Experienced and Anticipated Intersectional Violence and Psychological Distress Symptom Severity Among Black Transgender Women in the United States of America

Background: Black transgender women experience disproportionately high rates of violent victimization rooted in intersecting systems of oppression, including cisgenderism and anti-Black racism. Although victimization is linked to psychological distress, the mental health impacts of intersectional violence, which targets overlapping marginalized identities, remain understudied. Objectives: To examine the associations between anticipated and experienced intersectional victimization and psychological distress among Black transgender women. Methods: Online survey data from 151 Black transgender women (age ≥ 18) in the United States (US) between October 2021 and February 2024 were analyzed using t-tests and multivariate linear regressions. Results: In models controlling for age, employment, and US region, experienced sexual, physical, and threats of intersectional violence, as well as anticipated intersectional violence, were associated with increased post-traumatic stress disorder (PTSD) symptom severity, in separate models. Conversely, only experienced sexual intersectional violence and anticipated intersectional violence were associated with greater depressive symptom severity. When all violence variables were included simultaneously, experienced intersectional sexual violence and anticipated violence remained significantly associated with PTSD and depressive symptoms in separate models. Conclusions: Service providers who work with Black transgender women should routinely assess for anticipated and experienced intersectional victimization to guide person-centered interventions. Further research is needed to distinguish the effects of intersectional victimization from opportunistic victimization and to inform the adaptation of targeted mental health interventions.