“A center for trans women where they help you”: Resource needs of the immigrant Latinx transgender community

Abstract

Background

Immigrant Latinx transgender people often migrate to the United States because of a desire for increased safety and more opportunities. However, after migrating to the United States, immigrant Latinx transgender people often struggle to access basic needs, including health care, jobs, and stable finances. These struggles are exacerbated for undocumented immigrant Latinx transgender people. There is a gap in the literature regarding needed resources for immigrant Latinx transgender community members living in the United States.

Aims

Utilizing a critical intersectionality framework, the aim of the present study was to investigate the resource needs of immigrant Latinx transgender community members living in the United States.

Methods

A community sample of 18 immigrant Latinx transgender people living in a large metropolitan city in Florida participated in individual semi-structured interviews to explore their community resource needs.

Results

Thematic analysis revealed five themes related to resources that participants needed including: 1) Transgender healthcare/resources, 2) Public education, 3) Financial aid resources, 4) Homelessness resources, and 5) Addictions care. Two resource need-related themes were identified that pertain specifically to undocumented immigrant Latinx transgender people, including: 1) Documentation papers for access, and 2) Legal aid.

Conclusions

Findings suggest that immigrant Latinx transgender community members in this study provided guidance about broad resources needed to enhance their wellness and safety, and promote liberation of community members. Participants’ resource needs suggest the importance of policy and structural level changes from institutions with power that consider and enhance the wellness of immigrant Latinx transgender people. Findings also suggest the need for more tailored interventions and case work to better support immigrant Latinx transgender people.

The present study is one of the first to explore the resource needs of immigrant Latinx transgender community members who currently live in the United States. Immigrant Latinx transgender individuals experience significant health disparities and face unique challenges because of systemic oppression at the intersection of their generational status, ethnic identity, and gender identity (Rhodes et al., 2020). These health disparities are at least partially due to the structural barriers put in place to limit access to needed resources for immigrant Latinx transgender people. Although emerging research explores some specific resource needs including the importance of healthcare resources for immigrant Latinx transgender people (see Abreu et al., 2020; Howard et al., 2019; Hudson, 2019; Nemoto et al., 2004), there is a dearth of research on the comprehensive needs of this community. The present study extends the current scholarship focused on healthcare needs by using a critical intersectional qualitative framework to center the voices of immigrant Latinx transgender people as they talk about general resources that they need to enhance their wellness and quality of life.

Intersectionality as a theoretical framework

We (the authors) use a critical intersectionality framework (Crenshaw, 1989) to understand the experiences of immigrant Latinx transgender people at the intersection of generational status, ethnic identity, and gender identity. Intersectionality, rooted in Black feminist thought, asserts that interlocking systems of oppression exist that hinder the wellness of marginalized community members. Individuals who hold multiple marginalized identities are stigmatized at the intersection of multiple oppressive systems, including racism, classism, and cissexism (Collins, 2015; Combahee River Collective, 1995/1977; Crenshaw, 1991). Crenshaw (1989) challenged the often single-axis approach to understanding oppression by using intersectionality theory to describe how power structures in society (i.e., racism, heterosexism, and patriarchy) work together to create structural inequities and enact violence toward Women of Color broadly, and Black Women specifically. Critical intersectionality frameworks are needed to center the experiences of immigrant Latinx transgender people while analyzing how systems of power position this community within social institutions (see de Vries, 2015; Hines, 2010). Intersectionality asserts that social identities are always interconnected, making it impossible to tease apart or explore how institutional power impacts or creates inequity for marginalized community members when only considering one aspect of identity (Bowleg, 2008; de Vries, 2015). Thus, it is necessary to situate any scholarship on the needs and wellness of immigrant Latinx transgender communities, by exploring how interlocking systems of oppression influence and impact their lives. We encourage readers to hold an intersectional framework as they consider the following sections and the results.

Migration experiences of immigrant Latinx transgender communities

Immigrant Latinx transgender individuals face unique challenges in the United States when compared to other marginalized groups as a result of their immigration process and journey. To begin, immigrants regardless of gender identity or sexual orientation may migrate because they are in search of better job opportunities or living options (see Yakushko, 2009). Immigrant Latinx transgender people often migrate to the United States because they are fleeing violence in their home country and are searching for a safer home with better access to healthcare (Cerezo et al., 2014; Morales, 2013). Immigrant Latinx transgender people may also migrate because of sexual orientation and gender identity-based stigma and oppression experienced in their home country (see Toro-Alfonso et al., 2012). Although immigrant Latinx transgender people often migrate to the United States with the hope of improving their lives, Cerezo et al. (2014) found that immigrant Latinx transgender people experienced violence, stigma, and discrimination, increased psychological distress, struggles to obtain legal documentation, and because of limited work options, were forced into sex work after migrating to the United States. These structural and interpersonal barriers ultimately lead to decreased psychological well-being for immigrant Latinx transgender community members.

Health disparities of immigrant Latinx transgender communities

In addition to facing challenges after migrating, immigrant Latinx transgender people also experience unique health disparities when compared to other marginalized groups because of the stigma they experience as a result of their generational status, race and ethnicity, and gender identity (Rhodes et al., 2020). A dearth of research exists that explores these unique health disparities with larger samples of immigrant Latinx transgender people. Much of the literature on health disparities in this area of scholarship focuses on experiences of immigrant Latina transgender women (see Bazargan & Galvan, 2012; Cerezo et al., 2014; Hwahng et al., 2019; Pinto et al., 2008; Rhodes et al., 2013). However, scholarship suggests that immigrant Latinx transgender people experience increased rates of HIV (Clements-Nolle et al., 2001; Nuttbrock et al., 2009), increased depressive symptoms (Allen & Leslie, 2020; Sun et al., 2016), heavy alcohol and drug use, and unprotected sex (Bruce et al., 2008), increased risk for suicide (James & Salcedo, 2017), and live in extreme poverty (Grant et al., 2011; James et al., 2016). Given the unique health disparities and challenges faced by immigrant Latinx transgender community members, it is important to explore the resources available to them to reduce these disparities and increase wellness.

Immigrant Latinx transgender resources

Resources and services can be viewed as avenues that alleviate systems of oppression and reduce health disparities while increasing wellness for marginalized community members. Specifically, immigrant Latinx transgender individuals face marginalization as a result of their intersecting identities. Providing resources and services to immigrant Latinx transgender individuals helps to offset the negative impact of societal forces designed to reinforce systemic oppression and hinder wellness. Much of the scholarship on resource needs of immigrant Latinx transgender people has come from the broader literature on transgender People of Color that is inclusive of immigrant Latinx transgender individuals. Based on the current literature, immigrant Latinx transgender people might need access to different resources such as how to navigate engaging in survival sex work in a safe way, connection to religious and spiritual resources, and a safe space to be in community with other immigrant Latinx transgender people (Cerezo et al., 2014). We begin by reviewing the general literature on transgender People of Color and then discuss the limited literature on immigrant Latinx transgender people.

Health care resources

Transgender People of Color struggle to access adequate and affirming health care (see Howard et al., 2019), including addressing substance abuse related needs (Bruce et al., 2008) and HIV prevalence (Clements-Nolle et al., 2001; Nuttbrock et al., 2009). For transgender People of Color, access to adequate healthcare can also be an important component needed to live in congruence with their gender identity. For example, health care providers often need to submit letters of support on behalf of transgender patients in order to be eligible for transition related procedures (National Center for Transgender Equality, 2020). This requires that transgender people have a strong affirming connection and relationship with their healthcare provider in order to optimize their wellness and meet their healthcare needs. However, transgender People of Color have identified barriers to accessing healthcare including lack of trust in providers, difficulties with accessing consistent care, provider disrespect, financial strain, and too few providers available who specialize in trans issues (Johnson et al., 2020). Specific to immigrant Latinx transgender people, a recent study of immigrant Latinx transgender women by Abreu et al. (2020) found that participants experienced significant barriers to accessing care, inappropriate treatment including ridicule and harassment by healthcare providers, and recognized that providers generally lacked training in working with transgender people.

Other resources

Transgender People of Color also have financial resource needs (Singh & McKleroy, 2011), including access to jobs to make money for transgender-specific healthcare needs like hormones and gender affirmation surgery; needs related to job training and work, legal services, transportation, and educational opportunities (Kenagy, 2005); and struggle with housing insecurity (Kenagy, 2005; Reck, 2009). Although some emerging research suggests that immigrant Latinx transgender people need healthcare resources (Abreu et al., 2020), less is known about other resources needed by this community. Further, little is known about whether immigrant Latinx transgender community members experience similar or divergent needs from the broader community of transgender People of Color. Given that immigrant Latinx transgender people face unique challenges at the intersection of their generational status, ethnic identity and gender identity, more research is needed to understand the resource needs of this specific community as well as systemic barriers present that prevent access to care.

Statement of the problem and the current study

Scholarship suggests that immigrant Latinx transgender community members face unique challenges because of the dominant interlocking oppressive power structures and systems that lead to discrimination and victimization while creating barriers to access and care (see Cerezo et al., 2014). Scholars also suggest that a gap in the literature exists and more research is needed to explore how oppressive power structures and systems negatively impact Latinx transgender individuals (see Cerezo, 2020), including the resources they need. Most of the literature on needed resources with immigrant Latinx transgender individuals focuses on health care access (see Abreu et al., 2020; Howard et al., 2019; Johnson et al., 2020). Given the literature that documents the health disparities experienced by the immigrant Latinx transgender community, a gap in the literature exists for exploring how this community talks about and identifies their community resource needs. Thus, the aim of the current study was to engage a community sample of immigrant Latinx transgender people living in the United States to explore the resources they need within their immigrant Latinx transgender community. The following research question guided the current study: What are the resource needs of immigrant Latinx transgender people living in the United States?

Materials and method

The current study was part of a larger study on immigrant Latinx transgender peoples’ experiences in the current sociopolitical climate under the presidency of Donald Trump as well as their access to resources and their resilience. The authors used Levitt et al.'s (2018) published standards for reporting qualitative research to make decisions about manuscripts from this dataset. The authors wrote two other manuscripts from this dataset focused on how immigrant Latinx transgender people were impacted by Trump’s presidency (Abreu et al., revised and resubmitted) and how immigrant Latinx transgender people conceptualize their community as a support system and a mechanism for resilience (Abreu et al., under review). All manuscripts are distinct from one another and data analyzed for the previous two manuscripts are separate from the data used for this manuscript. The authors also decided to divide the results into three papers because of the richness of the data and the importance of giving ourselves ample space to highlight the voices of our immigrant Latinx transgender participants as we explored their narratives (see Braun & Clarke, 2006, 2013; Levitt et al., 2018).

We analyzed data from semi-structured interviews with 18 self-identified Latinx transgender participants who lived in a large city in Florida that is heavily populated with Latinx individuals, and who sought services from a local nonprofit organization. Given the depth of participant interviews, the authors felt it was important to have one manuscript dedicated to solely focusing on immigrant Latinx transgender participants’ resource needs.

A qualitative approach was used to illuminate the narratives of immigrant Latinx transgender people as they talked about the community resources they needed. Thematic analysis (Braun & Clarke, 2006, 2013) was used because the authors were interested in understanding and exploring patterns and themes about the resource needs identified across participant interviews (Braun & Clarke, 2006). Thematic analysis (Braun & Clarke, 2006, 2013) offered a way for the authors to work with the words and phrases used by participants in their interviews to make meaning of their resource needs while centering the voices and narratives of the immigrant Latinx transgender community members in the sample.

Participants

Participants in the study (N = 18) were immigrant Latinx transgender community members living in a major city in Florida. When reporting participant demographics in the following section, the authors intentionally use the labels and language participants used to describe their demographic information. Participants ranged in age from 21 to 69-years-old (M = 46.06, SD = 14.43). Participants reported that they were from seven Latin American countries including Cuba (n = 11), Nicaragua (n = 2), El Salvador (n = 1), Peru (n = 1), Puerto Rico (n = 1), Uruguay (n = 1), and Colombia (n = 1). At the time of the study, participants were United States citizens (n = 7, 38.89%), permanent residents of the United States (n = 7, 38.89%), or were undocumented (n = 4, 22.22%). Participants were first generation immigrants (n = 15, 83.33%), third generation migrants (n = 2, 11.11%), and fourth generation migrants (n = 1, 5.56%). Participants identified their race as White (n = 9, 50%), Mestiza (n = 4, 22.22%), Hispanic (n = 2, 11.11%), Black (n = 2, 11.11%), and Mulata (n = 1, 5.56%). Participants’ identified their gender identity as women (n = 11, 61.11%), transgender males (n = 2, 11.11%), transsexual (n = 1, 5.56%), queer (n = 1, 5.56%), shemale (n = 1, 5.56%), female (n = 1, 5.56%), and male (n = 1, 5.56%). See Table 1 for a complete description of participant demographics.

Table 1.

Participant demographics.

Documentation Status	n	%
United States citizens	7	38.89
Permanent residents of the U.S.	7	38.89
Undocumented	4	22.22
Latin American Heritage
Cuba	11	61.11
Nicaragua	2	11.11
Colombia	1	5.56
El Salvador	1	5.56
Puerto Rico	1	5.56
Peru	1	5.56
Uruguay	1	5.56
Race
White	9	50.00
Mestiza	4	22.22
Hispanic	2	11.11
Black	2	11.11
Mulata	1	5.56
Generational Status
First Generation Migrants	15	83.33
Third Generation Migrants	2	11.11
Fourth Generation Migrants	1	5.56
Sexual Orientation*
Heterosexual/Straight	7	38.89
Gay	3	16.66
Bisexual	2	11.11
Lesbian	2	11.11
Pansexual	2	11.11
Transsexual/Trans	2	11.11
Gender*
Women	11	61.11
Transgender males	2	11.11
Transsexual	1	5.56
Queer	1	5.56
Shemale	1	5.56
Female	1	5.56
Male	1	5.56
Relationship Status
Single	15	83.32
Married	1	5.56
Divorced	1	5.56
Cohabitating with a significant other	1	5.56
Level of Education
Attended High School	5	27.78
College Degree	5	27.78
High School Diploma or GED	4	22.22
Some College or Technical School	2	11.11
Post-bac or graduate program education	2	11.11
Religious Identity
Catholic	7	38.88
Atheist	5	27.77
Yoruba	3	16.67
Christian	1	5.56
Baptist	1	5.56
Ambiguous	1	5.56
Frequency of Attendance at Religious Services
Never	9	50.00
Several Times a Year	4	22.22
1-2 times a year	2	11.11
About Once a Month	1	5.56
2-3 times a month	1	5.56
Every Week	1	5.56

*Note We intentionally use the labels verbatim that participants use.

Recruitment

Participants were eligible to participate in the study if they had Latinx heritage, lived in the United States at the time of the study, were at least 18-years-old, and identified as transgender. Participants were recruited from a nonprofit organization that provides public health, counseling, advocacy and support services and programs for LGBTQ community members in a large city in Florida. This nonprofit organization provides: 1) free HIV testing, counseling, case management, and care for people living with HIV; 2) referrals for medical care, PrEP and PeP, and hormone replacement therapy; 3) free condoms; 4) family and individual mental health treatment; and 5) referrals for free legal immigration attorneys and services. Abreu worked with the director of the nonprofit center to create a recruitment flyer that provided information about the purpose of the study, eligibility criteria for participating, Abreu’s contact information, and compensation information. The flyer was distributed on the nonprofit organization’s listserv where the information was shared with clients seeking services and service providers of the nonprofit organization. Hard copies of the flyers were placed in meeting spaces and on announcement boards at the nonprofit organization’s physical location. Twenty participants expressed an interest in participating in the study but two did not participate because of technological difficulties that prevented them from participating.

Procedure

After receiving IRB approval from Tennessee State University, eligible and interested participants were invited to participate in a phone interview conducted by Abreu. Participants in the current study were invited to ask any questions and agreed to participate in a recorded phone interview. All interviews were conducted in September of 2019 and lasted anywhere from 30 to 65 minutes (M = 35.83; SD = 9.01). At the start of the interview, participants verbally answered demographic questions and then answered open-ended questions about the resources they needed as immigrant Latinx transgender people. Participants were given the option of participating in English, Spanish, or a combination of English and Spanish. All interviews were conducted in Spanish. When answering the interview questions, participants were primed by Abreu to think about their identities as immigrant Latinx transgender individuals. Abreu has a previously established relationship with the nonprofit organization and was able to easily establish rapport with participants. Using an intersectionality framework, participants were encouraged to consider their identities as immigrant Latinx transgender people when answering the interview questions. The following questions were analyzed for the current study: What are the resources provided to you as an immigrant Latinx transgender person? What resources would you like to see as part of your community of immigrant Latinx transgender people to better address your needs?

Transcription and translation of data

Participant interviews were recorded and identifying information was removed to protect the identities of participants. Recorded interviews were then transcribed and translated by a doctoral candidate in Hispanic studies who is a native English speaker fluent in Spanish with expertise in Spanish to English translation work. Abreu translated the transcripts from English back to Spanish to ensure that the English transcripts accurately represented the Spanish interviews (see Ozolins, 2009). Abreu made minor changes to the English transcripts to increase the accuracy of the Spanish to English translations. The English transcripts were ultimately used so that all of the authors (including those not fluent in Spanish) could analyze the data. As a native Spanish speaker, Abreu oversaw the data analytic process to ensure that the coding process stayed true to the Spanish narratives.

Researchers’ positionality and self-reflection

The research team had a range of identities across race, ethnicity, generational status, nationality, sexual orientation, and gender identity that allowed for meaningful dialogues during data analysis. The first author, Gonzalez, is an assistant professor of counseling psychology who identifies as a third-generation Latinx (Mexican descent) heterosexual cisgender woman. The second author, Abreu, is an assistant professor of counseling psychology who identifies as a first-generation Latinx (Cuban descent), gay cisgender man. The third author, Capielo Rosario, is a heterosexual cisgender woman and an assistant professor of counseling psychology who identifies as Latinx (Puerto Rican descent). The fourth author, Koech, is a counseling psychology PhD student who identifies as a first-generation Latina (Mexican descent) cisgender woman. The fifth author, Lockett, is a counseling psychology PhD student who identifies as an African American queer trans man. The sixth author, Lindley, is a counseling psychology PhD student who identifies as a White queer trans man. Several members of the research team have expertise in qualitative research and have coauthored multiple peer-reviewed published qualitative research papers. Lockett and Lindley, who are transgender, served as the primary coders on this project and kept coding journals to document their reactions, feelings, and thoughts while coding (Gilbert, 2001). Gonzalez and Abreu, who are cisgender, served as auditors during the coding process and engaged in discussions with Lockett and Lindley during data analysis to protect against bias in the coding process (see LeCompte & Goetz, 1982). As cisgender auditors, Gonzalez and Abreu worked with Lockett and Lindley who are transgender during the coding process to facilitate objectivity during data analysis. Additionally, Lockett and Lindley served as coders in the data analysis process because they do not identify as Latinx, and they helped to facilitate objectivity during data analysis with Gonzalez, Abreu, Capielo Rosario, and Koech who identify as Latinx.

Data analysis

Thematic analysis (Braun & Clarke, 2006; Morales, 2013) was used to explore immigrant Latinx transgender participants’ resource needs. Data analysis began with Lockett and Lindley coding the data by independently reading through the participant interviews. Lockett and Lindley began by breaking down each word or clause in the participant transcripts and grouping together words and clauses with similar meaning units and ideas (see Giorgi, 1985). The grouped together words and clauses formed the preliminary themes. Lockett and Lindley met to discuss and agree upon the preliminary themes. Gonzalez and Abreu then reviewed the initial themes and provided feedback to Lockett and Lindley. With the feedback from Gonzalez and Abreu, Lockett and Lindley met to revise and establish themes to represent the data. Then, independently, Lockett and Lindley coded each participants’ response into the themes. Gonzalez, Abreu, Lockett, and Lindley met throughout the coding process to discuss and reconcile coding discrepancies, and edit the initial themes by eliminating themes and identifying new themes until a thematic structure was finalized.

Results

The authors of this study utilized an immigration framework for conceptualizing the study and contextualizing the results because an immigration narrative was shared across participants regardless of generational status (i.e. first, third, or fourth generation). That is, even though 83.33% (n = 15) of the sample were first generation immigrants while 16.67% (n = 3) of the sample were third or fourth generation migrants, all participants considered immigration and the barriers to accessing resources for immigrants regardless of their generational status. Thus, our results rely on a strong immigration lens when articulating our findings.

Participants discussed resources they needed that would better address their needs as immigrant Latinx transgender community members. Participants also directly spoke to the lack of resources for undocumented Latinx transgender community members. Immigrant Latinx transgender participants identified specific resources they needed, including: 1) Transgender healthcare/resources, 2) Public education, 3) Financial aid resources, 4) Homelessness resources, and 5) Addictions care. Two resource-related themes were identified that pertain specifically to undocumented immigrant Latinx transgender people, including: 1) Documentation papers for access, and 2) Legal aid.

Needed resources

Almost all of the participants (n = 16, 88.89%) talked about resources needed to better address their needs as immigrant Latinx transgender people. One participant exemplified the comprehensive nature of her needs and the needs of other immigrant Latinx transgender people when she said,

A center for trans women where they help you as much with … your health to migration issues and that they train women to look for day jobs so they aren’t in risky situations and getting arrested (55-year-old first generation White Cuban heterosexual woman).

This participant named the importance of having multi-purpose trans-specific spaces and centers that would cater to the needs of the immigrant Latinx transgender community. Participants identified five resource-related themes that they needed, including: 1) Trans healthcare/resources, 2) Public education, 3) Financial aid resources, 4) Homelessness resources, and 5) Addictions care.

Trans healthcare/resources

Trans specific healthcare resources were discussed by 72.22% (n = 13) of the sample. Some of these participants discussed trans healthcare resources that they already had access to while other participants discussed trans healthcare resources that they needed but did not currently have access to. One 65-year-old first generation White Cuban heterosexual transgender woman exemplified trans healthcare resources she had when she said, “I have a primary care doctor, and another general doctor. I don’t have problems of any type.” In contrast, another participant exemplified the struggle with accessing trans healthcare resources when she said,

A health plan for the trans community. That’s definitely something we need here. Like, ninety, ninety-five percent of trans people don’t have health insurance (55-year-old first generation White Cuban heterosexual woman).

Trans-specific healthcare resource needs were seen through five subthemes including needs related to: 1) insurance, 2) hormones, 3) surgery, 4) mental health treatment, 5) AIDS/sexual health resources.

Insurance

Participants in the current study detailed how having access to basic health insurance was an important and needed resource during the current sociopolitical climate. One participant said,

I turned 65 this year. I have my health insurance that provides [for] me, for example if I want hormones (65-year-old first generation Cuban woman).

For this participant, having health insurance afforded opportunities for gender identity-specific medical care.

Hormones

The immigrant Latinx transgender participants in the study also talked about their hormone needs as trans people. One 37-year-old third generation Black Colombian bisexual male exemplified this subtheme when he said, “They do the hormone therapy and everything, they do have that, but I think a lot of the resources that I’ve mentioned, um more availability, ya know, um, of those resources.” This participant shared how he was able to access needed hormone treatments but also commented that more of these resources are needed for the immigrant Latinx transgender community.

Surgery

Immigrant Latinx transgender participants also expressed a need for having medical care resources that would cover gender identity-related surgeries. One participant stated,

I understand that it [insurance] pays for part of that operation if I want it. In other words, at this point I think we are doing well. It’s there if I want it (58-year-old first generation Hispanic Cuban heterosexual transsexual person).

Participants named the need to have access to gender identity-related surgeries if they desired.

Mental health treatment

Participants detailed specific mental health needs that are important to helping them manage their mental health and transition. One 49-year-old first generation White Cuban gay queer person said, “They [non-profit] gave me free therapy and like they helped me get my letter and they helped me get my gender marker and name changed for free, and stuff like that.” Another participant stated:

Um, besides that, counseling. I would say, definitely. I went through counseling, I do have the option to go back, and when I have any issues, I come back and they’ll, ya know find someone for me, but, counseling, definitely, to be able for someone to hear me and what may be going on in my life, how I’m feeling, and be able to ya know, just give me a different perspective, round me back, um, so I don’t flip the lid or anything. And it’s free! (37-year-old third generation Black Colombian bisexual male).

Participants emphasized the need to have access to affordable mental health providers who could support them and help them navigate the stressors related to transitioning as a transgender person.

Sexual health resources

Participants reported that they needed sexual health resources including receiving affordable and easy access to condoms and STD/HIV testing. One 23-year-old first-generation Mestiza Salvadorian heterosexual woman exemplified this subtheme when she said, “They [the non-profit] have provided condoms.” Another participant stated,

The [resources] are strictly related to safe sex, so you don’t get sexual diseases, for example, AIDS. Mainly that (47-year-old first-generation White Puerto Rican heterosexual woman).

A third participant said,

Free testing too and free condoms (49-year-old first generation White Cuban gay queer person).

Many of the participants in the study talked about how access to free testing and condoms was an important medical care resource they needed to promote their wellness and safe sex practices.

Overall, participants reported that access to medical care resources was important to their well-being. Participants spoke to the importance of having access to health insurance, hormones, opportunities for gender identity-related surgeries, therapy and mental health care, and sexual health resources. Although these resources were available to some of the participants in the study, several participants named the importance of having more of these resources available to the broader immigrant Latinx transgender community.

Public education

Seven of the immigrant Latinx transgender participants (38.89%) identified the need for more education for the public about transgender issues that would ultimately improve their lives and well-being. Specifically, this theme manifested through three subthemes, including increased education and training for: 1) the police, 2) medical doctors, and 3) the general public.

Increased education and training for police

Immigrant Latinx transgender participants talked about the difficulties they encountered during interactions with the police. Participants spoke to the importance of better education and training of police and correctional officers that would improve their lives. One participant exemplified this subtheme when she said:

Yes, the police in the area, they are tremendous, they need to be taught. Resources that I would like to see? Is that policemen and correctional [officers], they accept us, ya know? They really accept us and they really integrate with us and respect us, that’s what I would really like to see (47-year-old first generation Mestiza Cuban straight female).

Another participant echoed this subtheme when she said,

Same thing for judges and police officers, you know, no one likes, someone born male, masculine, who is trans, no one likes to be called by their male birth name (65-year-old first generation White Cuban heterosexual woman).

Participants expressed a strong desire to be correctly gendered, respected, and treated with dignity by police officers. As a result, participants recommended that police officers obtain additional education and training in how to be more affirming in working with immigrant Latinx transgender community members.

Increased education and training for medical doctors

Participants also named the importance of increasing the education and training of medical doctors so that they can be more affirming in their work with immigrant Latinx transgender community members. One participant exemplified this subtheme when she said:

I would ask for doctors who specifically cover transsexual people. For me, that would be a great move forward; that way we would know ourselves better, how we feel, everything. Because aside from the hormones and other things, there are other things in your body that you have to take care of (50-year-old first generation White Nicaraguan pansexual shemale).

This participant continued, “You know that, you feel better with a doctor designed specifically for that – for transsexual people, nothing more. That would be a great contribution to the community that I still haven’t seen.” This participant identified a need and desire for doctors specializing in treating members of the trans community. Another participant named the importance of trans-affirming paperwork in doctors’ offices when she said:

Honestly, we need them [doctors] to put in the application forms a box to check with the word trans. It needs to specify what a person is. For example, if you go to the hospital, if should say male, female, trans, you see? And they should call you by however you want to be called, however you feel. Because no one, no trans person, likes to be called [male name] (65-year-old first generation White Cuban heterosexual woman).

Increased education and training for the general public

Participants discussed the importance of training and educating the general public. One participant exemplified this subtheme when she stated,

Knowledge. Education. Educate people so they know who we really are (55-year-old first generation Mestiza Cuban gay woman).

Another participant echoed this subtheme when she said:

But I also wish that there was better education for the general public, that the general public was more educated, not only the LGBT community, but also the community in general about what is going on right now, that there aren’t just women and men, that transsexuals also exist, that they also exist (50-year-old first generation White Nicaraguan pansexual shemale).

Overall, participants expressed the importance of the general public and public figures, who participants often interact with including police officers and doctors, obtaining more training on how to effectively work with transgender people. Enhanced training for the general public will ultimately create a more inclusive and affirming environment that enhances the safety and wellbeing of immigrant Latinx transgender people.

Financial aid resources

Five participants (27.78%) identified a need for more financial aid resources to support the wellbeing of immigrant Latinx transgender community members. One participant exemplified this finding when she said,

There is no economic support for us. I need more help to get the groceries, and a special car only for me (69-year-old first generation Black Cuban gay woman).

This participant voiced needing help with access to basic necessities like groceries. Another participant talked about a need for more support for low-income immigrant Latinx transgender people when she said:

I would like for example, help for the low-income, for us to live, something like that, I would like that. More things like groups that will take us to the theater, excursions, to the beach. There is none of that (62-year-old first generation Mestiza Cuban lesbian woman).

A third participant shared how more structural economic support is needed when she said,

Like economic help … help them economically because many of them live in the streets, they have a bad economic situation. So, they need help (23-year-old first generation Mestiza Salvadorian heterosexual woman).

Overall, participants named how having additional financial support including access to transportation, groceries, and housing would enhance the wellness of immigrant Latinx transgender community members. Many of these participants struggled with accessing basic needs and would benefit from programming and institutional support to cultivate stability for immigrant Latinx transgender communities.

Homelessness resources

Three participants (16.67%) identified the need for more resources for homeless immigrant Latinx transgender individuals. One participant exemplified this theme when she said:

Well, I'd like … to have more organizations interested in street people who are addicts, who are gay, who are sick, who are not helped … I think sufficiently. They aren’t cared after the way they should be. There is help for them, but they can’t afford it, or don’t have access to the resources. It’s like people forget they are human. They are human, the people on the street. Some are mentally ill, and in need of help. I think that they should be helped a little bit. Give a little more attention to that (65-year-old first generation White Cuban heterosexual woman).

This participant named the stigma associated with homelessness and urged people to care more for the immigrant Latinx transgender people who are living on the street. Another participant echoed this theme when she said:

Support of the community, and I see this that there are a lot of girls that are living on the streets that are drug addicts. There are girls that need to see a psychologist, there are girls that need hormone therapy … (55-year-old first generation Mestiza Cuban gay woman).

A third participant discussed the need for trans-specific housing to help increase feelings of safety and security for immigrant Latinx transgender people without stable housing. A 37-year-old third generation Black Colombian bisexual male stated:

Creating a shelter that caters specifically, you know how you have those [shelters] that cater just for women, or women and children, what about [shelters for] transgender [people], what about ya know, those who identify with who they want to. I think that’s a big resource that’s needed.

Overall, participants shared the need to address housing insecurity and provide resources for homeless immigrant Latinx transgender community members. Participants expressed sadness and disappointment that members of the general public would stigmatize the immigrant Latinx transgender community and called for more structural and community support to address their housing needs.

Addictions care

Two participants (11.11%) specifically named a need for addictions care and treatment in the immigrant Latinx transgender community. One participant reported,

Well, I'd like to address more of the drug problem in the gay community (65-year-old first generation White Cuban heterosexual woman).

Another participant echoed this concern when she said:

I think that now trans people can get emotional because we have problems here. There’s some drug dependency … there are many who are locked up for dumb reasons, for stupid stuff, really because they’re undocumented and they’re being held. You see? So, I think those things, if you study a bit more about how to help those girls, you see? (55-year-old first generation Mestiza Cuban gay woman).

Overall, participants voiced the complexity of being an undocumented Latinx immigrant who is also transgender and the complicated interlocking systems of oppression faced by this community. Specifically, participants identified a need for addictions treatment while also discussing the real systemic barriers to addictions treatment without adequate access and cost- affordable care for members of the community.

Barriers to resources as undocumented immigrant Latinx transgender people

Eleven participants (61.11%) in the current study also recognized the struggles inherent in being undocumented as immigrant Latinx transgender people. Two resource-related themes were identified that pertain specifically to undocumented immigrant Latinx transgender people, including: 1) documentation papers for access, and 2) legal aid.

Documentation papers for access

Eleven participants (61.11%) described how lack of documentation papers significantly limited the access to needed resources for undocumented immigrant Latinx transgender community members. One participant exemplified this theme when he said:

Undocumented you don’t get that type of treatment um food, medical care, um things like that as an undocumented individual here, you don’t get to walk in and just get the same, and I’m going to call them amenities that, ya know, me as a citizen could get. So, to me, you suffer more, you get a hardship on top of a hardship (37-year-old third generation Black Colombian bisexual male).

Another participant shared how undocumented immigrant Latinx transgender people are not afforded any rights when she said,

Like, you have the right to work, like the 8 plan, food, stamps, bus tickets. The undocumented person doesn’t have any kind of rights (23-year-old first generation Mestiza Salvadorian heterosexual woman).

Participants also named how lack of documentation papers created more suffering for immigrant Latinx transgender people. One participant said,

Whatever it is, they [undocumented people] have to fight harder, they suffer more because they don't have that little piece of paper where it says they are … see? (65-year-old first generation White Cuban heterosexual woman).

Some participants shared how being undocumented was intertwined with other structural barriers including lack of access to work. One participant said:

It is tougher for a trans person without papers. They don’t have a job, they are working in the streets. They live up of prostitution, they need help from someone to get the information on how to get their papers done. They have to live their lives in the streets (69-year-old first generation Black Cuban gay woman).

Finally, participants named how lack of access to documentation papers served as legitimate barriers to accessing assisted care. One participant echoed this finding when she said:

There are a lot of organizations that don’t pay attention to that, but when it comes to legal stuff I guess, just like everyone else … I don’t know … because you need legal documents for assistance, for documented people that’s going to be easier, regardless of whether they’re trans or not (50-year-old first generation White Nicaraguan pansexual shemale).

Both documented and undocumented participants stressed how not having access to documentation papers severely limited the resources available to undocumented immigrant Latinx transgender people. Being undocumented was associated with significant stress, housing insecurity, unstable work, inadequate food sources, and lack of medical care.

Legal aid

Three participants (16.67%) discussed how legal aid was harder to come by as an undocumented immigrant Latinx transgender person. One participant exemplified this theme when she said:

But when it’s something legal, some document, like residence or stuff like that, if you’re undocumented it’ll be harder for you because you have to go through the same process that everyone else has to. But that’s what I’ve experienced (50-year-old first generation White Nicaraguan pansexual shemale).

This participant expressed the barriers experienced by undocumented Latinx transgender community members and specifically named how fighting the path to citizenship is an uphill battle as an undocumented person. Another participant echoed this finding when she said:

I can do something about it. However, an undocumented [transgender] woman is taken prisoner for any reason and goes directly to prison. Or, she is deported. That's the difference between an American like me, in this naturalized case, and an undocumented one because she would have to start by filling out papers, paying attorneys, which there are none … not like before, there used to be more attorneys, in this kind of thing. And that is the difference (65-year-old first generation White Cuban heterosexual woman).

Overall, participants talked about how being undocumented often resulted in legal trouble without access to adequate legal aid for undocumented immigrant Latinx transgender people. Lack of documentation led to significant consequences for community members, including imprisonment and threats of deportation.

Discussion

The current study reports the narratives of 18 immigrant Latinx transgender individuals from a large metropolitan city in Florida who shared with us the needed resources they consider crucial to enhancing their well-being. While other studies have documented the different community resources available to immigrant Latinx trans individuals (e.g., Abreu et al., 2020) and how these resources buffered oppressive experiences (e.g., Cerezo et al., 2014), it is unclear what other resources this community needs in order to thrive and not merely survive. Given the documented increased disparities among transgender individuals when compared to their cisgender counterparts (e.g., lack of affirming healthcare providers, increased prevalence of poor health; Abreu et al., 2020; Johnson et al., 2020; Meyer et al., 2017), it is clear that existing resources do not fully address the needs of this community. Therefore, we sought to gain information directly from immigrant Latinx transgender individuals themselves, as the experts of what they need to achieve well-being and liberation, including what resources they need to thrive.

Latinx transgender individuals’ transgender healthcare resources

The immigrant Latinx transgender participants in this study shared narratives about the transgender related healthcare resources they currently have available within their communities. Specifically, some of the participants in this study discussed having access to insurance, hormone treatment, gender affirming surgery, mental health treatment, and sexual health resources. While a scant body of literature has documented healthcare access for transgender individuals broadly (e.g., Guss et al., 2019; Johnson et al., 2020), and Latinx transgender individuals specifically (e.g., Abreu et al., 2020; Barreras et al., 2019), our study adds to this small body of research. To our knowledge, our study is the first to document the different healthcare resources immigrant Latinx transgender individuals have access to in a large metropolitan city. In fact, we were not able to locate any study with immigrant Latinx transgender individuals that documents this population’s access to gender affirming surgery. However, these findings should be interpreted with caution given that all participants were recruited from a nonprofit organization that provides public health, counseling, advocacy, and support services to members of the LGBTQ community. Given that all participants are or have been clients who seek services at the nonprofit organization, it is possible that these participants were uniquely able to seek out transgender healthcare opportunities that are not typically offered to or affordable for immigrant Latinx transgender community members. Additionally, even though participants described their access to transgender healthcare, several participants reported that these resources need to be more widely available to other immigrant Latinx transgender community members. Taken together, our findings suggest that there are some organizations that do provide needed transgender healthcare resources, but less is known about how widespread these nonprofit organizations are across the United States. Additionally, more work is needed to explore transgender healthcare resources of a larger immigrant Latinx transgender community outside of the city where this research was conducted.

Latinx transgender individuals’ needed resources

The participants in this study provided rich narratives about resources they deem crucial to enhance their well-being as immigrant Latinx transgender people. Participants shared the need for spaces (e.g., community-centers, organizations) where immigrant Latinx trans individuals are able to get their various needs met, from documentation-related issues to healthcare services. While current research has documented the ways in which communities have provided a sense of safety, support, and resilience for immigrant Latinx transgender individuals (e.g., Abreu et al., under review; Cerezo et al., 2014; Reading & Rubin, 2011), this study specifically asked about what other resources they needed in their community in order to thrive. Our findings call attention to the need for community-based comprehensive services in the immigrant Latinx transgender community. While there are some national-level organizations specific for Latinx transgender individuals (e.g.,Translatin@ coalition, TransLatinx Network), there is a clear need for more localized efforts to support this community.

Our findings suggest that immigrant Latinx transgender individuals have unique resource needs, and would benefit from federal social services programs that provide comprehensive transgender related care. These programs are needed not just in major metropolitan cities but in small towns and rural areas across the United States. Also, given that the participants in our study chose to participate in this research study in Spanish, we pose that it is crucial that resources be available in Spanish and that this community have access to bilingual and Spanish-speaking providers. Our participants expressed the need for comprehensive care organizations and places because they felt like they were not able to get all of the resources they needed from their current providers. This suggests the importance of federal funding to support the development and maintenance of comprehensive care organizations so that immigrant Latinx transgender community members can get their needs met. These organizations are crucial to enhancing and promoting the wellness of immigrant Latinx transgender people.

Our participants provided extensive narratives about the need for the public to be educated on Latinx trans-related issues to create awareness and promote the well-being of immigrant Latinx trans individuals. Specifically, our participants named police and medical doctors as the individuals who most need to be educated about immigrant Latinx trans-related issues. While a small body of research has documented the over policing and negative experiences with law enforcement of immigrant Latinx trans individuals (e.g., Abreu et al., revised and resubmitted; Galvan & Bazargan, 2012) and experiences of oppression and discrimination by healthcare providers (e.g., Abreu et al., 2020), our study adds to the current body of literature by providing concrete examples from immigrant Latinx trans individuals themselves about what kind of education and information these professionals need to know to better serve and affirm their needs and promote their well-being and survival.

These findings suggest a need for more training and intervention work to train professionals with direct access to immigrant Latinx transgender communities, including police officers and medical providers. Transgender specific prejudice reduction and advocacy building interventions can help police officers and medical providers to be more affirming, accepting, and welcoming of immigrant Latinx transgender individuals, thus improving the climate, their safety, and well-being. Requiring on-going mandatory transgender specific trainings for police and doctors would be an important first step to addressing immigrant Latinx transgender resource needs. Additionally, participants discussed the unique legal challenges faced by undocumented immigrant Latinx transgender individuals when they are arrested. As a result, police and correctional officers need better comprehensive training in working directly with immigrant Latinx transgender individuals who are undocumented.

Many of our participants also discussed financial resources as a crucial need for immigrant Latinx transgender individuals to be able to access basic needs (e.g., transportation, food, housing). While other studies have documented financial resources as instrumental to transgender People of Color’s well-being (Singh & McKleroy, 2011), our study provides narratives from immigrant Latinx transgender individuals about specific financial resources they see as a need within their communities to thrive. Specifically, participants reported a strong need for money, access to personal transportation, and groceries. Difficulty obtaining a job likely exacerbates the financial stress experienced by our participants. This finding suggests a need for building partnerships between organizations that support immigrant Latinx transgender individuals and businesses that could employ members of this community. Additionally, immigrant Latinx transgender community members would benefit from educational opportunities to expand skill sets that will help them gain employment. These educational resources must also be available in Spanish. Our findings suggest a need for educational grants and funding opportunities that would allow immigrant Latinx transgender people to pursue advanced education and training.

The participants in this study named homelessness as an important area that directly affects the well-being of immigrant Latinx transgender individuals. Current research has addressed homelessness as a systematic issue that affects the well-being of LGBTQ individuals (e.g., Castellanos, 2016) and transgender Individuals of Color (e.g., Reck, 2009). Our study makes an important contribution by specifically naming homelessness as a systemic issue for immigrant Latinx transgender individuals and provides specific ways in which homelessness affects this community (e.g., addiction, mental health concerns). Findings suggest that immigrant Latinx transgender community members need safe places and housing opportunities where their identities as immigrant Latinx transgender people will be welcomed, affirmed and cared for. Offering Latinx transgender-specific housing and shelters would provide immigrant Latinx transgender people with basic housing needs that would provide stability and allow for growth in other aspects of their lives (i.e., obtaining jobs/employment, enhanced psychological well-being etc.).

The participants in our study called for addictions care and treatment to be part of comprehensive services for the immigrant Latinx trans community. Although this finding adds to the current body of research that documents the use of substances among Latinx individuals (e.g., Guerrero et al., 2017; Paris et al., 2018), transgender individuals (e.g., Lyons et al., 2015; Matsuzaka, 2018), and Latinx LGBTQ individuals broadly (e.g., Nemoto et al., 2005; Senreich, 2010), little is known about addictions treatment needs specifically for Latinx transgender individuals. Given the lack of research addressing the addictions treatment needs for Latinx transgender individuals, our study makes a significant contribution to addictions treatment literature in that it provides specific information, directly from Latinx transgender individuals, about how they are affected by addiction. Findings suggest a need for addictions treatment that is affordable and easily accessible. Given that much of the addictions treatment options require insurance, funds, and access, our immigrant Latinx transgender participants experience real barriers to accessing addictions care. Results from this study suggest a need for communities to rethink and re-imagine comprehensive healthcare while including addictions care and other mental health treatment. In-patient addictions treatment centers should offer pro-bono services for immigrant Latinx transgender people who are uninsured or underinsured, thus allowing access to a resource that is sorely needed but currently unattainable. It is crucial that these services be grounded on Latinx cultural community values such as the importance of being together as a collective, or convivencia (e.g., Delgado Bernal et al., 2008).

Current research has documented the struggles undocumented immigrant Latinx transgender individuals experience in the United States in relation to accessing services and resources (e.g., Cerezo et al., 2014; Yamanis et al., 2018). The narratives from participants in our sample add to this literature by discussing the shared resources the community needs specifically for undocumented immigrant Latinx transgender people. Most of our participants discussed how lack of documentation significantly reduces immigrant Latinx transgender peoples’ access to basic survival needs such as food, housing, jobs, and local resources (i.e., community organizations). That is, while our participants recognize that immigrant Latinx transgender individuals have less access to resources compared to their White American, cisgender counterparts, they acknowledged that these already scarce resources are even less accessible to undocumented individuals within their already marginalized community. In addition, similar to findings in the current literature (e.g., Cerezo et al., 2014; Palazzolo et al., 2016), some participants named legal aid as a crucial need for undocumented immigrant Latinx transgender individuals, and a source for help in obtaining a path to citizenship. Our findings not only contribute to the scant body of research about the need for resources for undocumented immigrant Latinx transgender individuals, but they provide specific information about what resources undocumented members of this community need in order to survive and thrive. Findings from the current study suggest that the path to citizenship is crucial for the survival and wellness of immigrant Latinx transgender community members. Participants in our study named how lack of documentation prevented their immigrant Latinx transgender siblings from accessing social services supports including money for groceries, bus tickets, and legal aid and put them in more vulnerable positions when arrested and faced with legal trouble. Therefore, findings from the current study suggest the importance of immigration reform so that undocumented immigrant Latinx transgender people can pursue citizenship, thus enhancing their wellness and survival. Competent transgender affirming practice with Latinxs must include knowledge of relevant immigration legislation and advocacy. To illustrate, in the early part of 2020, DHS sought to enforce a new regulation defining asylum seekers who used public services (e.g., Medicaid) as a public charge (U.S. Citizenship & Immigration Services, 2019). This now blocked policy would have prevented immigrants labeled as a public charge from obtaining asylum or permanent residency in the future (Welna, 2020). It is then critical for health professionals to know and understand how Department of Homeland Security (DHS) anti-immigrant legal structures and policies threaten the psychological and physical health of immigrant Latinx transgender individuals, particularly low-income immigrants like many of the participants in our study.

Implications for clinical services and policies

Put together, results from this study call for multidisciplinary and multilevel interventions that promote wellbeing for transgender Latinx communities. At the individual level, psychologists and mental health professionals can act as change agents in charge of delivering culturally competent psychological interventions to increase the awareness, knowledge, and skills of members of the community to support the wellness of immigrant Latinx transgender individuals. Psychologists have a duty as mental health professionals to engage in actions that problematize and change the structural problems and barriers that oppress the communities we serve (Toporek et al., 2012). At the community level, our participants recognized the need for all members of the community and law enforcement to learn more about transgender communities and issues. Law enforcement training models like the one proposed by Israel et al. (2014) provide empirically supported methods for educating law enforcement agencies about transgender issues and changing negative attitudes toward transgender individuals. As mental health professionals we can use our knowledge and skills to help educate other professional and community members. Public education can be guided by the multiple transgender affirming training methods already available in the literature (e.g., physicians, Dubin et al., 2018; teachers, Case & Meier, 2014 ). However, reforming oppressive structures and barriers will also require practitioners to engage in advocacy actions with higher risks (e.g., community organizing, protesting; Varghese et al., 2019). For example, the authors of this manuscript collaborate with local pro-transgender immigrant organizations to advocate (e.g., visiting jails to monitor and witness detention conditions) for the rights of undocumented immigrant Latinx transgender people. The Framework for Justice System Advocacy by Varghese et al. (2019) provides another list of practical advocacy efforts (e.g., organizing community prevention) health professionals can implement to advance equitable justice for Latinx transgender communities. For example, our organizational, research methods, and program evaluation expertise allows us to collaborate with local Latinx transgender communities to develop affirming transgender community interventions and later evaluate the effectiveness of our interventions. Research that evaluates the needs of Latinx transgender communities, like the present study, and assesses the effectiveness of transgender affirming care can also have a critical policy change impact.

Future directions and limitations

The contributions of our study should be contrasted against some important limitations. The Latinx ethnic diversity of our sample is both a strength and a limitation. For example, the pre- and post-migration process of Latinxs vary widely based on their country. In our results, barriers to resources were related to the participants’ undocumented status. However, lack of documentation is not a barrier for immigrant Latinx transgender people from Puerto Rico or for immigrant Latinx transgender people who are not first-generation migrants. Future investigations should replicate our study to explore potential differences in barriers between documented and undocumented transgender Latinx immigrants as well as differences across generational status. Additionally, future research should explore the immigration narratives of immigrant Latinx transgender people across generations (i.e., first-generation, second-generation, third-generation, and fourth-generation) to determine how the immigration narrative shifts across generations.

The sample for our study was based in a metropolitan area with a large Latinx representation. All participants were recruited from a nonprofit organization that provides public health, counseling, advocacy, and support services to members of the LGBTQ community. Given that all participants were recruited from an organization that already provides needed resources, future research should explore the resource needs of immigrant Latinx transgender individuals who are not connected to similar nonprofit organizations across the United States, including those living in rural areas.

Additionally, none of the participants in our study identified as nonbinary and most of the participants in the study identified as transgender women. Thus, we are unable to generalize our findings to all immigrant Latinx transgender individuals. Future research should explore the resource needs of a larger sample of immigrant Latinx transgender individuals to better understand the needs of nonbinary participants and transgender men.

Finally, future research should explore how having access to the resources identified by participants impacts their overall mental health and well-being. Although we could hypothesize that access to more resources would lead to improved mental health for immigrant Latinx transgender individuals, we did not directly quantitatively assess the current mental health of participants and thus cannot comment on how access to resources informs mental health. Future research should explore the relationship between access to resources and improved mental health for immigrant Latinx transgender people. Future research should also develop and test the efficacy of interventions designed to increase access to needed resources for immigrant Latinx transgender community members and explore how interventions designed to increase access to needed resources improves mental health and wellness.

Conclusion

In conclusion, immigrant Latinx transgender community members in our study provided concrete recommendations for how governments and institutions in positions of power can effectively provide for them. Participants named the importance of accessing better transgender healthcare, addictions care, financial aid resources, permanent housing, and more education of the general public. Additionally, participants shared how being undocumented as immigrant Latinx transgender people created new barriers to accessing care. Findings from this study suggest that institutions and societal structures must use their power to create legislative changes and policies that provide for documented and undocumented immigrant Latinx transgender people.

Declaration of conflict of interest

The authors have no conflict of interest to declare.