Transgender individuals face heightened risks for discrimination, harassment, and violence that impact their psychosocial well-being and physical health. However, few studies have thoroughly examined the general physical and mental health of transgender adults or within-group health differences by race/ethnicity and income. To that end, after controlling for health insurance status, age, and engagement in exercise, this study asks: (a) Are transgender people of color more likely than White transgender individuals to experience poor health outcomes? and (b) Is lower annual household income among transgender adults associated with poorer health outcomes? The study analyzes secondary data from a survey of transgender adults (N = 417) in one state in the western United States using multiple linear regression and logistic regression models. Results showed that transgender people of color had significantly greater odds than their White counterparts of having arthritis/rheumatoid arthritis/gout/lupus/fibromyalgia, or asthma but lower odds of being told by a provider that they had depression. Having a lower income was significantly associated with worse general health as well as multiple indicators of poor physical and mental health, including depression, anxiety, and suicidal ideation. We discuss implications for health care delivery for transgender people and for future research.

Background: Guided by an ecological systems theory (EST) framework, the purpose of the present study was to investigate how multiple micro, mezzo, and macro factors influence the suicidality continuum from suicidal ideation to suicide attempt among Latinx LGB (lesbian, gay, and bisexual) youth living in the United States. Methods: Data for this cross sectional-study included 451 participants who self-identified as Latinx LGB on the 2017-National Youth Risk Behavioral Survey. The analysis explored micro, mezzo, and macro-level factors’ association with three suicidality outcomes (ideation, planning, and attempt) at the bivariate and multivariate level. Since the outcome variables were dichotomized, univariate logistic regressions and backward elimination logistic regressions were used. Results: The most commonly reported suicidal behavior was ideation (n = 173; 40%), followed by planning (n = 150; 34%), and then attempt (n = 64; 21%). Findings from the backward elimination logistic regression on suicidal ideation suggest the best set of independent variables are being bullied at school (odds ratio [OR] = 2.81; CI: 1.61–4.89), experiencing sexual assault (OR = 2.32; CI: 1.32–4.07), experiencing depressive symptoms (OR = 1.99; CI: 1.07– 3.69), being cannabis use (OR = 1.76; CI: 1.08–2.89), and being female (OR = 1.72; CI: 1.01–2.93). For suicide planning the model suggested, experiencing depressive symptoms (OR = 3.21; CI: 1.74–5.91), cannabis use (OR = 2.46; CI: 1.49–4.07), being bullied at school (OR = 2.04; CI: 1.17–3.58), and experiencing sexual assault (OR = 1.88; CI: 1.07–3.31) exhibited the strongest relationships. Suicide attempt was significantly associated with cannabis use (OR = 3.12; CI: 1.60–6.08), experiencing depression (OR= 2.89; CI: 1.30–6.43), experiencing sexual assault (OR = 2.77; CI: 1.34–5.71), and being bullied at school (OR = 2.34; CI: 1.12–4.91). Conclusion: Given the findings of this study, it is essential that tailored suicide prevention efforts be established that uniquely address the intersections of race/ethnicity and sexual orientation and how this intersection influences micro, mezzo, and macro factors associated with suicide ideation, planning, and attempt among Latinx LGB adolescents.

Using data from the 2015 United States Transgender Survey, this study investigates which patient sociodemographic characteristics and psychosocial risks are associated with likelihood of transgender mistreatment in healthcare and how patterns vary for patients of color. Numerous predictors, including alignment of identity documents, were associated with healthcare mistreatment. Among subgroups of transgender patients of color, psychosocial risks were more consistently significant than sociodemographic characteristics in predicting mistreatment. National and international health organizations are called to enact clear policies that affirm transgender patients and patients of color and establish a commitment to effectively serving these populations within their ethical codes.

This article examines the definitions and implementations of the concepts of culture and cultural competence in social work education and practice. We take a look at the history and evolution of diversity and cultural competence in the social work curriculum. This article also identifies four theories and models of cultural competence taught in social work education, and the strengths and limitations of each theory and model are discussed. A new approach to cultural competence, the Dialectic and Uniqueness Awareness Approach, considers the triadic relationship between the social worker, the client, and the interaction of both with a multiplicity of systems and experiences. Finally, the five main principles of this approach are discussed using a case example.

Objective: Examine how student demographics and perception of on-campus counseling service availability, accessibility, acceptability, and quality is related to utilization. Participants: A total of 262 students from 49 Georgia (U.S.) higher education institutions. Methods: A logistic regression examined student perception of on-campus counseling services and associations with service utilization, controlling for covariates. Results: (1) Non-heterosexual students were more likely to use on-campus counseling services than heterosexual students, (2) students in rural areas were more likely to utilize services than students in urban areas, (3) insured students had higher odds of utilizing services than uninsured students, and (4) higher ratings of perceived accessibility were associated with likelier service use. Conclusions: The perception of accessibility was significantly associated with higher odds of on-campus service use. Thus, a better understanding of student perception of on-campus counseling center accessibility is warranted.