title: A Tale of Two Cities: Access to Care and Services Among African-American Transgender Women in Oakland and San Francisco.
abstract: OBJECTIVE
  The San Francisco Bay Area attracts people from all over the country due to the perception of lesbian, gay, bisexual, and transgender (LGBT) acceptance and affirmation. African-American transgender women are severely marginalized across society and as such have many unmet health and social service needs. This study sought to quantitatively assess unmet needs among African-American transgender women with a history of sex work by comparing residents of Oakland versus San Francisco.
  
  
  METHODS
  A total of 235 African-American transgender women were recruited from San Francisco (n=112) and Oakland (n=123) through community outreach and in collaboration with AIDS service organizations. Participants were surveyed regarding basic, health, and social needs and HIV risk behaviors. Pearson Chi-squared tests and a linear regression model examined associations between city of residence and unmet needs.
  
  
  RESULTS
  While participants from both cities reported unmet needs, Oakland participants had a greater number of unmet needs in receiving basic assistance, mental health treatment, and health care services. Oakland participants also reported less transgender community identification but higher social support from the family.
  
  
  CONCLUSIONS
  These findings demonstrate the enormity of African-American transgender women's needs within the Bay Area. Greater resources are needed for social service provision targeting this marginalized group of people, particularly in Oakland.
authors.affiliation: 1 Health Intervention Projects for Underserved Populations, Public Health Institute , Oakland, California.
authors.forename: Tooru
authors.initials: T
authors.lastname: Nemoto
authors.affiliation: 1 Health Intervention Projects for Underserved Populations, Public Health Institute , Oakland, California.|2 Department of Social & Behavioral Sciences, University of California , San Francisco, San Francisco, California.
authors.forename: Taylor M
authors.initials: TM
authors.lastname: Cruz
authors.affiliation: 1 Health Intervention Projects for Underserved Populations, Public Health Institute , Oakland, California.
authors.forename: Mariko
authors.initials: M
authors.lastname: Iwamoto
authors.affiliation: 1 Health Intervention Projects for Underserved Populations, Public Health Institute , Oakland, California.
authors.forename: Maria
authors.initials: M
authors.lastname: Sakata
mesh_terms: D000293:Adolescent; D000328:Adult; D001741:Black or African American / Q000706:statistics & numerical data*; D000368:Aged; D002947:Cities; D005260:Female; D006297:Health Services Accessibility / Q000706:statistics & numerical data*; D006304:Health Status; D006801:Humans; D008297:Male; D008605:Mental Health Services / Q000706:statistics & numerical data; D008875:Middle Aged; D020380:Needs Assessment; D060386:Sex Workers / Q000706:statistics & numerical data; D012944:Social Support; D012959:Socioeconomic Factors; D019966:Substance-Related Disorders / Q000453:epidemiology; D063106:Transgender Persons / Q000706:statistics & numerical data*; D014481:United States; D055815:Young Adult
keywords: access to care; mental health needs; transgender