Transgender stigma and health: A critical review of stigma determinants, mechanisms, and interventions

Rationale: Transgender people in the United States experience widespread prejudice, discrimination, violence, and other forms of stigma. Objective: This critical review aims to integrate the literature on stigma towards transgender people in the US. Results: This review demonstrates that transgender stigma limits opportunities and access to resources in a number of critical domains (e.g., employment, healthcare), persistently affecting the physical and mental health of transgender people. The applied social ecological model employed here elucidates that transgender stigma operates at multiple levels (i.e., individual, interpersonal, structural) to impact health. Stigma prevention and coping interventions hold promise for reducing stigma and its adverse health-related effects in transgender populations. Conclusion: Additional research is needed to document the causal relationship between stigma and adverse health as well as the mediators and moderators of stigma in US transgender populations. Multi-level interventions to prevent stigma towards transgender people are warranted. (C) 2015 Elsevier Ltd. All rights reserved.