Feds Spend $226,364 on ‘Gender Affirmation’ for Jailed Transwomen

NIH study of ‘culturally relevant’ interventions in San Francisco

The University of California, San Francisco / Wikimedia Commons
February 25, 2015

The National Institutes of Health (NIH) is spending over $200,000 on a study involving "gender affirmation" and incarcerated transwomen in San Francisco.

Claiming that incarceration "disproportionally impacts" transwomen—individuals born as males but who self-identify as women—the University of California, San Francisco (UCSF) is studying how to bring "culturally relevant" interventions to this demographic.

The interventions will focus on HIV, substance abuse, mental health, and "transgender-related medical care."

"Incarceration is a significant public health issue that disproportionately impacts transgender women, and the cycle of incarceration interacts with high levels of substance use, mental illness, and HIV to produce an elevated burden of disease among this population," a grant for the project states.

"Trans women who have been arrested are more likely to report mental illness, using substances, engaging in risky sex, and needing trans-sensitive services upon release," it said. "Gender differences in health, post-release service needs, and predictors of engagement in healthcare call for gender-specific strategies."

The project will use an "innovative, transgender-specific theoretical model," called the "Model of Gender Affirmation."

Gender affirmation is "the process by which individuals are affirmed in their gender identity through social interactions," according to a 2012 paper written by the project’s lead investigator, Jeanne M. Sevelius. Sevelius is an assistant adjunct professor at UCSF.

The grant argues that without gender affirmation, transwomen are more likely to suffer from poor mental health and are at risk for HIV.

"Unmet need for gender affirmation predicts HIV risk among HIV- trans women and treatment failure among those who are living with HIV, and access to gender affirmation is related to better mental health," the grant said. "Furthermore, access to gender affirmation supports linkage, engagement, and retention in care among trans women who are living with HIV."

Fifteen to 20 transwomen in the San Francisco County Jail will be interviewed before and after their release for the study. The project will then test the gender affirmation intervention on 50 transwomen who "who have been incarcerated for a minimum of one week."

The researchers believe that those who receive the intervention will report higher rates of HIV testing, higher HIV medical appointment attendance, and "higher levels of linkage to and engagement in substance abuse treatment, mental health care, and transgender-related medical care."

"With the data from the feasibility and acceptability pilot, we will leverage funding to conduct a larger efficacy study of the adapted curriculum with the goal of producing a replicable, culturally relevant, evidence-based health promotion intervention for incarcerated trans women who are preparing for release into the community," the grant said.

The project, which began last September, is scheduled to continue until August 2017. It has cost taxpayers $226,364 so far.

Sevelius has also received $452,389 from the NIH for a separate project entitled "Sheroes," a "culturally grounded intervention to reduce sexual risk behavior" among transwomen.