Abstract
PURPOSE: Transgender-based discrimination is associated with poor mental health, unemployment, and poverty. Travestis and transgender women (trans women) frequently experience transgender-based discrimination, but associated factors are understudied. Our objective was to identify the factors associated with transgender-based discrimination among trans women from Brazil. METHODS: We used data from Transcendendo, a clinic-based cohort of trans women in Rio de Janeiro, Brazil. Eligible participants were ≥18 years old, assigned male sex at birth, and self-identified as travestis, transgender women, or other trans feminine identities. We analyzed baseline data for participants enrolled from August 2015 to March 2020. Face-to-face questionnaires collected data on socio-demographics, gender identity and expression, and transgender-based discrimination experience. Factors associated with transgender-based discrimination were evaluated through multivariable linear regression. RESULTS: Out of the 587 participants, 559 (95%) were included (28 excluded due to missing data). Mean age was 33 years, the majority identified as transgender women (40%), 71% reported current or past sex work, and 43% self-reported as living with HIV. In multivariable regression models, factors significantly associated with transgender-based discrimination included having no supporting or one supporting parental figure (vs. support from both parents), living in poverty (vs. not), and current and past sex work (vs. never). CONCLUSIONS: Trans women without family support, who engaged in sex work or were economically deprived were more prone to transgender-based discrimination. A lack of parental support, the strongest independent predictor of transgender-based discrimination experiences, likely contributes to emotional and structural vulnerabilities.