Compromised survivors—that’s how Dr. Scout describes members of the transgender community. “You can’t talk about the challenges we face without talking about our incredible resilience,” he says.
And that resilience is necessary, as transgender people are not only misunderstood, but often experience extreme forms of discrimination. One in five transgender people in the U.S. experiences homelessness at some point during their life. And when they turn to shelters, one in three is turned away – simply because of their transgender status.
But that is one thing that is changing, says Dr. Scout, who is the Director of The Network for LGBT Health Equity at The Fenway Institute. A recent ruling by the U.S. Department of Housing and Urban Development (HUD) mandates that Federal housing programs—including shelters—offer their services to anyone who needs them, without regard for sexual orientation or gender identity. “The shelter system is supposed to be a safety net,” says Dr. Scout. “But right now, that net has huge holes.”
The transgender community is diverse; it includes people who are straight, gay, and bisexual, and it spans a continuum, from people who cross-dress to people who alter their birth sex completely. Part of Dr. Scout’s job is to help providers and policy makers around the country understand and respond to this diversity by making their services more LGBT-friendly.
One critical step for providers is to understand the devastating circumstances many transgender people face when they come out to their families, which often propel them into homelessness.
“I know of one person, Angie*, who had everything—family, kids, money, professional life,” Dr. Scout says. “But the minute she came out as transgender, she lost it all. It was so extreme that, a year later, and still homeless, the only job she was being offered repeatedly was sex work.”
Dr. Scout says Angie was someone who would have never conceived of doing sex work before—she had an advanced degree and a professional position. But suddenly, with everything in her life stripped away, it literally became her only option. And this is a story he’s heard over and over again.
This level of intense social exclusion begins to define the lives of transgender people, says Dr. Scout. It shapes their life development and their understanding of positive relationships. Extreme levels of internal and external stress cause some to develop mental health and substance use issues, which they must often deal with in isolation. Many—like Angie—end up on the streets, rejected by everyone they love. And even those who don’t end up homeless still live with the constant threat of violence and discrimination.
“I live every day knowing I could be murdered,” says Dr. Scout matter-of-factly, “and I wouldn’t be surprised if I were. The fact is, it’s a regular occurrence in my community.”
Transgender people who end up in homeless shelters often face hostility and discrimination from staff and other residents. Shelters are often strictly segregated by sex, and staff may be unsure of where to put them—placing a transgender woman in the male dorm because of her male birth sex, for instance. This can be not only offensive and mentally distressing, but can also make her extremely vulnerable to physical violence or rape.
“But,” Dr. Scout stresses, “all transgender people are survivors.” And there are some simple ways for providers to support the ones who pass through their agencies. Although HUD’s non-discrimination policy is a positive step, Dr. Scout encourages shelters to take the opportunity to go above and beyond the bare minimum.
One of his first suggestions is to put a transgender person on the shelter’s community advisory board. He also suggests networking with local community projects serving at-risk transgender people. There are also many structural ways to show transgender people they are welcome—by hanging a rainbow flag, for instance.
“We have so few services that welcome us that news travels very fast when one does,” says Dr. Scout. But, he says, it is still important to remember to advertise services in places where transgender people look for information. And even more critical is to ask for feedback about their experiences in the organization.
Training all staff in cultural competency—including frontline staff—is also vital, says Dr. Scout. “If a third of transgender people have been turned away from shelters, it means that until you tell them it’s safe, they will expect it not to be safe,” he says. Staff should understand that transgender people may be dealing with posttraumatic stress disorder (PTSD), a history of violence, family rejection, untreated mental health problems resulting from stress, and addictions.
But Dr. Scout says even the simplest forms of respect can be the most meaningful. “Don’t underestimate how powerful it can be to refer to a transgender woman with the pronoun ‘she,’ or by her preferred name,” he says. “By treating her with dignity and respect, you are showing her that you are more concerned with her being homeless than you are with her being transgender.”
For Dr. Scout, it all comes down to a simple question. Faced with these challenges, what do we do about it? He says that even providers who are not knowledgeable about transgender issues can make a big difference.
“There are so many stories of individual heroism, of champions in shelters around the country who stand up and say, ‘I am going to learn about this, and I am going to change it,’” he says. “And those people—they are our real strength and power.”
*Not her real name. Her name has been changed to protect her identity.
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