The document discusses several key issues related to transgender Hispanic/Latino culture, including: 1) Transgender Latinos face stigma from both Hispanic and American cultures due to differing views on gender roles and identity. 2) Family acceptance is crucial but often lacking for transgender Latinos due to traditional views of masculinity and femininity. This can lead to replacing family support with external support systems. 3) Media influences like telenovelas often promote negative stereotypes of transgender individuals in Hispanic communities through depictions as deceivers or mentally ill people. This fuels transphobia.

1. Hispanic/Latina/Latino Culture: Transgender Issues Presented by Jeffrey Hasson Michelle Scoggins Vinh Tran

3. Limitations and availability of research Specific information on Latino/ Hispanic transgender and religion is very limited Studies primarily focused on Lesbian/ Gay people and religiously focused

4. Topics Cultural Perspective Transgender Stigma Family Perspective Religious Perspective Support/Health Services Clinical Considerations

5. Cultural Perspective

6. Wide Cultural Diversity Many Hispanic Americans speak the same language although they come from various cultural backgrounds. These groups are from such countries like: Mexico South America Cuba Dominican Republic Puerto Rico

7. Cultural Diversity It is important to keep in mind that, because of the large number of countries that compose the Hispanic culture, we must be open to cultural variations (however slight they may be)

9. Culture Cultural values and societal norms in America are highly influenced by European/Caucasian norms. Transgender Latina/os in America must face views of their gender differences from both cultures, as well as cope with the interaction of the two.

10. Culture Machismo Provide, protect, and sacrifice for the family Often viewed as cold and domineering as emphasis is placed on finances rather than care giving. Marianismo Purity, moral strength, feminine passivity, sexual purity Familismo Emphasis on family relationships, childbearing, and the feminine gender role Defined through family and children, rather than through independence

11. Culture Latina/os who do not fit into their cultural norms may be seriously discriminated against. See Angie Zapata and Gwen Araujo in later slides However, this is not always the case. As the Hispanic culture is rather family oriented, many transgender individuals are accepted with open arms.

12. Culture Travesti – “those persons who, having been assigned the masculine gender at birth, identify themselves in different versions of femininity, and who may or may not surgically or hormonally modify their bodies. Thought to possess a “particular political specificity, in that it unites a generalized condition of social vulnerability, an association with sexual work, the exclusion of basic rights, and the recognition of the same as a political identity.” Often marginalized.

13. Culture Travesti – Often include gay, lesbian and bisexual individuals It is not common for these individuals to be belittled socially, economically, and politically. This term does seem to be associated more with MTF individuals, though it as occasionally used with FTM individuals.

14. Culture – Sex Individuals who play an active/insertive role during sex may identify as “straight” or “macho” Reactions to sexually female individuals in this role may vary as they may be viewed as gay, macho, butch, or transgender

15. Culture – Sex Individuals who play a more passive/receptive role are more likely to identify as “gay,” “transvestite,” et cetera Sexually male individuals may not hold the same status as they would otherwise, and may be discriminated against as they are viewed as more feminine (in a degrading manner, as opposed to respecting their identity)

16. Cultural Media Influence Homosexual, travesti, and cross-dressing are often attached to negative qualifiers such as “decadent,” “sick,“ “grotesque,” “deceivers,” “prostitutes,” “killers,” and “mentally unstable” Fuels negative stereotypes and travestophobia Heterosexual is most often associated with positive qualifiers

17. Cultural Media Influence Teleovela (soap operas) have a large role and presence in the viewer’s lives Often times there viewers have a fusion/confusion of fiction and life, a blurring of the lines between fantasy and reality Life expectations are eventually based on life and viewing experiences This has the ability to color many individuals view of transgender individuals (whether positive or negative)

18. Cultural Media Influence How do you suppose that the highly influential nature of telenova may be used in order to benefit the transgender community?

19. Cultural Gender Roles Often well defined with regard to machismo, marianismo, and familismo cultural norms Breaking these norms may not matter to some families, yet can also bring a large amount of discrimination and/or harassment anomg other families and the surrounding community

20. Cultural Gender Roles Variations in the reactions to transgender Latina/os may be dependent upon the level of acculturation as well as how traditional the individual’s/family’s views are However, there is a lot of variation regarding this subject, and the research, as of now, is relatively inconclusive regarding predictability

21. Cultural Gender Roles Deception – “Gender presentation is generally taken as a sign of sexed body . . . And it is precisely for this reason that transpeople who ‘misalign’ gender presentation and sexed body are construed as either deceivers or pretenders.”

22. Cultural Gender Roles Because of the generally strict view of gender presentation in the Hispanic community, “deceivers” or “pretenders” are at a greater risk to be victims of hate crimes. In some Hispanic communities there have been laws based on “morals” prohibiting “men who dress as women”

23. Cultural Gender Roles What underlying message is being sent to transgender individuals as they are labeled as “deceivers” or “pretenders” and as there are “moral” laws that may prevent them from fully expressing themselves? How would attempt to work, clinically, with an individual faced with these problems?

24. Transgender Latina/o Stigma

25. Stigma Stigma – Disapproval of those whose lifestyles differ from dominant cultural norms – often resulting in discrimination. Stigma can be internalized over time, resulting in feelings of worthlessness Contributing factors include Appearance Language Culture Immigration Status

26. Stigma Considering the contributing factors to the stigma that many transgender latina/os face (appearance, language, culture, and immigrant status) – How may you direct your clinical interventions with a transgendered individual who faces these difficulties?

27. Stigma Transphobia – Avoidance, discrimination, et cetera due to the transgender lifestyle, often due to a lack of understanding and resulting in discrimination which may include verbal and physical assaults Such discrimination not only comes from the heterosexual community, but the homosexual communities as well.

28. Stigma The LGBT community is often viewed as a support network (being forced to deal with many similar issues) – Why do you suppose that transgendered individuals, particularly in the Hispanic community, may be discriminated against among a minority population that is able to identify with some of their hardships (i.e. the LGB community)?

29. Stigma - Violence Rape – 59% of transgender women Transgender men’s statistic unknown at this time Harassment – Over 50 % of transgender individuals Violent Incidents – 25%

30. Angie Zapata Angie Zapata was an 18 year old transgender Latina that was brutally beaten to death after a potential relationship partner discovered that she was transgendered

31. Gwen Araujo Gwen Araujo was also brutally murdered by four men after they found out that she was transgender – though this was not tried as a hate crime

32. Victims Readers are strongly encouraged to research the cases of Angie, Gwen, and other transgender individuals who have been victims of hate crimes. Their horrific experiences should never be forgotten and should be a testament to what many individuals are exposed to on a daily basis

33. Stigma - Harassment Education rates are very low Many transgender Hispanic individuals end up dropping out of high school Approximately 50 % of transgender Latina/os receive a high school diploma Employment is often just as difficult “ I couldn’t find a job, but I noticed as soon as I came out of the dress and the wigs and the make-up and what have- not, let my mustache grow, I got a job immediately.”

34. Stigma Because stigma and harassment related issues often affect transgender Latina/os so greatly – how do you feel that this community may be able to be successfully advocated for?

35. Family Perspective

36. Hispanic Family Structure In the Hispanic culture family connection is sought out instead of independence. Males are thought of as the dominant party in the family although through assimilation roles may change this. "Machismo is at the root of homophobia" Additionally, the male role model may become absent in some modern family structures as the number of 2 parent households are decreasing.

37. "In our culture, family is so important that no one wants to risk the rejection of family."

38. Social Support Generally, there is a strong emphasis on familial support/interaction within the Hispanic community. Transgender individuals who are not accepted by their families are forced to replace their traditional support system with some form of external support.

39. Hispanic Sexual Identity Sexuality is viewed in the Hispanic culture as private and not spoken about to family. Children then are less likely to gain proper sex education only what the family deems appropriate as a “male” and “female” roles. Americans label any sexual encounter with the same sex as gay, lesbian, or bi-sexual whereas the Hispanic culture only labels the partner that is submissive as homosexual.

40. Intimate Relationships Relationships are incredibly important as they are a source of affirmation, support and comfort against discrimination. Often times there is an incredible amount of emphasis placed on relationships (as well as friendships) as many transgender Latina/os are not accepted by their families.

41. Sex Increased trust among partners can result in sex without condoms. Transgender Latina/os who turn to prostitution due to employment difficulties may have difficulty discriminating between clients and partners, which significantly decreases their likelyhood of condom use. “ When we are infected, almost 99% is because of our husbands, because with them none of us tries to protect. I didn’t get HIV through prostitution . . . I was married and I got HIV from my husband.”

42. Sex – Prostitution Minimal employment opportunities result in many individuals turning to prostitution. There may be a plethora of issues related to this decision, though they are commonly related to Financial support in daily life Financial support for gender related surgical procedures The need to feel desired/affirmed as a woman, which is often fulfilled during sex work Drug related behavior including money as well as access

43. Sex – Prostitution How may you attempt to assist a transgender Latina/o client who is engaging in prostitution?

44. Sex – Prostitution “ A man like that comes up to me . . . and when the rent is due, or . . . You know it depends on your . . . your desperate level [whether you use a condom or not]. It’s . . . it’s just weird how, you know, people will pay extra. A male will pay you extra without the condom thing.” “ For a long time I didn’t care about using condoms. I think the biggest part was I needed affection. For me prostitution was finally, I had an opportunity where people would hold me and touch me in a more gentle way.”

45. Religious Perspective

46. LGBT and Religion LGBT sexual and gender identity is not accepted by most religions LGBT people tend to abandon their religion of origin at higher rates than their heterosexual peers

47. Latino/ Hispanic & Catholicism Catholicism is the predominant religion in Latin America and among Latinos in the United States Influence of Catholicism in culture and daily lives is not unique to those raised in Latin America The Catholic Church has condemned LGBT people which brings guilt and anxiety to many Catholic LGBT people

48. Latino/ Hispanic &Catholicism cont’d “ Outreach to the transgender community will be a slow process because transsexuals feel dirty and unworthy and these feelings don’t go away with just one talk with them. When people in the community hear the word religion, they automatically close up. ….The orthodoxy of the Catholic Church has made them feel like they are unworthy and that they do not have the right to be present at a religious service. The church has generated guilt, embarrassment and marginalization.” - Rodolfo Contreras, Deacon of the Apostolic Reformed Catholic Church in Guadalajara

49. Transgender and Religion - As a clinician, what do you say to a transgender client when they approach you feeling that they are unworthy of following their own religion? - How can we as clinicians help the Latino transgender community decrease the guilt and embarrassment that has been generated by the Catholic church and other religions?

50. Purpose of the study: to analyze the religious and spiritual life of Latino GBTs Research questions: What role does religion play in their lives? How does religiosity change over time, from childhood to adulthood? How do these GBTs negotiate sexual and gender identities with their religious and spiritual life? Method: life history interviews were conducted with a sample of 80 Latino GBTs living in Chicago (n = 40) and San Francisco (n = 40). The religious and spiritual journeys of Latino gay men

51. The religious and spiritual journeys of Latino gay men cont’d 83% participants indicated being Catholic during childhood in adolescence, over 50% of participants experienced a conflict because of their religious values and their sexual orientation 40 participants left the Catholic Church in adulthood(Garcia, et.al, 2008)

52. Transgender & Religion - A Latino family is seeking mental health services because they have a gender-variant child. They are very religious, however, have stopped attending services because the church has rejected them because of their child. They are struggling with balancing their religious beliefs with their gender-variant child and need your help. They want your help to “fix” their child so they can be accepted back in their church. How would you approach this?

53. Support/Health Services

54. Support/Health Services Stigma strongly influences a transgender individuals ability to seek out/receive many different types of services. Many individuals cannot or will not reveal their identities, which makes this population incredibly difficult to reach. Limited research and available resources for this specific population increase the difficulty. Monolingual (Spanish speaking) Latina/os have an increased level of difficulty

55. Support/Health Services Many transgender Latina/os find it difficult to navigate most healthcare systems – resulting in a lack of health services. Health Services that are sought by transgender Latina/os mainly consist of hormone therapy. Lack of identification or hormone therapy status can result in unsuccessful treatment Many transgender Latina/os self medicate, with hormones, from nonmedical providers – increasing the possibility of untreated health related issues.

56. Unsought Support/Health Services Fear – Discrimination - feeling unwelcome even among clinics that cater to gay, lesbian, and bisexual individuals. Communication – Beyond the typical communication barriers than transgender individuals face, some Latinas are intimidated by possible language barriers or are unaware of available resources. Payment – Difficulties related to employment, available funds, and documentation

57. Unsought Support/Health Services As mentioned earlier, transgender latina/os are often subjected to a wide variety of discrimination, even from the LGB community – What are some proactive steps that you may take (with a client or as you advocate for the community) to reduce the fear and discrimination that surrounds LGBT ‘friendly’ healthcare services.

58. Support/Health Services – HIV Of 392 transgender individuals tested, 35% were HIV+, over half of which were unaware

59. Support/Health Services – HIV HIV testing/treatment may not be sought among all transgender Latina/os Many believe that the contraction of HIV is inevitable Many believe that their life is so bad that it cannot get any worse Some individuals believe that they have a low life expectancy Many question their qualification for available services

60. Support/Health Services – HIV The extremely negative and distorted thoughts that have come to light would appear to fit into CBT treatments well. How would you approach the discussion/treatment with a client presenting with such thoughts (whether using CBT or any other theoretical orientation)?

61. Drugs Some transgender Latina/os may begin to use or abuse drugs in order to help them cope with issues such as (but not limited to): Struggling to accept their own identity, expression and minority status Dealing with the reactions of others who are not accepting of their expression/identification Coping with work environments and experiences (or lack thereof)

62. Drugs Many transgender Latina/os will also resort to the use (and possible abuse) of non-medically administered/monitered hormones, silicone and collagen Common issues regarding sterilization arise here, increasing the risk of medical complications and the transference of diseases such as HIV Pumping parties further these risks as there are multiple users and a lack of proper sterilization “ My addiction was based on just hating the world, and hating everything and everybody, and everybody who fucked me around.”

63. Drugs How do you suppose that you would begin to work with a transgender Latina/o who was abusing drugs?

64. Clinical Considerations

65. Clinical - Client Transgender Latina/os may be apprehensive about seeking therapy due to fears of self disclosure, judgment, and/or the therapist not being knowledgeable of transgender or cultural issues.

66. Clinical - Client Some transgender Latina/os may come to therapy for a wide variety of reasons, especially a lack of support and understanding (of self and others) However, as financial difficulties are a large issue among this population, treatment seeking may not be likely unless required for various medical procedures, such as sexual reassignment surgery

67. Clinical - Client Transgender Latina/os may have certain reactions to their need for therapy as well as to the therapist These reactions are likely to include nervousness, apprehensiveness, frustration, resistance, and feeling as if the therapist is not sensitive or knowledgeable of their relevant issues

68. Clinical - Therapist As in any clinical situation, professionals need to be adequately trained to work with specific populations It is important to be proactive in this search for training Understanding the Hispanic culture, along with transgender issues, and the interaction of the two is important when working with this population

69. Clinical - Therapist Understanding personal views of sex and gender related issues is of great importance Awareness of countertransferential issues should never be overlooked Have appropriate sources and support networks for client referrals Disadvantaged clients may likely benefit from advocacy An awareness of relevant laws and/or policies is highly reccommended

70. Clinical - Therapist Stay open to learning from client experiences, everyone will have something clinically valuable to keep in mind for future clients Never stop researching the issues relevant to client issues Research information regarding transgender Latina/os is relatively scarce, though it will (hopefully) become more prevalent in the future Again, take note of client presented issues

71. Clinical - Therapist Keep in mind the many cultural and media influences that may affect or influence the client in their daily life Be sensitive to the client’s issues Do not unnecessarily detract from their current struggles /problems/issues Stay well informed of and be able to conceptualize interrelated difficulties as much as possible Do not fear asking for clarification or information if there is a lack of understanding

72. Clinical - Therapist Do not underestimate the benefits that may be gained from extra supervision and consultation This will not only benefit the current client/s but future work with the population

73. Clinical - Issues The process of/decision to come out, along with related emotions such as fear and anxiety Loss of family and/or support network Family and cultural (American and Hispanic) reactions to transgender issues Discrimination, harassment, and abuse (verbal, physical and emotional) Employment and education difficulties

74. Clinical - Issues Financial difficulties May lead to risky behaviors such as prostitution, safe sex practices, and non-medically administered body alteration Proper care of health (self care and a lack of insurance) Maladaptive coping mechanisms (e.g. drugs) Suicide and self harm

75. Clinical – Diagnostic Considerations Common diagnoses among transgender Latina/os include (but are not limited to) Substance Abuse Depression/Dysthymia Anxiety (particularly social in nature) Somatization

77. Related Videos http://www.youtube.com/watch?v=hEiwmybJWRU SYLVIA RIVERA - LATINO TRANS HISTORY http://www.youtube.com/watch?v=j3CXEjX6sQY Gender Spectrum-- Latino/a final project http://www.youtube.com/watch?v=f2kUDcbU4nI Supporting Gay, Bisexual, Trans-identified People in Church http://www.youtube.com/watch?v=UyIrPFntrqM Tal Como Somos/Just As We Are -- Gay and Trans Latinos http://www.youtube.com/watch?v=idUOFdjDY7c ALL OF US ARE FAMILY

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79. References Crapotta, J.F. 2010. Stonewall and Beyond: Lesbian and Gay Culture. Hispanic Gay & Lesbian Issues. http://www.columbia.edu/cu/lweb/eresources/exhibit . Retrieved on April 7, 2011. Carlos P. Zalaquett, Lic., M.A., Ph.D. University of South Florida: College of Education . 2010. His/Her Name isToday:Culture. http://www.coedu.usf.edu/zalaquett/hoy/culture.html . Retrieved on April, 7,2011. Estrada, G. (2011). Paris is burning, frontera, Atrevete!. Retrieved March 10, 2011, from http://www.jrank.org/cultures/pages/4521/Transsexuals.html García, D. I., Gray-Stanley, J., & Ramirez-Valles, J. (2008). 'The priest obviously doesn't know that I'm gay': The religious and spiritual journeys of Latino gay men. Journal of Homosexuality , 55(3), 411-436.

80. References Israel, G.E. & Tarver, D.E. (1997). Transgender Care: Recommended guidelines, practical information, and personal narratives. Philadelphia, PA: Temple University Press. Lewis, V. (2008). Of lady-killers and ‘men dressed as women’: Soap opera, scapegoats, and the Mexico City Police Department. Journal of Multidisciplinary International Studies, 5 (1), 1-28. Lev, A. I. (2004). Transgender emergence: Therapeutic guidelines for working with gender-variant people and their families . Binghamton, NY US: Haworth Clinical Practice Press. National Center for Transgender Equality, (2010). Preventing Transgender Suicide. Retrieved March 10, 2011, from http://transequality.org/PDFs/NCTE_Suicide_Prevention.pdf

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