Food Insecurity among Transgender and Gender Non-conforming People in the Southeast United States

Food insecurity in the United States (U.S.) has been identified as a pressing public health problem, as it contributes to hunger, obesity, chronic disease, and poor overall health. Despite increased national attention to addressing issues of food insecurity in the general population, nearly nothing is known about food insecurity in the transgender and gender non-conforming (TGNC) community. National population-based surveys do not include information on gender identity, rendering this population nearly invisible to public health professionals. Data from my dissertation sought to uncover and address issues of food insecurity in this otherwise “hidden” population. In Chapter II, qualitative interviews were conducted with 20 food insecure TGNC people living in the Southeast U.S. In this study, I found that participants were suffering from severe food insecurity and poverty. Study participants reporting facing multi-level discrimination that contributed to their food insecurity. In Chapter III, I documented the use of Facebook as a recruitment strategy for TGNC people. Results suggested that the use of targeted Facebook advertisements can be successful, however, gender-based digital harassment to potential study participants was also witnessed. Detailed protocol must be followed to minimize risk when recruiting highly-stigmatized populations. In Chapter IV, I further investigated issues of food insecurity, minority stress, community resilience, and the use of local food pantries by TGNC people living in the Southeast U.S. through an online, cross-sectional survey. Results indicated that many survey participants were food insecure (80.5%), few utilized Federal (19%) and local (22%) food assistance resources, and minority stress and community resilience were present. Minority stress indices were not related to food insecurity or the use of local food pantries. However, community resilience measures were related to the use of local food pantries.This dissertation informs a significant public health problem in a population at high risk for food insecurity. Chapters II and IV inform public health practitioners and the general public about food insecurity and the use of local food assistance resources among TGNC people. Chapter III provides critical guidance for researchers using targeted Facebook advertisements as a recruitment strategy for highly-stigmatized populations.