1. On the Margins of the Marginalized: Exploring Sex Work and Homelessness Among Transgender/Gender Non-Conforming Individuals Shanna K. Kattari, M.Ed and Stephanie Begun, MSW University of Denver On the Margins of the Marginalized: Exploring Sex Work and Homelessness Among Transgender/Gender Non-Conforming Individuals Shanna K. Kattari, M.Ed and Stephanie Begun, MSW University of Denver Abstract Objectives  Transgender/gender non-conforming (GNC) individuals experience homelessness at rates twice that of the broader national population, with nearly 20% reporting that their homelessness was due directly to their transgender or GNC identities (Grant et al., 2011).  Literature demonstrates that homeless individuals frequently practice sex work and/or trade sex (also known as survival sex) in exchange for food, housing, and to obtain other basic necessities.  While often perceived as one of few viable options for survival and self- sufficiency on the streets, sex work has been linked with myriad adverse outcomes, including elevated rates of HIV, STIs, unwanted pregnancies, and substance abuse (Halcón & Lifson, 2004).  This study uses a national survey to examine, specifically among transgender/GNC individuals: 1) What is the prevalence of homelessness and sex work?, and 2) What relationships exist between homelessness experiences and sex work?  Bring attention to each of these unique areas of marginalizing experiences  Highlight these intersections that are under-studied and under-examined in social work research 19th Annual Conference, January 14-18, 2015, New Orleans, LA 1 Literature Research indicates that homeless individuals frequently practice sex work and/or trade sex (also known as survival sex) in exchange for food, housing, and to obtain other basic necessities (Anderson, Freese, & Pennbridge, 1994; Halcón & Lifson, 2004; Haley, Roy, Leclerc, Boudreau, & Bolvin, 2004; Warf et al., 2013; Watson, 2011). An estimated 10% to 50% of homeless individuals engage in survival sex at some point (Greene, Ennett, & Ringwalt, 1999; Haley et al., 2004; National Alliance to End Homelessness, 2009; Warf et al., 2013). While often perceived as one of few viable options for survival and self-sufficiency on the streets, sex work has been linked with many adverse outcomes, including: o Elevated rates of HIV and STIs (Gangamma, Slesnick, Toviessi, & Serovich, 2008; Solorio et al., 2008) o Unintended pregnancies (Warf et al., 2013) o Substance use disorder (Halcón & Lifson, 2004) o Suicide ideation/attempts (Greene et al., 1999; Walls & Bell, 2011; Warf et al., 2013; Whitbeck, 2009) Many homeless shelters in the United States are segregated based on legal sex, thus forcing assumptions about a given individual’s gender (Mottet & Ohle, 2006). Transgender individuals, who may identify as or express gender differently than their assigned sex at birth, may encounter challenges in accessing safe and adequate shelter while homeless (Mottet & Ohle, 2006). Research has shown that many homeless shelters fail to provide physically safe environments for transgender individuals, do not adequately protect their privacy, and do not display respect for transgender individuals’ autonomy in defining and expressing their gender identity (Mottet & Ohle, 2006).

2. On the Margins of the Marginalized: Exploring Sex Work and Homelessness Among Transgender/Gender Non-Conforming Individuals Shanna K. Kattari, M.Ed and Stephanie Begun, MSW University of Denver On the Margins of the Marginalized: Exploring Sex Work and Homelessness Among Transgender/Gender Non-Conforming Individuals Shanna K. Kattari, M.Ed and Stephanie Begun, MSW University of Denver Hypothesis Methods What is the prevalence of homelessness and sex work in the transgender/GNC community? What relationships exist between homelessness experiences and sex work for transgender/GNC individuals?  While research has established the prevalence of and risks associated with homeless individuals’ sex work, as well as discrimination faced by homeless transgender/GNC individuals in shelter/service provision milieu, little to no research has sought to understand the intersections of these identities and experiences.  We hypothesize that the intersectionality of transgender/GNC identity, homelessness, and engagement in sex work is indicative of stark marginalization, and may subsequently warrant further innovations to how service provision is approached. The current study uses the 2011 National Transgender Discrimination Survey (N=6,454), collected by The National Center for Transgender Equality, and the National LGBTQ Task Force; two national advocacy organizations. Data were collected using online surveys, distributed through social media, partner organizations, and advertisements to participants from 50 U.S. States, Puerto Rico, and Guam. All participants in this survey identified as transgender and/or gender non-conforming, and were 18+. Participants were asked various questions regarding current living situations, experiences of harassment, victimization and discrimination, health questions, and demographic information. This current study examined relationships between homelessness experiences and reported sex work by using a series of Chi-square analyses. Specifically, analyses explored whether transgender/GNC individuals had engaged in sex work, and if so, if they reported higher rates of current homelessness, homelessness at any point, and if they were more or less likely to access shelters while homeless. 2 19th Annual Conference, January 14-18, 2015, New Orleans, LA Results  Data indicate that while many (n = 721, 11.2%) transgender/GNC individuals experienced homelessness at some point, many transgender/GNC (n = 694, 10.8%) also engaged in sex work.  Sex work was associated with current homelessness, X 2 (1) = 224.486, p <.001, and homelessness at some point due to being transgender/GNC, X 2 (2) = 457.114, p <.001.  Interestingly, of the transgender/GNC individuals who experienced homelessness, sex work was more highly associated with accessing a shelter compared to those who were homeless but did not engage in sex work, X 2 (2) = 953.417, p <.001.

3. On the Margins of the Marginalized: Exploring Sex Work and Homelessness Among Transgender/Gender Non-Conforming Individuals Shanna K. Kattari, M.Ed and Stephanie Begun, MSW University of Denver On the Margins of the Marginalized: Exploring Sex Work and Homelessness Among Transgender/Gender Non-Conforming Individuals Shanna K. Kattari, M.Ed and Stephanie Begun, MSW University of Denver Implications References  Findings suggest that transgender/GNC individuals experience homelessness at higher rates because of their marginalized identities, and sex work is associated with such homelessness experiences.  However, as homeless transgender/GNC individuals who engage in sex work often reported accessing shelters, future social work research efforts should further explore transgender/GNC individuals’ homelessness and sex work experiences in order to inform how service provision may be optimized to better meet the needs of this highly-discriminated against and vulnerable population (particularly given little prior literature regarding service provision/discrimination).  Education for social workers should also include more information about the transgender/GNC population, including how social workers can be more culturally responsive to clients with these identities.  While survival sex/sex work is frequently viewed as a risk behavior, it may also be a protective factor, allowing participants more access to needed resources. Further research in this area is needed to better understand the nuances of these experiences, the unique prevention needs, and innovative approaches to outreach associated with safer sex practices/harm reduction strategies. 3 19th Annual Conference, January 14-18, 2015, New Orleans, LA Anderson, J. E., Freese, T. E., & Pennbridge, J. N. (1994). Sexual risk behavior and condom use among street youth in Hollywood. Family Planning Perspectives, 26(1), 22-25. Gangamma, R., Slesnick, N., Toviessi, P., & Serovich, J. (2008). Comparison of HIV risks among gay, lesbian, bisexual and heterosexual homeless youth. Journal of Youth and Adolescence, 37(4), 456–464. Grant, J., Mottet, L., Tanis, J., Harrison, J., Herman, J., & Keisling, M. (2011). Injustice at every turn: A report of the national transgender discrimination survey. Washington, DC: National Center for Transgender Equality and National Gay and Lesbian Task Force. Greene, J. M., Ennett, S. T., & Ringwalt, C. L. (1999). Prevalence and correlates of survival sex among runaway and homeless youth. American Journal of Public Health, 89(9), 1406-1409. Halcón, L. L., & Lifson, A. R. (2004). Prevalence and predictors of sexual risks among homeless youth. Journal of Youth and Adolescence, 33(1), 71-80. Haley, N., Roy, E., Leclerc, P., Boudreau, J. F., & Boivin, J. F. (2004). HIV risk profile of male street youth involved in survival sex. Sexually Transmitted Infections, 80(6), 526-530. Mottet, L., & Ohle, J. (2006). Transitioning our shelters: Making homeless shelters safe for transgender people. Journal of Poverty, 10(2), 77-101. National Alliance to End Homelessness. (2009). Homeless youth and sexual exploitation: Research findings and practice implications. Retrieved from: http://www.endhomelessness.org/library/entry/homeless-youth-and-sexual-exploitation-research-findings-and- practice-impli Solorio, M. R., Rosenthal, D., Milburn, N. G., Weiss, R. E., Batterham, P. J., & Gandara, M. (2008). Predictors of sexual risk behaviors among newly homeless youth: A longitudinal study. Journal of Adolescent Health, 42(4), 401-409. Walls, N. E., & Bell, S. (2011). Correlates of engaging in survival sex among homeless youth and young adults. Journal of Sex Research, 48(5), 423-436. Warf, C. W., Clark, L. F., Desai, M., Rabinovitz, S. J., Agahi, G., Calvo, R., & Hoffman, J. (2013). Coming of age on the streets: Survival sex among homeless young women in Hollywood. Journal of Adolescence, 36, 1205-1213. Watson, J. (2011). Understanding survival sex: Young women, homelessness, and intimate relationships. Journal of Youth Studies, 14(6), 639-655. Whitbeck, L. B. (2009). Mental health and emerging adulthood among homeless young people. New York: Psychology Press. Contact Information: Shanna K. Kattari: shanna.kattari@du.edu Stephanie Begun: stephanie.begun@du.edu