Nursing outlook · 2026
Associations between intersectional discrimination, self-efficacy to manage one's health, and health outcomes among Black transgender women.
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Sherman Athena D F, Kebede Sara, Akande Morayo, Duroseau Brenice, Pelkmans Jordan, Lishnoff Jacob, Allure Kisha, Poindexter Jey'nce, Schneider Jason S, Operario Don, Cimino Andrea N, Together We Thrive Community Advisory Board, Balthazar Monique S
Аннотация
BACKGROUND: Black transgender women are disproportionately exposed to discrimination and healthcare barriers associated with poor health and delayed treatment-seeking. Consequently, traditional treatment pathways may not be accessible. Thus, health self-management (HSM) may be critical in promoting health among Black transgender women.
PURPOSE: The purpose of this study is to examine the relationships among intersectional discrimination, self-efficacy for health management, and mental health outcomes (PTSD symptoms, depressive symptoms, and unhealthy days) among Black transgender women, and to determine whether self-efficacy modifies or explains the association between intersectional discrimination and these health outcomes.
METHODS: We analyzed quantitative survey data from a community-based United States sample of 154 Black transgender women to advance our understanding of the associations between intersectional discrimination, self-efficacy to manage one's health, and distal health outcomes. Analyses included Pearson's correlations, T-tests, and multiple linear regression.
RESULTS: Higher self-efficacy was associated with better mental health overall but did not consistently buffer the effects of intersectional discrimination, suggesting partial mediation rather than full mediation or moderation.
DISCUSSION: Among Black transgender women, racism and cisgenderism may be influencing other components in the pathway between context and health outcomes, contributing to higher self-reported self-efficacy or reducing the potential effect of self-efficacy on health outcomes.
CONCLUSION: Future research should further examine the historical and present-day prejudicial systems that affect one's self-efficacy to manage their health and take an anti-cisgenderist and anti-racist approach to discussing HSM with Black transgender women.
PURPOSE: The purpose of this study is to examine the relationships among intersectional discrimination, self-efficacy for health management, and mental health outcomes (PTSD symptoms, depressive symptoms, and unhealthy days) among Black transgender women, and to determine whether self-efficacy modifies or explains the association between intersectional discrimination and these health outcomes.
METHODS: We analyzed quantitative survey data from a community-based United States sample of 154 Black transgender women to advance our understanding of the associations between intersectional discrimination, self-efficacy to manage one's health, and distal health outcomes. Analyses included Pearson's correlations, T-tests, and multiple linear regression.
RESULTS: Higher self-efficacy was associated with better mental health overall but did not consistently buffer the effects of intersectional discrimination, suggesting partial mediation rather than full mediation or moderation.
DISCUSSION: Among Black transgender women, racism and cisgenderism may be influencing other components in the pathway between context and health outcomes, contributing to higher self-reported self-efficacy or reducing the potential effect of self-efficacy on health outcomes.
CONCLUSION: Future research should further examine the historical and present-day prejudicial systems that affect one's self-efficacy to manage their health and take an anti-cisgenderist and anti-racist approach to discussing HSM with Black transgender women.