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Experienced trauma threatens TGW's commitment to sexual healthcare. Trauma\u2010informed approaches to sexual healthcare can improve engagement. This study aimed to characterize the trauma experienced by TGW in the Southeastern US, especially related to sexual health. TGW completed in\u2010depth individual interviews guided by the Modified Social Ecological Model (MSEM) and Minority Stress framework. Interviews explored the nature of trauma, sexual health, and their intersection in TGW's lives, and a thematic analysis was performed. Between August 2022 and January 2023, 13 TGW enrolled (69% Black, 31% White). Mental illness was common (77%). Five participants (38%) were HIV+, and seven (54%) reported lifetime STI history. Themes reflected societal (barriers to healthcare, anti\u2010transgender legislation), community (misgendering\/deadnaming), network (limited support), and individual (dysphoria, sex work, fear for physical safety, stigma, mental health conditions, race) stressors. The physical\/sexual violence and resilience themes pervaded all stressor levels. Medical mistrust was exacerbated by past traumatic experiences within sexual healthcare settings. Resilience and transgender representation in healthcare settings were protective. Various experienced traumas and their cumulative effects were pervasive in the daily lives of TGW. Development of targeted interventions to improve sexual health engagement of TGW must optimize personal strengths and provide holistic support.<\/jats:p>","DOI":"10.1002\/adbi.202400200","type":"journal-article","created":{"date-parts":[[2024,8,26]],"date-time":"2024-08-26T08:05:00Z","timestamp":1724659500000},"source":"Crossref","is-referenced-by-count":6,"title":["\u201cSociety Isn't Designed for Us to Win\u201d: Trauma and Sexual Healthcare Experiences Among Transgender Women in the Southeastern United States"],"prefix":"10.1002","volume":"9","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9362-6234","authenticated-orcid":false,"given":"Olivia T.","family":"Van Gerwen","sequence":"first","affiliation":[{"name":"Division of Infectious Diseases University of Alabama at Birmingham  Birmingham AL 35294 USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christina A.","family":"Muzny","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases University of Alabama at Birmingham  Birmingham AL 35294 USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bulent","family":"Turan","sequence":"additional","affiliation":[{"name":"Koc University  Istanbul 34450 Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Krishmita","family":"Siwakoti","sequence":"additional","affiliation":[{"name":"Division of Endocrinology University of Alabama at Birmingham  Birmingham AL 35294 USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"D. Scott","family":"Batey","sequence":"additional","affiliation":[{"name":"School of Social Work Tulane University  New Orleans LA 70112 USA"},{"name":"Magic City Research Institute  Birmingham AL 35222 USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2024,8,26]]},"reference":[{"key":"e_1_2_9_1_1","volume-title":"How Many Adults and Youth Identify as Transgender in the United States?","author":"Herman J. L.","year":"2022"},{"key":"e_1_2_9_2_1","unstructured":"S. E.James J. L.Herman S.Rankin M.Keisling L.Mottet M.Anafi The Report of the 2015 U.S. Transgender Survey National Center for Transgender Equality Washington DC2016."},{"key":"e_1_2_9_3_1","first-page":"1","volume":"12","author":"Herbst J. H.","year":"2008","journal-title":"Estimating HIVprevalence and risk behaviors of transgender persons in the United States: asystematic review. 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