STDs Among Transgender College Students in the US: The Role of Experienced Discrimination

Background:  Limited research has explored the relationship between experienced discrimination and STDs among transgender college students in the U.S., which was the purpose of this investigation.

Methods:  We conducted a secondary analysis of the American College Health Association’s Spring 2010 National College Health Assessment-II survey data. A total of 95,712 students from 139 institutions completed the survey. We restricted the sample to include students who were of traditional college age (18-24 years), attended a 4-year institution in the United States, and reported their gender (female, male, or transgender) (n=61,548). A total of 106 students identified as transgender. Because the NCHA-II does not distinguish between trans-men and trans-women in the transgender category, we combined male and female college students into a “cisgender” category for comparison purposes. Multivariate logistic regression analyses were conducted to identify factors associated with an STD (past year) based on gender (cis vs. trans), demographic characteristics (age, race/ethnicity, international status, region of U.S.), behavioral risk factors (sexual, alcohol and poly-drug use), and experienced discrimination (racism, sexism, homophobia) (past year).

Results:  Overall, 2.5% of college students had an STD (past year) and 5.1% experienced discrimination (past year). Transgender students were significantly (p<.001) more likely than cisgender students to have had an STD (12.3% vs. 2.5%, respectively) and to have experienced discrimination (50.0% vs. 5.1%, respectively).  In unadjusted models, transgender students had 5.6 times greater odds (95% CI: 3.1-9.9) of having an STD than cisgender students. This relationship remained significant after adjusting for demographic characteristics and risk behaviors.  However, after adjusting for experienced discrimination, the association between gender and having an STD became non-significant, suggesting that experienced discrimination mediates this relationship.

Conclusions:  Results indicate that experienced discrimination is a significant risk factor for STDs among transgender college students and reinforces the need for stigma reduction/discrimination prevention efforts on campus.