Stigmatizing Experiences of Trans Men in Puerto Rico: Implications for Health.

The past decade has seen an increase in efforts aimed at understanding the health needs of the transgender population. In the context of Puerto Rico (PR), those efforts have primarily focused on trans women due to their high human immunodeficiency virus (HIV) incidence. However, due to the low impact of the HIV epidemic among trans men, this remains an understudied population in PR. Thus, it is important that research efforts ad- dress the health care needs of trans men in a range of cultural settings, including PR. Recent literature emphasizes the role of stigmatization as a social determinant associated with deleterious health consequences for diverse groups. Despite this worrisome scenario, little is known about how trans men in PR experience and are negatively impacted by social stigma. The objective of this study was to document the stigmatization experiences faced by trans men in PR and its impact on their overall health. We conducted an exploratory qualitative study with 29 trans men. We implemented focus groups and in-depth qualitative interviews. Thematic analysis guided our interpretation of the findings. Three categories of stigma are discussed: (1) structural stigmatization, (2) interpersonal stigmatization, and (3) individual stigmatization. The health implications of these stigma experiences are discussed. This study represents an initial step toward understanding the social context of this "invisible" community and its health and well-being. We provide recommendations to address social and health concerns related to this understudied community.