Magister Artium (Psychology) - MA(Psych) / There is a dearth of scholarly literature surrounding transgender female sex workers (TFSW) within South Africa. Their voices are often marginalised and not adequately heard in the literature and in a society that generally views gender as a fundamental element of the self, determining their subject positions against binaried heteronormative gender ideals. This process of the ‘othering’ of TFSW, is exacerbated by the moralistic judging of their occupation of sex work. This has left many TFSWs vulnerable to emotional abuse such as being socially stigmatised, discriminated against and socially isolated. The literature further echoes vulnerability to physical violence, such as hate crimes, rape, heightened HIV infection, homelessness, police brutality and murder. The current study aimed to explore the subjective experiences of TFSW within their families, occupations and the healthcare system within the Cape Town metropole, South Africa. The study was framed within an intersectional feminist epistemological position, highlighting intersecting identities that marginalise groups of people. Informant driven sampling was used in the case of this study where a total of eleven participants were individually interviewed using a semi-structed approach – interviews ranged from 35-90 minutes. The data collected was subsequently analysed using thematic analysis and the three themes that emerged were: transgender female (TGF), Sex work and HIV. Family rejection and abuse based on participants non-conforming gender identity was expressed by participants. Repressive home circumstances led to many opting to live on the street. Participants described being introduced to sex work through a network of other homeless TFSW, also described as ‘Sisters’ (who fulfil the role of family) as a means of survival. Sex work for TGFs is a particularly dangerous job, as sex workers run the risk of being exposed as TGFs, often resulting in severe physical harm for some. To cope with their severe realities of violence and homelessness, many reported turning to substances, such as alcohol and methamphetamine. A total of ten participants described being HIV positive and adherence was very poor among the group. This could be attributed to stigmatisation from health workers, substance use and homelessness. This group of women, though vulnerable and structurally oppressed, displayed exceptional resilience. It is suggested that further research should be conducted on this group in the South African context for a clearer understanding of their needs and improved policy, as well as interventions for TFSW.

Thesis advisor: Karen Rosen / Thesis advisor: Daniel Bowles / Transgender individuals in the twenty-first century face stigmatization across the globe. Discrimination contributes to the development of early life stress (ELS), and this may lead to depression, anxiety, and social and developmental problems as individuals enter adulthood. Suicide rates in transgender populations in Western countries peak above 41%, compared to 4.6% in the general population (Haas, Rodgers, & Herman, 2014). Though medical and social efforts to treat suicide in the community are being developed, existing measures have been unable to effect significant change regarding these disproportionately-high suicide rates. Some parts of the world are drawing ahead of others in this respect. As one of the most gay-friendly countries in the world (Rand, 2013), for example, Germany is making progress medically and legally, including recently having introduced a third gender option into legal documents and opened new discussions on depathologizing transgender identity in medical care. Germany has been able to build on its early history as the first country to publicly tolerate and provide healthcare to transgender individuals. This has fostered transgender activism from the postwar period to today and may contribute to lowered suicide rates among transgender Germans. This thesis aims to use Germany’s early history of transgender rights to contextualize the state of the transgender population there today. Using an analysis of existing literature, it looks at the effects of stigmatization on suicide rates in the transgender population. Positive and negative aspects of Germany’s LGBTQ+ and transgender culture are evaluated for their impact on neurological development and the perpetuation of suicidal behavior. The thesis concludes with proposals for improved social, legal, and medical practices regarding transgender health in Germany, with a particular focus on the development of cultural understanding of transgender identity. / Thesis (BA) — Boston College, 2018. / Thesis (BA) — Boston College, 2018. / Submitted to: Boston College. College of Arts and Sciences. / Submitted to: Boston College. College of Arts and Sciences. / Discipline: Psychology. / Discipline: German Studies.

This dissertation research constitutes a mixed methods investigation of the phenomenon of nonsuicidal self-injury (NSSI) among transgender and gender nonconforming (TGNC) people. An integrative review of the current literature about NSSI among sexual and gender minority populations established that NSSI is reported at higher rates by sexual and gender minorities than by cisgender (nontransgender) and heterosexual populations. Additionally, TGNC people appeared to report higher rates of NSSI than cisgender sexual minorities. Among TGNC people, transmasculine spectrum people (i.e., gender identity is male, man, transgender man, transmasculine, genderqueer, nonbinary, etc., with female sex assigned at birth) reported higher rates of NSSI compared to transfeminine spectrum people (i.e., gender identity is female, woman, transgender woman, transfeminine, genderqueer, nonbinary, etc., with male sex assigned at birth). Guided by Meyer’s (2003) minority stress model and Nock’s (2009) model of NSSI, qualitative interviews were conducted with eighteen transmasculine individuals to understand what contributes to the higher rates of NSSI in this population. The qualitative data supported aspects of Nock’s model as well as minority stress processes, and additionally revealed that NSSI may be related to transgender identity development processes. Aspects of Nock’s model that were supported included risk factors for NSSI (adverse childhood experiences), intrapersonal and interpersonal vulnerability factors, and identification with the behavior. Minority stress processes related to stigma associated with transgender identity included the impact of nonconformity in appearance and behavior, nonconformity in identity with nonbinary identified participants reporting additional stress, concealment of identity, and expectations of rejection. Transgender identity development stages of pre-coming out (confusion prior to understanding one’s gender identity), coming out, and exploration (finding a community of similar peers) were also related to NSSI. This latter finding highlighted that, in addition to being a response to stigma and minority stress, NSSI may occur in the context of normal transgender identity development. Finally, a quantitative investigation was conducted to examine correlates of past-year NSSI among a diverse community-based sample of TGNC people. In the total sample (N = 332), 53.3% (n = 177) of participants reported having engaged in NSSI in their lifetime. Lifetime history of NSSI was more common among transmasculine spectrum compared to transfeminine spectrum participants (60.5% vs. 39.5%, p < 0.001). Past 12-month NSSI was reported by 22.3% (n = 74) of the sample and was not significantly different between transmasculine and transfeminine spectrum participants. Younger age and higher levels of felt stigma were associated with higher rates of NSSI, while transgender identity acceptance and congruence were protective factors. Together, the findings of this mixed method investigation provided new insights into the onset and maintenance of NSSI among TGNC people, informing the development of interventions to address the high rates of NSSI among gender minority populations. Implications for theory, clinical practice, provider education and training, health policy, and future research are discussed.

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As transgender medicine developed in the course of the 20th century, medical professionals have slowly followed the lead of their clients. Patients during the early decades of transgender medicine sought to switch from one gender to another. Medical providers developed treatment protocols to guide this transition. In recent decades patients are no longer as quick to desire a switch from one gender to another. Rather, many younger transgender patients are more likely to explore the ambiguities of gender and adopt a gender-fluid identity. Healthcare professionals have, for the most part, accommodated their patients' changing ideas about treatment outcomes. But these currents towards a patient-centered approach are in contrast with transgender health organizations that seek professionalization through treatment protocols and standardization. Examining these socio-historical processes reveals how a nascent field of medicine negotiated the sometimes competing demands of standardization and patient desire. Three questions guide my research: 1) How do trans-identified people experience and resist social sanctioning, make meaning of a transgender identity within a limiting transnormative narrative, and actively seek to create new identities? 2) How do healthcare providers construct scientific discourse and make meaning of gender in the process of working with transgender people in this emergent field of medicine? And 3) How has the history of medical and mental health interventions shaped the contemporary experiences of providers? I used a mixed-methods approach including the analysis of archival documents from the Kinsey Institute in Bloomington, Indiana, in-depth interviews with 40 transgender-identified people and 23 healthcare providers, and participatory observations in community spaces. In part one of my dissertation I consider the nuances of transgender identities and the consequences of living in a society as a transgender person. Our society is organized in a two-gender system - individuals are either women or men. While some transgender people identify within these binary categories, as trans women or trans men, others resist a binary gender identification. Instead, they construct diverse gender identities like "genderqueer" or "genderfluid" that lack culturally agreed-upon definitions. Despite the diversity of identifications within transgender communities, most social scientific accounts adopt the binary model and position transgender people as moving from one gender to the other. This limits our understandings of transgender people and their own self-perception. Additionally, "transitioning" is understood as a process in which individuals move neatly from one stage to the next, and passing as women or men becomes the ultimate goal. Transgender people are creative in negotiating their identities within this system. Some resist binary systems and strategically deploy cultural resources to redefine gender categories in ways that fit their self-understanding. In part two of my dissertation, I consider the emergence of transgender medicine, the ways that scientific discourse shapes medical practice, and how providers - who are situated within this dialogue in several distinct ways - must work with conflicting interests. The standardization of transgender medicine runs parallel with many contemporary currents related to the changing structure of our healthcare system. Evidence-based medicine has become ubiquitous in systems of healthcare, and is coupled with the creation of professional guidelines for standardizing healthcare. However, providers gave voice to the idea that transgender people have unique healthcare needs that may not be met in a system structured by binary modes of thought and in general, are wary of standardizing transgender medicine. In these contexts, providers must learn to how to balance their professional responsibilities and client-driven needs, which sometimes are in contradiction.

Parents of transgender children face challenges when their children come out, including fear of negative reaction toward the parents and their transgender child by community members, concerns about social status in the community or religious organizations, and concerns about the inability of the transgender child to build his or her own family. The purpose of this qualitative phenomenological study was to investigate the emotional experiences of parents regarding their acceptance or rejection of their transgender child. Rohner's parental acceptance-rejection theory provided the framework for the study. Data were collected from parents (N = 13) who attended Parents and Friends of Gay and Lesbian support groups from various areas in the United States or who were identified through snowball sampling using semistructured interviews and a demographic questionnaire. Data were coded and analyzed to identify themes in parental responses to their transgender children coming out, which were either negative, neutral, positive, or mixed. Results indicated that even parents with negative emotions supported and loved their children unconditionally. Findings may be used to develop supportive interventions for parents coping with their transgender child's transition.

Transgender people, a minority population, are at increased risk for negative health and mental health consequences. Profound societal discrimination and stigmatization lead to systemic institutional barriers and lack of access to health care services. Research with lesbian, gay, and bisexual populations shows a strong association between minority stress and mental health; however, there is a gap in research for the transgender population. This study, based on theories of minority stress, positive psychology, the biopsychosocial model, and the transgender model, was conducted to clarify this relationship for the transgender population. Four research questions were proposed. A final sample of N = 29 transgender participants completed an online survey with 3 measures of minority stress (internalized transphobia, stigmatization, and prejudice events) and 5 measures of mental health (depression, suicide, anxiety, and substance abuse [drug and alcohol]). It was predicted that each minority stressor would have an independent effect upon each mental health variable, and when the effects of the stressors were combined, each would maintain an independent effect on mental health, so that their combined effect would be greater than their individual effects. Regression analyses indicated, as expected, participants with higher perceived stigma scores had higher suicidal ideation scores. Contrary to expectations, participants with higher internalized transphobia scores had lower scores on suicidal ideation. No other significant predictive relationships were found. The results of this study advocate for social change initiatives by presenting information on a poorly understood minority group for the purpose of promoting a positive effect for institutions, professionals, and transgender clients in the context of health care settings.

REMEMBER is a film script that operates within the horror genre but touches upon the subgenre of body horror as well as the sub-subgenre of body modification/alteration. It examines psychological and sociological issues such as identity and acceptance, gender understanding and social assignment. The story follows five young women who live outside the norms of ‘acceptable’ society. After an accident near a small, isolated, rural town called Tantalus leaves them stranded with strangers, the girls soon find that something is amiss. Having arrived during a tornado just before the towns Founder’s Day festival, they discover there is more in Tantalus than meets the eye. The town is founded on a dark past which appears to be returning in a fashion. Now with a body count rising and no way to leave, the women find themselves connected to the murders. The only question that remains is how?

The purpose of this study was to identify and describe the current campus climate for gay, lesbian, bisexual, and transgender persons at Texas A&M University as perceived by the faculty, professional staff, and administration at the institution. Specifically, the study looked at differences in perceptions and behaviors based on university position, race/ethnicity, gender, sexual identity, age, and interaction with members of the sexual orientation minority. The population for the survey consisted of 5,863 individuals at Texas A&M University, including 513 administrators, 1,992 faculty members, and 3,358 professional staff members. Based on the work of Krejcie and Morgan, a random sample of each of the three employment categories was taken, which resulted in a sample of 1,020 individuals. The survey instrument used was the Assessment of Campus Climate for Underrepresented Groups, developed by Susan R. Rankin, Ph.D. A selected group of questions from the survey were analyzed in order to conduct this research. The usable response rate was 47.9%. Overall, the data supported the finding that the University does not provide a campus environment that is welcoming to all members of the community, especially those individuals who identify as gay, lesbian, bisexual, or transgender. Several statistically significant differences were found to exist among the positions of the participants, as well as race/ethnicity, age, gender and sexual identity. The research also confirmed that an individual's attitudes and behaviors toward gay men, lesbians, bisexual men and women or transgender persons were influenced in a positive manner in relation to the frequency of contact that the person had previously had with members of this population. When compared to the norms established by a similar study across the United States, Texas A&M University was found to have a more negative campus climate. Implications for practice suggest ways in which the university can work toward improving the campus climate for gay, lesbian, bisexual and transgender students. Among the suggestions are the development of new policies that create a more supportive environment and new programs to serve the needs of the sexual orientation minority and to educate the campus community. Suggestions for future research are also discussed.

Adolescence is not experienced in the same way by all individuals or communities; individuals who cannot find harmony between their sense of identity and social norms often have a much harder time during this period. In this vein, there is an especially strong need for transgender adolescents to be able to locate themselves in the world around them. I examine current transgender representations available to (and specifically marketed towards) young adults through three venues—literature, television, and the Internet. The amount of material that deals directly with any instance of transgender or transsexual identity is minimal. I will argue at the very least that these representations are important for transgendered adolescents to find someone with whom they can identify but that more than likely, it is important for all adolescents to have exposure to representations of transgender individuals. I closely analyze the young adult novel, Parrotfish (Wittlinger 2007), and the CW television show, America’s Next Top Model, for narratives of success that are applied to transgender subjects. I also briefly analyze three websites and compare them to the previous texts, identifying key similarities and differences. I end with suggestions for future growth in all three areas. / text