Date of Conferral

2018

Degree

Ph.D.

School

Public Policy and Administration

Advisor

Karen Shafer

Abstract

In Colorado in 2014, suicidal ideation or suicide attempts occurred up to 10 times more frequently among transgender persons than the general population. This reality occurred within a milieu of stigma that included transgender persons' negative perceptions of healthcare, a higher incidence of psychological distress, and an uncertain role for social isolation in their well-being. The purpose of this quantitative study was to explore the interactions between social isolation, supportive medical care, and psychological distress within the framework of Meyer's minority stress theory. Data were acquired from the 2014 Colorado Transgender Health Survey conducted by the One Colorado Education Fund (n = 417). These survey data were analyzed using multivariate techniques and structural equation modeling. Key findings were that psychological health and social integration were positively related (p < .001), supportive medical care and psychological health were positively related (p = .016) and influenced by race and gender identity (p = .05), and, social integration and supportive medical care were not significantly associated. Access to medical care and disease history influenced these relationships (p < .001), and 5 distinct gender identity/race groups emerged. The positive social change implications stemming from this study include recommendations for healthcare and policy-making bodies to improve understanding regarding gender and racial disparities in medical and psychological healthcare, to expand collection of gender identity and victimization data, to improve availability of adequate insurance coverage, and, to foster employment and housing equity. Implementation of these recommendations may improve the lives of transgender Coloradans.

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