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The Experiences of Transgender and Cisgender Individuals in Oxford House Addiction Recovery Homes Emily Stecker; Christopher Beasley, PhD; Frank Ponziano Department of Psychology, Washington College Emily Stecker Washington College [email protected] Contact 1. Hotton, A.L., Garofalo, R., Kuhns, L.M., Johnson, A.K. (2013). Substance use as a mediator of the relationship between life stress and sexual risk among transgender women. AIDS Education and Prevention, 25(1): 62-71. 2. Xavier, J., Hitchcock, D., Hollinshead, S., Keisling, M., Lewis, Y., Lombardi, E. (2004) An overview of US trans health priorities: A report by the Eliminating Disparities Working Group. Retrieved from https://www.stdhivtraining.org/resource.php?id=267&ret=clinical_resources 3. Oxford House, Inc. (2011). Oxford House Manual, (4). Silver Spring, MD: Oxford House, Inc. 4. Jason, L.A., Olson, B.D., Ferrari, J.R., & Lo Sasso, A.T. (2006). Communal housing settings enhance substance abuse recovery. American Journal of Public Health, 91: 1727-1729. 5. Jason, L.A., Olson, B.D., Ferrari, J.R., Majer, J.M., Alvarez, J., & Stout, J. (2007). An examination of main and interactive effects of substance abuse recovery. Addiction, 102: 1114-1121. 6. Nagoshi, J.L., Terrell, H.K., Nagoshi, C.T., Brzuzy, S. (2014). The complex negotiations of gender roles, gender identity, and sexual orientation among heterosexual, gay/lesbian, and transgender individuals. Journal of Ethnographic & Qualitative Research, 8(4): 205-221. 7. Pflum, S. R., Testa, R. J., Balsam, K. F., Goldblum, P. B., & Bongar, B. (2015). Social support, trans community connectedness, and mental health symptoms among transgender and gender nonconforming adults. Psychology Of Sexual Orientation And Gender Diversity, 2(3), 281-286. doi:10.1037/sgd0000122 8. Regier, D. A., Farmer, M. E., Rae, D. S., Locke, B. Z., Keith, S. J., Judd, L. L., & Goodwin, F. K. (1990). Comorbidity of Mental Disorders With Alcohol and Other Drug Abuse. Journal Of The American Medical Association, 264(19), 2511. 9. Reyes, M. S., Alcantara, A. E., Reyes, A. C., Yulo, P. L., & Santos, C. P. (2016). Exploring the link between internalized stigma and self-concept clarity among Filipino transgenders. North American Journal Of Psychology, 18(2), 335-344. References This study aimed to understand the experiences of transgender (male to female) individuals and cisgender men living together in two Hawaiian Oxford Houses. Semi-structured interviews of seven transgender women and seven cisgender men were conducted. We used descriptive phenomenology to analyze the data in MaxQDA. Particularly interesting and salient themes include empowerment and familial connections with house. Additionally, both groups of participants followed similar paths in addiction and recovery. Abstract Seeking normalcy/stability • P3 (t-girl) “I move[d] into the house because I wanted to make a change.” • P9 (t-girl) “I knew I needed help and…so I tried to get myself into a treatment center.” • P13 (male) “I already knew basically that there were gonna be rules and…I was just all up for it.” Sobriety is priority • P3 (t-girl) “We’re all here to get sober. We’re all here to do our footwork.” • P10 (male) “…we’re all addicts so we all—you know—share the same problem and,…we call each other on our shit and…we help out each other whenever we can.” Depending on consequences to maintain sobriety • P2 (t-girl) “…what has really kept me sober is just knowing that I could not fake being high in front of these people…” • P11 (male) “…if I didn’t get into trouble, I wouldn’t be in this position…” Mentoring/helping others • P7 (t-girl) “I can help my sisters here, too.” • P12 (male) “…now I’m someone who gives social support.” Experiencing mutual acceptance • P2 (male) “…every guy that’s in [Oxford House] has accepted every transgender individual or homosexual individual that’s been in this house.” • P3 (t-girl) “The straight males treat me at me.” • P5 (t-girl) I get the same respect back as how I give them.” Feeling stable • P1 (t-girl) “To tell you the truth…Oxford Houses are a save haven…” • P3 (t-girl) “…everything is just…coming back together again.” • P12 (male) “…I’ve got nothing to worry about…” Experiencing familial connection with house • P1 (t-girl) “…they call us auntie.” • P5 (t-girl) “We’re all like a secondary family…” • P10 (male) “They are just like my sisters.” More acceptance in Hawaii than other parts of U.S. • P2 (male) “…I’d say Hawaii is a state…where we’re more understanding…than on the mainland.” • P9 (t-girl) “…I guess in Hawaii they’re more understanding.” Introduction Method • Audio-recorded telephone interviews up to one hour long • Snowball sampling • The two participating Oxfords were given coffee makers worth $60 • Data analyzed using descriptive phenomenology in MaxQDA Participants • Seven transgender women and seven cisgender men • Current and former residents of two specific Oxford Houses in Hawaii which are known for accepting transgender individuals Protocol (sample) • What was your support network like before you came to Oxford house? • What were your thoughts and feelings as you decided to join the house? • What was your initial experience in Oxford House like? • What do you think are some of the reasons why transgender individuals may or may not be coming to Oxford House? (Reasons they may, reasons they may not) Methods and Materials Connectedness & Stability • Higher levels of general social support (cisgender and LGBT communities) is correlated with fewer symptoms of depression and anxiety, 7 which are comorbid to substance dependence. 8 • Male-to-female transgender individuals also benefit from community connectedness within the transgender community in terms of mental health. 7 Ideal Self • Transgender women view the roles of women in society as being nurturers and communicators, 6 and Oxford House may give them opportunities to reinforce those traits within the household. • Evidence exists suggesting that higher self-concept reduces internalized stigma in transgender individuals. 9 Discussion Implications • Transgender women and cisgender men go through similar experiences in recovery. • Both groups may benefit from living together in a structured environment. • A sense of family within the home may lead to reinforcement of positive self- concept. Limitations • A test of reliability was not conducted. • Interviews conducted with a general thematic foundation; analyses employed descriptive phenomenology. • The small sample size and use of only Hawaiian houses limits the generalizability of the results. Future Directions • Quantitative validation of the results, specifically in terms of connectedness and familial relations. • Comparison of transgender women living in female recovery homes and those living in male homes. Conclusions • Substance abuse is a health concern for transgender individuals. 1 • Service provider insensitivity and gender policies are barriers to transgender addiction service seeking and provision. 2 • Oxford Houses are democratic, self-run addiction recovery homes that house a minimum of six same-sex residents. 3 • Those living in Oxford Houses for 6+ months after treatment were less likely to relapse, be incarcerated, and be w/o employment as compared with those not in OH. 4 • Although much is known about the effectiveness of OH and its mechanisms, 5 less is known about cultural differences in the Oxford House experience, such as with transgender issues. • Transgender women in the Oxford House program must live in male houses, because these women are considered biologically male. Results Chart 1. Flowchart detailing the relationships between salient themes. Lighter-colored boxes signify experiences that are more prevalent among transgender women than cisgender men.
