Predictors, Victimization, and Negative Health Outcomes Associated with Incarceration Among 9180 Trans Women from the US Transgender Survey

Transgender women face significant disparities within the criminal justice system. Previous studies of trans women prisoners examined small or convenience samples. The current study examined 9180 trans women’s responses from the 2015 US Transgender Survey-the largest nation-wide survey available. Within the past year, 43% of participants interacted with police and 2% were incarcerated. Black, Alaskan Native and Native American, and Latina/Hispanic trans women were incarcerated at rates 5, 4, and 2 times higher (respectively) than their White, non-Hispanic peers. Twenty-four percent of prisoners reported victimization; 12% and 10% were physically, and 16% and 5% sexually, abused by inmates and staff (respectively.) Controlling for demographics, logistic regression analyses revealed that trans-related stressors including homelessness (adjusted odds ratio [AOR] = 2.37; confidence interval [CI] = 1.60-3.51), sex work (AOR = 3.90; CI = 2.71-5.60), and physical intimate partner violence (AOR = 1.85; 1.25-2.75) significantly increased odds of incarceration. Significant negative health outcomes for prisoners included attempted suicide (AOR = 2.26; CI = 1.38-3.68), daily smoking (AOR = 1.98; CI = 1.16-3.39), and heavy alcohol use (i.e., binge drinking 5 or more days per month; AOR = 2.10; CI = 1.16-3.78). Recommendations are provided for research, public policy, and law enforcement.