ass? – Fatima

Black transgender youth are punished and criminalized by some police who view their gender nonconformity as a marker of fundamental social deviance (Marksamer 2008). Police perceptions of sexual deviance were used to justify investigative inaction and served as moral justification for the crimes committed against transwomen. The lack of trust for police regarding sex work became particularly apparent during one interview. Despite our team’s close association with trusted, trans-friendly community-based organizations, such as the REC, the otherwise-candid interviewee became suspicious that the interviewer was a police officer when the conversation shifted to the topic of sex work. Despite efforts to assure the participant that the information she shared, including that regarding sex work, would be made anonymous through our data management procedures, the participant opted not to share her experiences of sex work.

While seemingly stigmatizing participants for involvement in sex work, police were also implicated as participants in sex work as Johns or clients. This emerged as our team noticed there were blurred boundaries between narratives of clients and narratives of the police, suggesting a generalized blending of “law enforcement” and “Johns.” Dina and Darla provide two illustrative examples:

Oh, the police are no different than johns to me. They use their authority to get what they want… The same thing that the rest of them want, but they want it for nothing… Because they are police, ‘I can take you to jail if you don’t suck my dick.’ – Dina

I had a, I had a client before and after we, after we got finished, he told me, ‘you know not to come out here Thursdays or Tuesdays.’ And I said, ‘what do you mean?’ He said, ‘you know, that’s sting night.’ I said, ‘how you know it’s sting night?’ He said, ‘I’m an officer.’ – Darla

Beyond sex work specific interactions with law enforcement, participants described instances of law enforcement officials using transphobic and homonegative language, such as a story told by Imani, who was wrongly arrested on her brother’s warrant: “I’m handcuffed, and I’m being printed. I’m being told to shut up, and I’m being asked, am I girl or am I boy? You know, ‘am I some type of sissy girl?’” Exemplifying how extreme and dangerous the dehumanization by law enforcement can be, this same participant went on to tearfully describe being separated from other inmates and raped by an officer. The officer was later successfully prosecuted, but even in seeking justice, blatant transphobia was evident in the court, where Imani was told to come “dressed like a boy.”

Inmates of criminal justice facilities are constitutionally protected from “cruel and unusual punishment.” Graham and colleagues (2008) have previously argued, using Prison Rape Elimination Act (PREA) data, that the degree of criminal justice system staff involvement in perpetrating, rather than curbing, sexual violence and misconduct is radically at odds with the asymmetrical role of staff and inmate in facilities. Recent data from 2011 to 2012 show extreme vulnerability to sexual victimization for detainees who reported their sexual orientation as gay, lesbian, bisexual or other. Non-heterosexual males were more than ten times as likely to experience inmate-on-inmate victimization, and more than three times as likely to experience staff sexual misconduct. Most non-heterosexual inmates who experienced sexual misconduct by staff experienced it more than once (84 %), and 41.7 % occurred with force or the threat of force.

The prison and jail system, typically divided into male and female facilities, is designed to accommodate presumed heterosexual, cis-gender (gender identity socially associated with sex assigned at birth) populations, and is particularly problematic for transgender individuals. Some participants who had spent time in jail described the designation of “special” areas for gay or transgender individuals, and being given the option of either solitary confinement or conforming to normative gender codes, by cutting their braids and being housed with the male population. While not every interaction participants described with law enforcement was problematic, the existence of a pattern of severe maltreatment is unacceptable at any frequency, given the power entrusted in law enforcement officers to act as an arm of the justice system and the mandate of police to keep all citizens safe (Graham et al. 2008).

Troubled interactions with the police are particularly problematic for transwomen given the amount of time spent on the street due to unstable housing and high rates of harassment and violence. Thus, those who are most in need of basic public protections presumably afforded to all citizens are precisely those least likely to benefit from them. Once in a detention facility, an increased likelihood in part related to high incarceration rates and over-policing of black communities, black transwomen frequently endure abuse from staff and other inmates (Marksamer 2008). In facilities, transwomen are subject to intense gender and sexuality policing, having conformity forced on them masked as rehabilitation. If there is a response to this abuse, it is often to isolate transwomen (Wilber et al. 2006). Such abuse increases transwomen’s distress, escalating suicidality risk, and compounding the long-term psychosocial sequelae once they are released (Marksamer 2008).

Faith-Based Institutions

Participants who discussed their faith described a conflict between their perception of “God’s” acceptance of them, and the transphobia they associated with other individuals they identified as “religious.” Individuals paradoxically found faith to be both an internal source of strength or resilience, as well as others’ moral rationale for transphobia and discrimination. Some participants spoke of regularly attending church, though one noted that she does not dress as a woman at church. Adina, who had been forced to change churches after intense transphobia was directed publicly at her from the pulpit, was still unwavering in her testimony of the importance of and support she has derived from God:

The main reason why I made it was because of Jesus, because I am Christian. And, um, of course, you know, in my faith, you know, I’ve dealt with people interrogating me, asking me, “well, you know, that’s against his Word” and whatnot, but I have strived and searched all my life for enlightenment and answers of why I am the way I am, and I have come across some … God loves us all no matter what and Jesus understands what we go through. It’s not like he just totally avoids the fact that we are gay. He knows who and what we are and what we go through.

Participants’ stories highlight their perceived difference between their personal spirituality and more communal aspects of religion. Christian doctrine and beliefs that view homosexuality and gender variance as sinful have been identified as contributing to homonegativity and other oppressive forces in black communities (Graham 2012). However, foregoing religious affiliation or relying on less communal practices may not be optimal as black LGBT individuals may not be able to afford loss of social support from black community institutions, like the church, because of their role in helping contend with racism and racial discrimination (Battle and Crum 2007). While disaffiliating may not be viable, rejection from an institution regarded as a place of refuge from racism and with which one has strong solidarity, may be felt with greater intensity or may represent a unique form of denunciation.

Some participants described perceived religiosity as contributing to their fear of coming out as gay and later as transgender. Imani explains, “I didn’t have one problem in the world with my dad. Not one, and I thought I [would if I came out to him] because he’s a preacher.” In instances where a participant’s coming out was not well received, religion was often linguistically constructed as the rationale for the rejection. Eboni laments, for example, “My mom didn’t take it very good… we really into church.” Participants seemed concerned both with the moral or faith-based affronts of their gender and sexual identities and the potential embarrassment to their parents and families in the context of church-based social networks.

There is evidence to suggest that LGBT individuals employ religious beliefs and practices (e.g., prayer, attending worship services, meditation) to cope with VDH they experience related to their marginalized identities (Bockting and Cesaretti 2001; Fullilove and Fullilove 1999; Love et al. 2005). However, religiosity may be a double-edged sword for some LGBT individuals (Golub, et al. 2010), particularly black individuals demonstrating non-normative gender and sexuality. While religiosity and affiliation may help counter some oppression related to race, religious institutions likely do not offer parallel benefits related to gender nonconformity and marginalized sexualities (Graham 2012). Further, religious institutions may, on the whole, worsen mental health for black gender and sexually marginalized individuals (Fullilove and Fullilove 1999; Love et al. 2005), in this case, by contributing to delayed and stressful coming-out experiences, ironically masquerading “in drag” as men to conceal their true gender identity at church, and taking on the added stress of not wanting to embarrass or shame their families.

Broader Society

In reflecting back on pre-transition experiences, without identifying the specific instances that socialized them to feel different or unacceptable, participants described their fear and hurt:

I wanted to be this person, but I knew I couldn’t because I didn’t want to get beat up… And I think that is the most hurtful thing for a child. – Jasmine

To be born a male… I always felt different. And I always knew I was different, but in those days—and I’m speaking in concern of my childhood… it wasn’t the difference that I appreciated, it was just feeling alone – Imani

Participants described daily discrimination as posing significant challenges in their transitions. In the context of discrimination, participants placed an emphasis on “passing” as cis-women, further perpetuating the idea of gender dichotomy. Thus, participants saw passing as a social obligation that was perhaps a burden transwomen had to bear in exchange for acceptance. Jasmine described the importance of passing in order to earn respect:

Blending into society people will respect you. They may even know, but they’ll respect you more because they’ll say, okay, this person really isn’t bothering anybody, you know what I’m sayin’. But like if you out here just looking bad and doin’ this and doin’ that like people probably will shun you.

Participants’ gender transitions seemed significantly influenced by a desire to protect themselves from violence, loneliness, and disrespect through conforming to traditional or hegemonic notions of femininity. Early on in the transitioning process, many transwomen conceal their gender identities or refrain from disclosing a transgender identity in hopes of “passing” and avoiding social rejection (Stieglitz 2010). This process often began in our study with coming out about being “gay,” while avoiding reference to gender identity. Later in the transitioning process, transphobia and dichotomized notions of gender in the larger society made participants feel as though they had to achieve very narrow ideals of womanhood in order to be worthy of acceptance. That is, if they were not successful in “blending into society” or if they “looked bad” and could not “pass,” they did not deserve respect. These patterns are consistent with available scholarship. In the developmental period beginning at early adolescence throughout young adulthood, many transwomen have been found to struggle to develop a core sense of self and deal with feelings of shame and guilt about their identities while conforming to gender expectations in their families and communities (Brennan et al. 2012).

Employment was mentioned as a particularly troubling challenge for those transitioning. One participant aptly described the irony of feeling like people looked down upon her for turning to sex work for income, but concurrently erecting significant barriers to formal sector employment through work-place discrimination. The pressure to “pass” may be another double-edged sword for transwomen, such that they may gain some perceived acceptance in society, but it may have hidden perils or potential consequences such as pressuring transwomen into sex work to pay for bio-medical and non-biomedical transition technologies to facilitate “passing” (Manderson 2012). Transwomen need employment to pay for transitioning related expenses, but need to pass to obtain employment. This puts them in a double-bind, and the result is often the use of sex work as a mediating strategy to cope with societal rejection and construct a pathway toward some level of social acceptance.

Transgender Communities

These data and the literature illustrate the myriad challenges transwomen face as a result of pervasive marginalization and discrimination. However, many young transwomen support each other in various ways during adolescence and adulthood. While it is important to focus on challenges with which transwomen are confronted in institutions and society broadly, youth stories also depict the talents, skills, and strengths in their communities (Munoz-Plaza et al. 2002). In our study, connections with other black transwomen in Detroit provided communities of support during transition.

Establishing a connection with and integration into transgender communities was described as an important source of support, particularly early in participants’ transitions to living “full-time” as transgender. The willingness with which this support was extended to relative strangers was notable and suggests a strong sense of social responsibility within transgender communities. House (1981) characterized social support as being comprised of four dimensions: instrumental support (e.g., resources like money, time, and labor), informational support (e.g., advice), emotional support (e.g., caring, listening, love), and appraisal support (e.g., affirmations and positive feedback). Particularly early on in participants’ transition, and upon separating from family and friends in order to transition, participants described transgender peers as providing instrumental, informational and emotional support.

Often, this support took the form of housing, insider and experience-based information about transitioning, and empathy with struggles participants faced. For many participants, transwomen offering housing support was particularly important; Darla remembers transwomen who made generous offers to her if she had no place to live: “‘if you ever needed somewhere to come, you can come there.” Remarkably, these offers were made to women early in their transition, even when those women were near-strangers. A few participants referenced House Balls (black and Latino LGBT subcultural settings in which people compete for trophies and prizes through elaborate, stylized performances) as important events in transgender communities, seen as places where genders outside of the binary were created, valued, and celebrated. Others noted that Balls could foster competition within the community.

In large part due to family rejection or abuse, many transgender and gender-nonconforming young people are homeless. The National Network of Runaway and Youth Services has approximated that as many as 40 % of homeless youth are LGBT (Sullivan et al. 2001). Transgender communities and their social institutions, like Balls, appeared to serve as safe spaces for participants to build and establish supportive relationships (e.g., kin, friendships, romantic partners) with each other, which may help to create resilience in developing healthy gender identities and dealing with VDH and cultural orientation incongruence (Graham 2012). While transwomen in this study survived both their youth and initial transition period with the support of other transwomen and LGBT communities, narratives revealed numerous troubling experiences in schools, criminal justice systems, churches, and broader society. These structural factors raised the stakes of their relationships with transgender peers, who provided the needed support that was the primary safety net ensuring their very survival.

Conclusion

There are multiple sites and sources of social exclusion for black transgender women that influence their experiences of VDH. In our study, we examined these processes by analyzing narratives regarding the institutions and social settings that emerged as significant in shaping transwomen’s experiences. Significant policy intervention is needed to protect and support transwomen, and prevent VDH perpetuated against them in schools, the criminal justice system, and churches.

In schools, lack of integration of transgender persons into the overwhelmingly heteronormative context of childhood education made our participants feel alienated and misunderstood, and as though they were being punished for the exclusionary practices that were, in fact, imposed upon them in the form of expectations and rules requiring gender conformity. This resulted in acts of VDH being fostered in the school setting. Our findings further expose the central role that school staff and policy play in perpetuating disaffirming messages about transgender identities that interact with transphobia and genderism within broader communities, and provoke sometimes violent defensiveness from transgender individuals. Creating safe learning environments in schools improves student achievement (Munoz-Plaza et al. 2002).

LGBT youth need statewide legal protection from VDH, which could then be systematically implemented through policies and systems of accountability in public schools (Bauer 2002). Based on inferences from our data and the literature, some school policy recommendations that could promote the safety and well-being of transwomen include: (a) adding gender and sexual identity to non-discrimination policies, (b) amending dress codes to accommodate transgender youth, wherein youth cannot be sent home or punished in other ways for wearing clothes as expressions of their gender identity, and (c) prohibiting personnel and student use of transphobic and homonegative slurs. Additionally, schools can implement the following practices, which we believe would help mitigate the school-based experience of VDH among the participants in our study: (a) cultural sensitivity and anti-transphobia trainings focused on changing attitudes and use of appropriate language for all students and school personnel, including administrators, teachers, coaches, librarians, and others; (b) sponsorship of gay-straight and trans-cis-gender alliances that organize cross-cultural dialogues and affirming cultural productions about gender and sexuality (e.g., theater, art, spoken word); and (c) integrate LGBT authors and topics throughout curriculums (e.g., LGBT history, discussions of sexuality, sexual stigma, and sexual health). We follow other analysts who have argued that such policies and practices in schools will contribute to healthy gender and sexual identity development, decrease defensive violence, and prevent dropout (Kosciw et al. 2013).

In some cases, a lack of support and safety at school led participants to leave school, potentially lowering their educational attainment in the long-term and contributing to their vulnerability to both the criminal justice system and to survival sex work. There are serious problems in the criminal justice system that must be addressed. As a nonviolent act that can be consensual, prostitution should be decriminalized, rather than serve as an axis of arrest disparity and an excuse for investigative inaction of assaults perpetrated against transwomen. If sex work were a regulated industry, it would allow transwomen and others to exercise their practice- and relationship-based sexual rights (Graham and Padilla 2013); organize to protect themselves from violence, sexually transmitted infections, discrimination, arbitrary arrest; and serve as a source of tax revenue.

Additionally, the criminal justice system should rethink standards for evidence that constitute justifiable suspicion to stop, search, and arrest. Lax criteria may increase the potential for racially- and gender-biased stops, searches, and arrests, as some of the actions and practices regarded as indications of criminality may be raced, gendered, and culturally particular to an area or group. Further, as one way to increase police awareness of their enforcement efforts in aggregate and perhaps unconscious targeting and bias, police could be provided with real-time updates of arrest rates by race and gender. Tracking arrest disparities in real-time could inform more reflective and critical policing.

Once detained, gender and sexuality-based solitary confinement and forced gender conformity should be prohibited (Wilber et al. 2006). The safety of transwomen should be achieved by controlling inmates, staff, and the detention environment, not by isolating transwomen or adding gender reassignment to their sentences. At issue in the criminal justice system is not just that transwomen are over-policed, but that those perpetuating VDH against transwomen are under-policed. To help build trust between police and transwomen, the minimum investigative mandates for reported assaults should be enhanced, such that regardless of the circumstances (e.g., sex work involvement) all reported assaults are taken seriously and thoroughly investigated. Finally, criminal justice system regulation compliance should be assessed and overseen by external bodies (Marksamer 2008).

Advocacy efforts related to faith-based institutions can focus on integrating gender and sexuality into conceptualizations of black liberation theology, a religious perspective that casts Christianity as a tool to help African-Americans overcome oppression (Shaw and McDaniel 2007). Gender and sexual identities can be included in black liberation theology’s aim to free ethnic minorities from multiple forms of religious, political, and socioeconomic subjugation (Kornegay 2004). Incorporating transgender, gay, and other identities into black liberation theology’s quest for justice rooted in scripture may begin to change doctrines that view transgenderism and homosexuality as sinful (Thomas 2004). Infusing recognition of parallels in oppression across race, gender, and sexuality into curriculums in seminaries, where pastors are trained, could decrease transphobic sermons or rejection and change beliefs in churches and religious networks, which may ease the coming-out and disclosure experiences of black transwomen, while enhancing the resilience benefits of spirituality and religiosity.

To address discrimination against transwomen in employment, federal and state employment non-discrimination acts (ENDA) that include transgender protections should be passed into law, which would prohibit workplace discrimination on the basis of sexual orientation and gender – without regard to sex assigned at birth (Vitulli 2010). Community-based organizations, like the Ruth Ellis Center, that provide a safe and affirming environment for transwomen to meet, develop friendships, and support each other, should be supported and promoted through federal, state, and local initiatives that help secure service delivery space, train staff, and provide funds to develop and offer a range of culturally sensitive services. Future research should include ethnographic case studies that further identify and describe the institutional policies, practices, and attitudes in schools, the criminal justice system, faith-based organizations, and other social structures that influence the psychosocial wellbeing of young gender and sexually marginalized youth. Further, case–control studies are needed that more conclusively link specific institutional level factors to particular psychosocial indicators among gender and sexually marginalized youth. Whenever possible, research should incorporate communities of transwomen themselves in generating, evaluating, and disseminating scientific knowledge on their communities.