Content uploaded by Kevin L. Nadal
Author content
All content in this area was uploaded by Kevin L. Nadal on May 19, 2014
Content may be subject to copyright.
This article was downloaded by: [John Jay College of Criminal Justice], [Kevin L. Nadal]
On: 17 March 2014, At: 14:36
Publisher: Routledge
Informa Ltd Registered in England and Wales Registered Number: 1072954 Registered
office: Mortimer House, 37-41 Mortimer Street, London W1T 3JH, UK
Journal of Trauma & Dissociation
Publication details, including instructions for authors and
subscription information:
http://www.tandfonline.com/loi/wjtd20
Transgender Women and the Sex Work
Industry: Roots in Systemic, Institutional,
and Interpersonal Discrimination
Kevin L. Nadal PhD a , Kristin C. Davidoff BS a & Whitney Fujii-Doe
MA a
a John Jay College of Criminal Justice , City University of New York ,
New York , New York , USA
Accepted author version posted online: 07 Dec 2013.Published
online: 11 Mar 2014.
To cite this article: Kevin L. Nadal PhD , Kristin C. Davidoff BS & Whitney Fujii-Doe MA (2014)
Transgender Women and the Sex Work Industry: Roots in Systemic, Institutional, and Interpersonal
Discrimination, Journal of Trauma & Dissociation, 15:2, 169-183, DOI: 10.1080/15299732.2014.867572
To link to this article: http://dx.doi.org/10.1080/15299732.2014.867572
PLEASE SCROLL DOWN FOR ARTICLE
Taylor & Francis makes every effort to ensure the accuracy of all the information (the
“Content”) contained in the publications on our platform. However, Taylor & Francis,
our agents, and our licensors make no representations or warranties whatsoever as to
the accuracy, completeness, or suitability for any purpose of the Content. Any opinions
and views expressed in this publication are the opinions and views of the authors,
and are not the views of or endorsed by Taylor & Francis. The accuracy of the Content
should not be relied upon and should be independently verified with primary sources
of information. Taylor and Francis shall not be liable for any losses, actions, claims,
proceedings, demands, costs, expenses, damages, and other liabilities whatsoever or
howsoever caused arising directly or indirectly in connection with, in relation to or arising
out of the use of the Content.
This article may be used for research, teaching, and private study purposes. Any
substantial or systematic reproduction, redistribution, reselling, loan, sub-licensing,
systematic supply, or distribution in any form to anyone is expressly forbidden. Terms &
Conditions of access and use can be found at http://www.tandfonline.com/page/terms-
and-conditions
Journal of Trauma & Dissociation, 15:169–183, 2014
Copyright © Taylor & Francis Group, LLC
ISSN: 1529-9732 print/1529-9740 online
DOI: 10.1080/15299732.2014.867572
Transgender Women and the Sex Work
Industry: Roots in Systemic, Institutional,
and Interpersonal Discrimination
KEVIN L. NADAL, PhD, KRISTIN C. DAVIDOFF, BS,
and WHITNEY FUJII-DOE, MA
John Jay College of Criminal Justice, City University of New York, New York,
New York, USA
Because transgender people face discrimination on systemic, insti-
tutional, and interpersonal levels, the previous literature has sup-
ported that many transgender women view the sex work industry
as their only viable career option. The current article reviews the
literature on discrimination against transgender people, explores
how discrimination influences their participation in sex work, and
discusses how institutional discrimination against transgender
women manifests within the criminal justice system. Furthermore,
recommendations are provided for advocating for the rights of
transgender people while promoting healthy behaviors and higher
quality of life. Throughout the article, quotes from previous quali-
tative research are used to illustrate the experiences of transgender
women through their own voices and perspectives.
KEYWORDS transgender, sex work, systemic discrimination,
transphobia, gender identity
Although substantial gains have been made in the fight for equal rights for
members of the lesbian, gay, bisexual, transgender, and queer community,
transgender and gender-nonconforming people still face significant discrimi-
nation on systemic, interpersonal, and institutional levels (Hill & Willoughby,
2005; Nadal, 2013). Research suggests that transgender people in general
Received 30 November 2012; accepted 24 September 2013.
Address correspondence to Kevin L. Nadal, PhD, John Jay College of Criminal Justice,
CUNY, 524 West 59th Street, New York, NY 10019. E-mail: knadal@jjay.cuny.edu
169
Downloaded by [John Jay College of Criminal Justice], [Kevin L. Nadal] at 14:36 17 March 2014
170 K. L. Nadal et al.
experience a lower quality of life in comparison to their cisgender (i.e., non-
transgender or gender-conforming) counterparts in that they encounter an
array of obstacles that prevent them from realizing optimal physical and psy-
chological health (see Nadal, 2013, for a review). The discrimination that
transgender people experience on interpersonal levels (e.g., being discrimi-
nated against or harassed by strangers or coworkers), institutional levels (e.g.,
being employed at a workplace without anti-transgender discrimination poli-
cies), and systemic levels (e.g., belonging to a society in which transgender
people have higher rates of unemployment, poverty, and homelessness) are
all major contributing factors to negative life outcomes for this group (Nadal,
Skolnik, & Wong, 2012).
One negative aspect of discrimination is that it can potentially lead
to risky behaviors, including sex work. Recent studies have revealed how
transgender women experience pervasive workplace discrimination, which
leads them to view sex work as a feasible option (Nadal, Vargas, Meterko,
Hamit, & McLean, 2012; Sausa, Keatley, & Operario, 2007). Sex work in
general exposes individuals to a multitude of harms, including violence,
HIV/AIDS and other sexually transmitted diseases, drug use, and incarcera-
tion (Rekart, 2005). Furthermore, because sex work is illegal in almost all
of the United States, there are pervasive, negative societal attitudes and
stigma toward sex workers, which allows for victimization of and trauma
toward sex workers to continue. Because of this and the systemic bias toward
transgender people in general, transgender sex workers are at high risk for
a spectrum of dangerous outcomes. For example, transgender sex work-
ers are often victims of physical violence and emotional abuse, engage in
high-risk behaviors (e.g., risky sexual practices, substance abuse), and are
even abused in the criminal justice system (Nadal, Vargas, et al., 2012).
Thus, regardless of one’s personal view of whether sex work should be
criminalized, sex workers (particularly transgender sex workers) experience
significant trauma, which potentially has a detrimental effect their physical
and mental health.
The current article comprises four major sections. First, we provide a
review of discrimination toward transgender people in the United States,
highlighting how systemic, institutional, and interpersonal discrimination
often leads to a lower quality of life for transgender people. Second, we dis-
cuss the previous literature on transgender female sex workers in the United
States, underscoring how systemic discrimination can result in sex work as
a career possibility. Third, we discuss areas of the criminal justice system
in which transgender women face significant violence and discrimination.
Finally, we offer recommendations for transgender advocacy on interper-
sonal, institutional, and systemic levels. Although we recognize that this
article focuses primarily on experiences in the United States, we believe that
many of our arguments are applicable to other societies around the globe
Downloaded by [John Jay College of Criminal Justice], [Kevin L. Nadal] at 14:36 17 March 2014
Journal of Trauma & Dissociation, 15:169–183, 2014 171
while recognizing that some of these positions are specific to the United
States.
Throughout the article, quotes are provided from two previous qual-
itative studies in order to illustrate the personal perspectives and lived
experiences of transgender women. Nadal, Skolnik, et al. (2012) utilized
focusgroups(N=9) to study experiences of subtle discrimination with
transgender participants; a directed content analysis was used to extrapolate
transgender participants’ common experiences with discrimination. Nadal,
Vargas, et al. (2012) used structured individual interviews with male-to-
female sex workers (N=5) to collect a broad range of information about
experiences within the sex work industry; a consensual qualitative research
analysis was used to highlight participants’ typical experiences. The institu-
tional review board at John Jay College of Criminal Justice, City University of
New York, approved both studies prior to data collection, and we use both
studies here to emphasize that systemic discrimination affects transgender
sex workers while also being harmful to transgender people who are not
sex workers.
DISCRIMINATION AGAINST TRANSGENDER PEOPLE
Before delving into the experience of transgender female sex workers, it is
necessary to examine the experiences of discrimination against transgender
people in general and how such encounters negatively influence their psy-
chological health and quality of life. Discrimination against transgender
individuals is perpetuated through both prejudicial attitudes toward, and
assumptions about, what it means to identify as transgender. Because the
United States and most other societies tend to normalize a gender binary (i.e.,
believe that there are only two genders—male and female), many individuals
pathologize anyone who does not subscribe to gender binary norms (Nadal,
Rivera, & Corpus, 2010). In fact, because this gender binary has become so
ingrained in every aspect of society, many individuals are not even aware
of the existence of transgender people or of gender-nonconforming people
or gender-queer people (i.e., people who do not conform to societal gender
role norms or who do not identify as any one gender). As a result, some
negative attitudes and biases toward transgender people can be overt and
conscious (i.e., people might be completely aware of their prejudices toward
transgender people), whereas other negative attitudes are often covert and
unconscious (i.e., people do not recognize how their biases affect their
behavior toward transgender people).
Discrimination toward transgender people is often defined as
transphobia or “an emotional disgust toward individuals who do not conform
to society’s gender expectations” (Hill & Willoughby, 2005, p. 533). One of
Downloaded by [John Jay College of Criminal Justice], [Kevin L. Nadal] at 14:36 17 March 2014
172 K. L. Nadal et al.
the ways that overt transphobia manifests is through hate crimes. Although
often undocumented, these criminal acts have been pervasive throughout
history (Nadal, Skolnik, et al., 2012). The 11th International Transgender Day
of Remembrance was held on November 20, 2009, to remember the 600 or
more known transgender people across the globe that had been killed.
Although there has been a dearth of literature involving anti-transgender
hate crimes, one study revealed two major findings: (a) Hate crimes toward
transgender and gender-nonconforming people are especially violent, and
(b) transgender victims are targeted for violence for more complex rea-
sons than their gender variance alone (Stotzer, 2008). Finally, the previous
literature has suggested that when anti-LGBT (lesbian, gay, bisexual, and
transgender) hate crimes occur, LGBT people often experience a vicarious
traumatization, in that their fundamental assumptions of benevolence and
meaningfulness of the world (and of other people) were challenged (Noelle,
2002). Thus, hate crimes toward transgender people (and LGBT people in
general) have a negative impact on actual victims as well as LGBT people in
general.
In addition to hate crimes and other severe forms of victimization, the
previous literature has also described other types of transphobic discrimi-
nation. One study found that 60% of its participants had been victimized
(e.g., experiencing harassment by strangers on the street, verbal abuse,
assault with a weapon, and sexual assault) because of their gender iden-
tity (Lombardi, Wilchins, Priesing, & Malouf, 2001). Another study reported
how transgender people encounter a range of discriminatory experiences
in their families—from physical violence and open hostility to indifferent
or neglectful responses from parents (Koken, Bimbi, & Parsons, 2009).
Many participants reported having to leave their homes during adolescence
because they either (a) were forced by their parents or (b) chose to leave
because of the antagonistic home environment upon revealing their gender
variance.
A qualitative study involving microaggressions, or subtly biased behav-
iors, found that transgender people experienced both overt and subtle forms
of discrimination (Nadal, Skolnik, et al., 2012). Participants discussed inter-
personal microaggressions that they encountered, including people who
used transphobic and/or incorrectly gendered terminology or people who
asked invasive questions about their bodies. One participant shared, “The
deli by my building—they know me. But a couple of boys came in and
started saying [in a threatening tone] ‘Why are you dressed like that? You’re a
guy, what’s wrong with you?’”1Another participant described how she lived
in fear of being physically attacked: “I would feel uncomfortable and my
safety would definitely be at risk because everyone would start to look at
me and there’s no telling who would do what and how they’d do it.”1
Though research on the discrimination faced by transgender individuals
is limited, there is research to support the claim that transgender persons
Downloaded by [John Jay College of Criminal Justice], [Kevin L. Nadal] at 14:36 17 March 2014
Journal of Trauma & Dissociation, 15:169–183, 2014 173
experience discrimination in the workplace. For example, a report published
by the National Center for Transgender Equality and the National Gay and
Lesbian Task Force (2009) revealed an array of disparities experienced by
their sample of 6,450 transgender people across the United States and Puerto
Rico:
1. The number of participants in the sample who were unemployed was
twice that of the national average of unemployed people.
2. A total of 47% had experienced an adverse job outcome, such as being
fired, not hired, or denied a promotion.
3. A total of 97% of those surveyed reported experiencing harassment or
mistreatment on the job.
Other researchers found that 37% of their sample reported economic dis-
crimination, such as being fired, demoted, or unfairly disciplined (Lombardi
et al., 2001). One transgender person described her difficulties in being hired:
I remember a lot of them looking at me ...and taking the paper. I gave
them my resume, and “If we have an opening we’ll call you.” Even
though in the window it says “Now Hiring,” they go, “If we have an
opening we’ll call you.” So they would say that but they didn’t just come
out and go “how dare you, hell no we ain’t gonna hire you.” But they
did not say it, it was just they watch what they say cause there were
witnesses.1
When transgender people are able to find employment, they often expe-
rience many forms of interpersonal discrimination (e.g., transphobic jokes
or language, harassment), making it challenging for them to obtain or
maintain a job. The added complication of inadequate workplace policies
and legislation that fail to protect transgender people makes securing gain-
ful employment difficult. Individuals undergoing gender-affirming transition
processes while maintaining the same job (particularly at workplaces without
policies protecting against transgender discrimination) encounter even more
obstacles (Barclay & Scott, 2006; Schilt & Connell, 2007).
Although workplace discrimination is harmful for all, it is particularly
harmful for transgender people for many reasons. First, previous studies
have found that harassment and discrimination of transgender people is a
predictor of mental health issues, including depression, suicidal ideation, and
substance abuse (Nadal, Skolnik, et al., 2012). Second, because transgender
people have higher rates of unemployment and are likely to be fired or
denied promotions in their jobs, they are at greater risk of living in poverty
or even becoming homeless (National Center for Transgender Equality and
the National Gay and Lesbian Task Force, 2009). Finally, because of these
obstacles with employment, transgender people often choose to engage in
Downloaded by [John Jay College of Criminal Justice], [Kevin L. Nadal] at 14:36 17 March 2014
174 K. L. Nadal et al.
sex work as a means of survival (Nadal, Vargas, et al., 2012; Sausa et al.,
2007), which puts them at risk for adverse (and potentially fatal) outcomes,
including violence, poor sexual health, and incarceration. Thus, recogniz-
ing the harmful impact of discrimination toward transgender people might
be a first step in promoting healthier lives for this community. Moreover,
acknowledging how American society is transphobic in nature can assist in
placing more appropriate responsibility on faulty systems and institutions
rather than solely blaming or punishing transgender individuals who engage
in sex work as a means of survival or as a perceived last resort.
EXPERIENCES OF TRANSGENDER WOMEN SEX WORKERS
Sex work is generally defined as the act or practice of engaging in promis-
cuous acts in exchange for money (Nadal, Vargas, et al., 2012). Although
this definition can be used to define numerous acts in which sex is used
for a gain, it is generally assumed that sex work refers to the forms of ille-
gal actions by people such as streetwalkers, escorts, and brothel workers.
Despite the vast amount of sex work in the United States and abroad, few
areas of sex work have been addressed in research, which mainly focuses
on experiences of cisgender female sex workers. Although there is some
research focusing on male sex workers (particularly those who have sex
with other men), there is a dearth of research on transgender female sex
workers.
Of the few existing research articles addressing transgender male-to-
female sex workers, the majority tend to focus on safe sex practices and
HIV/AIDS (Nadal, Vargas, et al., 2012). There are only two known studies
that concentrate on transgender sex workers exclusively without look-
ing at HIV/AIDS. Sausa and colleagues (2007) examined numerous facets
of transgender sex workers, such as why they became involved in sex
work, documented risks, and what motivated participants to continue sex
work; one of their major findings was that many participants continued
and remained in the sex work industry because of the discrimination and
transphobia they experienced in other workplaces.
Nadal, Vargas, and colleagues (2012) conducted a qualitative study in
which male-to-female transgender women were interviewed about their
experiences in the sex work industry. They found that the ability of
transgender women to secure legal employment was hindered by the reluc-
tance of employers to hire a transgender individual. Some of these women
felt that sex work was the only choice available to them because of discrim-
inatory hiring practices and personal factors, such as the lack of a support
system. Furthermore, one unique finding was that transgender female sex
workers reported positive experiences in the sex work industry. Because
they felt appreciated as real women by their male clients, they chose to
Downloaded by [John Jay College of Criminal Justice], [Kevin L. Nadal] at 14:36 17 March 2014
Journal of Trauma & Dissociation, 15:169–183, 2014 175
continue their sex work because they did not experience that appreciation
in other aspects of their lives. Positive experiences of sex work are one of
many reasons why some individuals believe that sex work should be decrim-
inalized; many argue that instead of punishing sex workers, governments
should focus on educating sex workers on safer sexual practices and provid-
ing securer working environments for them (Harcourt, Egger, & Donovan,
2005).
TRANSGENDER DISCRIMINATION AND THE CRIMINAL JUSTICE
SYSTEM
Now that we have highlighted the numerous ways that transgender discrim-
ination manifests in families, workplace environments, and other aspects
of society, we turn to one system in which transgender discrimination is
found to be particularly harmful—the criminal justice system. Utilizing pre-
vious studies with transgender sex workers (Nadal, Vargas, et al., 2012) and
transgender people who are not sex workers (Nadal, Skolnik, et al., 2012),
we examined the types of discrimination that transgender people experi-
enced from figures within the criminal justice system (e.g., police officers,
correctional officers, inmates) or through the structure and culture of the
system as a whole (e.g., laws, policies, and regulations). In these two stud-
ies, as well as other research involving transgender people, it has been found
that there are two main areas in which transgender people experience dis-
crimination in the criminal justice system: (a) within the prison system and
(b) with police and other law enforcement officers.
The previous literature found that enforcement-based policing strate-
gies were independently associated with gender-based violence toward
transgender people (Shannon et al., 2009). Transgender people are often
mistreated by police officers above and beyond their suspected crimes and
more likely for their stigmatized identities as transgender women. In a study
on transgender sex workers, one participant stated the following:
When it comes to somebody like me, it’s harder ‘cause I think it changes,
it’s like, you know, it’s worse because they look at you not only because
of what you’re doing—they judge you for that—but they also judge you
for who you are ...I don’t know how to explain it but it was something
that like—there was a lot of abuse involved. You know, I was abused—
verbally abused, physically abused and even sexually abused.1
Experiencing transphobic discrimination by law enforcement reduces the
likelihood that transgender individuals will seek help when they need it,
leading to underreporting of harassment and crime in the population (Peek,
2003; Witten & Eyler, 1999). Even when crimes are reported following a
Downloaded by [John Jay College of Criminal Justice], [Kevin L. Nadal] at 14:36 17 March 2014
176 K. L. Nadal et al.
physical or sexual assault, transgender individuals are less likely to get appro-
priate help from law enforcement (Witten & Eyler, 1999), which increases the
risk for underreporting in the future.
In addition, transgender people (particularly male-to-female women)
report how police officers commonly stereotype them as being sex work-
ers, which often leads to mistreatment of transgender women who are not,
and never have been, sex workers. For example, one transgender woman
described an interaction with a detective while reporting a crime with a
friend. The detective stated,
“Can you hurry up and write your statements? Because it’s late and we
all have families. So do you wanna write a statement or do you want
to leave?” And I just said [to my friend] “Write your statement because
something happened to you,” and so she was gonna write it ...and the
detectives were passing by and they said ...(singing) “Transformers ...
men up in disguise” ...Just like that ...I said “What the hell?”...Isaid
these are the detectives. I said “Wait, wait, wait ...Don’t write anything.
They’re gonna throw this in the garbage—they want us to leave.”2
This participant believed that the detectives would discard her complaint
simply because she was trans-identified.
Meanwhile, transgender women who do engage in sex work report
encountering severe physical abuse by police. In the study examining sex
workers, one participant shared the following:
A lot of times the officer would come up to you, pat you down, you
know if you were dressed as a female, then find out I have this birth
defect between my legs, he’d freak out. And I mean I’ve been hit with a
billy club, I’ve gotten both of my leg broke, I’ve gotten my ankles broke,
my hips broke. I’m almost blind in one eye ‘cause he hit me upside the
head so hard. I’ve gone to the hospital with a shattered skull. When the
cops discovered I was male bodied but identified as a female ...every
time I see a cop I get apprehensive cause I knew I was either going to
go to central booking or the nearest hospital.1
Other participants in the same study described how prison guards utilize
similar brutal methods as a way of “disciplining” inmates, citing that they
felt especially victimized because of their transgender status (Nadal, Vargas,
et al., 2012).
The dichotomous categorization of prison inmates as either male or
female based on birth sex or genitalia creates a host of problems for peo-
ple who identify as gender-nonconforming or transgender (deManda, 2002;
Rosenblum, 2000). Prison placement policies generally dictate that genital
Downloaded by [John Jay College of Criminal Justice], [Kevin L. Nadal] at 14:36 17 March 2014
Journal of Trauma & Dissociation, 15:169–183, 2014 177
surgery is the determining factor in whether transgender inmates are classi-
fied as male or female for the purpose of housing. If the individual has not
undergone genital surgery, his or her biological sex establishes where the
individual is housed (Peek, 2003). Thus, a transgender female who has been
living as a woman her entire adult life and has undergone hormone therapy
or other surgical procedures to look more like a woman (yet still has male
genitalia) would likely be placed in an all-male facility. Such experiences
invalidate an individual’s gender identity while also creating significant logis-
tical concerns. For example, one transgender female sex worker described
confronting this issue early on in her imprisonment: “When I got to prison,
when I first came in they go, ‘What’s your name?’ And I told them my name,
they go, ‘No, no, no, what’s your male name?’”1So although this participant
had legally changed her name at the age of 18 and had been living fully as
a woman, she was still viewed as a man and was subsequently housed in a
men’s prison.
Furthermore, when transgender inmates are placed in the facility that
they do not identify with, they are prone to be sexually harassed by other
inmates (or even by prison guards). One transgender woman described the
humiliation she felt at having to strip in front of guards:
You all get into a line and you’re going to get strip searched, you’re
gonna take a shower, and you know, they put your clothes through the
metal detectors, and you take your clothes [back after] because it’s not
sentencing yet. So, you know, we’re going into the thing, the guys were
stripping. They have like five guys go into this room and strip in front of
them and then put their clothes into a bin through a metal detector and
to shower. I started stripping right in front of all the guys ...I felt very
uncomfortable.2
Finally, housing transgender women in a men’s prison facility not
only causes discomfort and embarrassment due to living arrangements and
shower situations but causes a significant risk to the transgender inmate’s
safety. Physical and sexual abuses are common to the prison system, but
those who are transgender face discrimination and harassment to a more
pronounced degree than other prisoners (Peek, 2003; Rosenblum, 2000).
One author described the hierarchy that exists within prison settings, as
well as how rape and coercive sex is used to establish dominance in men’s
facilities (Peek, 2003). One participant in the study focusing on transgender
sex workers reported that other prisoners had raped her while she was
incarcerated:
There [were] four guys, two came on that side and two came on that side
and came in there. The first guy sliced his face with the little cutter thing
I had, when I woke up I could feel them in me, one of the guys were in
Downloaded by [John Jay College of Criminal Justice], [Kevin L. Nadal] at 14:36 17 March 2014
178 K. L. Nadal et al.
me and they were holding me and choking me and someone socked me
out again. I woke up again, they choked me out, I could feel, eventually
I woke up I had to get 15 stitches in my anus, and they kept doing HIV
tests, they didn’t find nothing. One month after I got out of prison I got
a HIV diagnosis. They told me I could file charges but it’s hard to prove
cause, can you prove they raped you and can you prove they gave you
HIV?1
It is evident that the rape of transgender prisoners by other inmates may
serve as an intense personal trauma for victims. Moreover, because the sex-
ual contact is unprotected it raises the risk of contracting HIV, which may
then turn a prison term into a death sentence for many transgender inmates
(Rosenblum, 2000).
Because of these negative, traumatic, and often life-threatening expe-
riences in the criminal justice system, it is possible that transgender sex
workers face a number of mental health problems. For example, partici-
pants in the study exploring the lives of transgender female sex workers
reported a spectrum of mental health issues, including depression, anxiety,
and posttraumatic stress disorder. The aforementioned participant who was
raped in prison shared, “Ever since the rape happened, what’s really bad is
the anxiety. I have panic attacks all the time and they’re really scary, like I
think I’m having a heart attack. It’s really scary, the panic.”1Meanwhile, the
aforementioned participant who was brutally beaten by police officer shared,
“[I have] [posttraumatic stress disorder]. Certain things startle me and scare
me. Certain situations I avoid. I still have nightmares of being stabbed ...I’m
so terrified of cops.”1The events described by participants concur with the
literature and suggest that transgender discrimination in the criminal justice
system, prison placement policy in particular, is more than insensitive—it
constitutes tangible, life-threatening risks to the physical and mental health
of transgender individuals.
RECOMMENDATIONS FOR POLICY AND PREVENTION
There are many recommendations that can benefit transgender people, par-
ticularly transgender women who are involved in the sex work industry.
We support the need to advocate for transgender rights on systemic levels
(e.g., pro-transgender legislation) and on institutional or individual levels
(e.g., promoting inclusive working environments). In doing so, we provide
a more inclusive and supportive environment for transgender people, which
in turn may decrease discrimination and promote a higher quality of life.
Regarding sex workers specifically, we aim to address the risks that are
associated with sex work while also reducing some transgender women’s
perceptions of sex work as the only alternative.
Downloaded by [John Jay College of Criminal Justice], [Kevin L. Nadal] at 14:36 17 March 2014
Journal of Trauma & Dissociation, 15:169–183, 2014 179
Regarding workplace discrimination, employers need to ensure policies
are in place (and enforce these policies) to protect transgender individuals in
order to promote a safe working environment. Although there have been a
few increases of federal and state laws that protect transgender people (e.g.,
President Barack Obama signing the federal Hate Crimes Bill in 2009, which
classified hate crimes to include sexual orientation and gender identity),
there are very few laws that protect transgender people from workplace
discrimination. Only 15 out of 50 U.S. states outlaw discrimination based on
gender identity. Furthermore, Title VII of the Civil Rights Act (1964) prohibits
workplace discrimination based on sex, race, color, religion, and national
origin but does not directly cover sexual orientation or gender identity (see
Nadal et al., 2010, for a review). As a result, there is a need for legislation on
federal, state, and local levels to view discrimination that is based on sexual
orientation and gender identity as a criminal act.
Systems that interact with transgender women also need to be informed
about discrimination against transgender people and how it contributes to
stigma and perpetuates harm. Viewing sex work as a criminal act without
considering the factors that lead transgender individuals to engage in sex
work in the first place leads to punitive measures, whereas rehabilitative
efforts can benefit all involved. Creating alternatives to incarceration that
target the needs specific to this population and provide help with obtaining
and maintaining gainful employment may reduce recidivism and improve
the quality of life for those involved. Furthermore, programs that use a harm
reduction approach to sex work and reduce the risks associated with this line
of work are greatly needed. Harm reduction strategies were originally utilized
with individuals who participate in illicit drug use, but the principles have
been applied to other high-risk behavior such as sex work (Cusick, 2005;
Rekart, 2005). The framework approaches the high-risk behavior not as a
problem but as a decision that often leads to negative consequences that can
be attenuated and targets those negative consequences in a nonjudgmental
manner. Instead of criminalizing this behavior, the criminal justice system
should provide resources to assist individuals who want to leave the sex
work industry to find other employment or help reduce the risks involved in
ongoing sex work for those who choose to continue.
The criminal justice system must be better prepared to meet the needs,
and ensure the safety, of transgender people. Forcing a transgender female
inmate (whose birth sex is not consistent with her life as woman) to undress
in front of male prison guards and male inmates can be dehumanizing and
objectifying. Maintaining policies that restrict transgender people to living
in the same quarters as those of their birth sex can create hazardous and
dangerous environments where transgender people can be physically and
sexually assaulted. If the government would not allow a cisgender woman
to reside in an all-male prison facility because it recognizes the safety issues
Downloaded by [John Jay College of Criminal Justice], [Kevin L. Nadal] at 14:36 17 March 2014
180 K. L. Nadal et al.
that would be involved, the government should not condone the same type
of harm occurring toward a transgender woman.
Furthermore, given that there has been an abundance of instances of
police misconduct toward transgender people, including physical, verbal,
and sexual abuse, as well as dismissals of transgender hate crimes as being
untrue or the fault of the victim (Amnesty International, 2005), it is necessary
for police officers to be better trained in working with transgender people.
When police misconduct does occur, leadership must take these incidents
seriously and disciplinary action must occur in order to promote the idea
that anti-transgender is not acceptable. Police policies that may directly or
indirectly affect transgender people need to be modified in order to improve
the quality of life of transgender people. For example, just as police profiling
policies (e.g., New York City’s Stop and Frisk) have been found to dispro-
portionately target people of color, some authors have found that it is also
common for transgender women to be unjustly assumed of engaging in, or
arrested for, sex work (Center for Constitutional Rights, 2012). In fact, media
outlets have reported that many transgender women are being stopped,
searched, and arrested by police on the suspicion of being sex workers sim-
ply for carrying condoms on their person (Crabapple, 2013). Government
officials and policymakers must recognize that policies that do unfairly target
transgender people and other subgroups not only are unconstitutional but
also are detrimental to people’s lives.
One tangible recommendation is to follow the lead of the Los Angeles
Police Department, in which a transgender-specific detention center was
created to minimize discrimination and violence that tends to occur in gen-
der facilities. At this facility, transgender inmates are able to receive their
hormones and any medical treatments, officers are instructed to address
transgender inmates with their preferred names and gender pronouns, and
officers are prohibited from conducting body searches simply to deter-
mine one’s birth sex (Miles, 2012). If the criminal justice system does not
change its policies to protect transgender people in the same manner as this
police department has, transgender inmates will continue to be victimized,
harassed, and assaulted on a regular basis.
The systemic, institutional, and interpersonal discrimination faced by
transgender individuals in the United States serves as a potent illustration
of the larger picture of discrimination due to the society’s tendency to view
gender as a binary (Rosenblum, 2000). Thus, it is important for advocacy
to also occur on individual levels; if individuals can enhance awareness
of transgender issues, there is a potential for change on a societal level.
For instance, educators must be conscious of the ways in which they allow
discrimination to pervade their school systems and how these experiences
send a hurtful message to transgender students. Physicians and psychologists
must be cognizant of how they can often pathologize transgender people,
which often leads to further psychological distress and physiological health
Downloaded by [John Jay College of Criminal Justice], [Kevin L. Nadal] at 14:36 17 March 2014
Journal of Trauma & Dissociation, 15:169–183, 2014 181
problems. Parents, families, and friends must learn to become sensitive to
and aware of the needs of loved ones who may be struggling with their
transgender identities. When transgender people are often neglected, aban-
doned, or disowned, they often isolate themselves and engage in destructive
behaviors, including substance use, risky sexual behaviors, or sex work.
Thus, although it is necessary for systems and institutions to improve in
order to promote the highest quality of life for transgender people, advocacy
and change can occur on individual, family, and group levels too.
ACKNOWLEDGMENTS
We thank the Professional Staff Congress-City University of New York and the
Forensic Psychology Research Institute for providing funding for our studies.
We also thank the transgender participants for sharing their perspectives and
experiences.
NOTES
1. From “Transgender female sex workers: Personal perspectives, gender identity development,
and psychological processes,” by K. L. Nadal, V. Vargas, V. Meterko, S. Hamit, and K. McLean, 2012,
in Managing Diversity in Today’s Workplace: Strategies for Employees and Employers, Volume 1: Gender,
Race, Sexual Orientation, Ethnicity, and Power, pp. 123–153, Santa Barbara, CA: Praeger. Copyright
2012 by ABC Clio.
2. From “Interpersonal and systemic microaggressions toward transgender people: Implications
for counseling,” by K. L. Nadal, A. Skolnik, and Y. Wong, 2012, Journal of LGBT Issues in Counseling,6,
p. 55–82. Copyright 2012 by Taylor and Francis Group, LLC.
REFERENCES
Amnesty International. (2005). Stonewalled: Police abuse and misconduct against
lesbian, gay, bisexual and transgender people in the U.S. New York, NY: Author.
Barclay, J. M., & Scott, L. J. (2006). Transsexuals and workplace diver-
sity: A case of “change” management. Personnel Review,35, 487–502.
doi:10.1108/00483480610670625
Center for Constitutional Rights. (2012). Stop and frisk—The human impact:The
stories behind the numbers, the effects on our communities.NewYork,NY:
Author.
Crabapple, M. (2013). New York Cops will arrest you for carrying condoms.
Retrieved from http://www.vice.com/read/new-york-cops-will-arrest-you-for-
carrying-condoms
Cusick, L. (2005). Widening the harm reduction agenda: From drug
use to sex work. International Journal of Drug Policy,17, 3–11.
doi:10.1016/j.drugpo.2005.12.002
Downloaded by [John Jay College of Criminal Justice], [Kevin L. Nadal] at 14:36 17 March 2014
182 K. L. Nadal et al.
deManda, J. M. (2002). Our transgressions: The legal system’s struggle with providing
equal protection to transgender and transsexual people. University of Missouri-
Kansas City Law Review,71, 507–527.
Harcourt, C., Egger, S., & Donovan, B. (2005). Sex work and the law. Sex Health,
2(3), 121–128.
Hill, D. B., & Willoughby, B. L. B. (2005). The development and validation of the
Genderism and Transphobia Scale. Sex Roles,53, 531–544. doi:10.1007/s11199-
005-7140-x
Koken, J. A., Bimbi, D. S., & Parsons, J. T. (2009). Experiences of famil-
ial acceptance—rejection among transwomen of color. Journal of Family
Psychology,26 , 853–860. doi:10.1037/a0017198
Lombardi, E. L., Wilchins, R. A., Priesing, D., & Malouf, D. (2001). Gender vio-
lence: Transgender experiences with violence and discrimination. Journal of
Homosexuality,42, 89–101.
Miles, K. (2012, April). Transgender prison: LA police open separate detention facil-
ity for transgender inmates. The Huffington Post. Retrieved from http://www.
huffingtonpost.com/2012/04/13/transgender-prison-la-police_n_1423879.html
Nadal, K. L. (2013). That’s so gay! Microaggressions and the lesbian, gay, bisex-
ual, and transgender community. Washington, DC: American Psychological
Association.
Nadal, K. L., Rivera, D. P., & Corpus, M. J. H. (2010). Sexual orientation and
transgender microaggressions in everyday life: Experiences of lesbians, gays,
bisexuals, and transgender individuals. In D. W. Sue (Ed.), Microaggressions
and marginality: Manifestation, dynamics, and impact (pp. 217–240). New
York, NY: Wiley.
Nadal, K. L., Skolnik, A., & Wong, Y. (2012). Interpersonal and systemic
microaggressions toward transgender people: Implications for counseling.
Journal of LGBT Issues in Counseling,6(1), 55–82.
Nadal, K. L., Vargas, V., Meterko, V., Hamit, S., & McLean, K. (2012). Transgender
female sex workers: Personal perspectives, gender identity development, and
psychological processes. In M. A. Paludi (Ed.), Managing diversity in today’s
workplace: Strategies for employees and employers: Vol. 1. Gender, race, sexual
orientation, ethnicity, and power (pp. 123–153). Santa Barbara, CA: Praeger.
National Center for Transgender Equality and the National Gay and
Lesbian Task Force. (2009). National Transgender Discrimination Survey:
Preliminary findings. Retrieved from http://transequality.org/Resources/
NCTE_prelim_survey_econ.pdf
Noelle, M. (2002). The ripple effect on the Matthew Shepard murder: Impact on
the assumptive worlds of members of the targeted group. American Behavioral
Scientist,46 (1), 27–50. doi:10.1177/0002764202046001004
Peek, C. (2003). Breaking out of the prison hierarchy: Transgender prisoners, rape,
and the Eighth Amendment. Santa Clara Law Review,44, 1211–1248.
Rekart, M. L. (2005). Sex-work harm reduction. Lancet,366 , 2123–2134.
doi:10.1016/S0140-6736(05)67732-X
Rosenblum, D. (2000). “Trapped” in Sing Sing: Transgendered prisoners caught in
the gender binarism (Pace Law Faculty Publications Paper No. 207). Retrieved
from http://digitalcommons.pace.edu/lawfaculty/207
Downloaded by [John Jay College of Criminal Justice], [Kevin L. Nadal] at 14:36 17 March 2014
Journal of Trauma & Dissociation, 15:169–183, 2014 183
Sausa, L. A., Keatley, J., & Operario, D. (2007). Perceived risks and benefits of sex
work among transgender women of color in San Francisco. Archives of Sexual
Behavior,36, 768–777.
Schilt, K., & Connell, C. (2007). Do workplace gender transitions make gen-
der trouble? Gender, Work & Organization,14, 596–618. doi:10.1111/j.1468-
0432.2007.00373.x
Shannon, K., Kerr, T., Strathdee, S. A., Shoveller, J., Montaner, J. S., & Tyndall, M. W.
(2009). Prevalence and structural correlates of gender based violence among a
perspective cohort of female sex workers. British Medical Journal,339, b:2939.
Stotzer, R. L. (2008). Gender identity and hate crimes: Violence against transgender
people in Los Angeles county. Sexuality Research & Social Policy,5(1), 43–52.
Witten, T. M., & Eyler, A. E. (1999). Hate crimes and violence against the
transgendered. Peace Review,11, 461–468.
Downloaded by [John Jay College of Criminal Justice], [Kevin L. Nadal] at 14:36 17 March 2014
