title: Transgender stigma and health: A critical review of stigma determinants, mechanisms, and interventions.
abstract: BACKGROUND
  Transgender people in the United States experience widespread prejudice, discrimination, violence, and other forms of stigma.
  
  
  OBJECTIVE
  This critical review aims to integrate the literature on stigma towards transgender people in the U.S.
  
  
  RESULTS
  This review demonstrates that transgender stigma limits opportunities and access to resources in a number of critical domains (e.g., employment, healthcare), persistently affecting the physical and mental health of transgender people. The applied social ecological model employed here elucidates that transgender stigma operates at multiple levels (i.e., individual, interpersonal, structural) to impact health. Stigma prevention and coping interventions hold promise for reducing stigma and its adverse health-related effects in transgender populations.
  
  
  CONCLUSIONS
  Additional research is needed to document the causal relationship between stigma and adverse health as well as the mediators and moderators of stigma in US transgender populations. Multi-level interventions to prevent stigma towards transgender people are warranted.
authors.affiliation: Chronic Disease Epidemiology, Yale University School of Public Health, New Haven, CT, USA; The Fenway Institute, Fenway Health, Boston, MA, USA. Electronic address: Jaclyn.White@Yale.edu.
authors.forename: Jaclyn M
authors.initials: JM
authors.lastname: White Hughto
authors.affiliation: The Fenway Institute, Fenway Health, Boston, MA, USA; Division of General Pediatrics, Children's Hospital/Harvard Medical School, Boston, MA, USA; Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA.
authors.forename: Sari L
authors.initials: SL
authors.lastname: Reisner
authors.affiliation: Chronic Disease Epidemiology, Yale University School of Public Health, New Haven, CT, USA.
authors.forename: John E
authors.initials: JE
authors.lastname: Pachankis
mesh_terms: D005260:Female; D006801:Humans; D008297:Male; D008603:Mental Health / Q000592:standards; D011287:Prejudice / Q000523:psychology; D063507:Sexism; D012725:Sexual Behavior / Q000523:psychology*; D057545:Social Stigma; D063106:Transgender Persons / Q000523:psychology*; D014481:United States
keywords: Health; Inequities; Interventions; Stigma; Transgender