***Under construction***
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 | The impact of social determinants |
| Gender oppression |
| Compromised survivors |
The impact of social determinants
Three types of social determinants really shape the lives of transgender people. These social determinants all stem from the stigma transgender people experience, and the discrimination that flows from it.
1. stress, especially violence related stress
2. social exclusion
3. (lack of) social support
The strong negative influence of these social determinants means transgender people have fewer life chances than non-transgender people. They are less likely to be in a position to excel on a personal or professional level. Often, these influences result in transgender people being particularly vulnerable -- to negative health outcomes, or negative life experiences like violence. This creates a model for understanding some of the adverse health outcomes reported for transgender populations. For example, why is the HIV infection rate for transgender sex workers higher than for others? Through this lens we see that transgender people are likely to be less stable than other sex workers. The constant battle against extreme violence and discrimination and social exclusion leaves them with fewer resources to make choices that protect their health.
Gender Oppression
It has been hypothesized that gender oppression is a continuum, that probably affects everyone in some way or another. If a young boy feels pressure to enter a traditionally male profession, he's affected. If a woman feels pressure to have a child, she is affected. Our society has made great strides in blurring the distinctions between gender roles, but we also have some deeply-held ideas about how people should act. Transgender people are often bend or break these gender conventions. It is hypothesized that visibly transgender people just receive the most extreme end of the same gender oppression at work everywhere. The discrimination, exclusion and violence that transgender people experience is consistent with this hypothesis -- especially since the most visibly gender variant people experienced the greatest amount of problems. In real life this means that as a group male-to-female transgender people are more likely to have major discrimination-based life challenges, because they are often less able to "pass" as gender normative. This is consistent with the greater number of health problems reported for this subgroup. Of course it all varies person by person.
Compromised Survivors
Transgender people show great ability to survive, not through luck, but through determined effort. People in the study routinely told of intense daily battles to achieve survival. For ???, this meant making sure they were always with a friend as they did their sex work. For ??? it meant not going out in the day and taking cabs everywhere to guard against unprovoked violence. Many people in the study also told of outliving a whole generation of their peers -- emphasizing how precarious this survival can be.
--UNDER CONSTRUCTION--