Housing Stability and Transactional Sex among Spanish-Speaking and English-Speaking Transgender Women

There is evidence for a relationship between housing instability and transactional sex among transgender women. However, less is known about this relationship among monolingual Spanish-speaking transgender women. We compared Spanish- and English-speaking transgender women for differences in ever reporting transactional sex, and if perceived housing stability moderated these differences. Using a cross-sectional design, we surveyed 186 Spanish- and English-speaking transgender women in Philadelphia, Pennsylvania, and the San Francisco Bay Area, California. All variables in this study were from a brief demographic questionnaire in a larger parent study. Using a multivariate regression model for moderation, we tested whether the odds for reporting transactional sex were different between English and Spanish speakers, and whether housing stability moderated these odds. Overall, Spanish and English speakers reporting similar percentages of transactional sex (52.3–53.8%) and similar scores on the housing stability measure. In the moderation regression model, Spanish speakers had 7.9 times the adjusted odds of transaction sex, versus English speakers, but housing stability moderated the probability of transactional sex in the form of a crossover interaction. That is, lesser housing stability was associated with a higher probability of reporting transactional sex among Spanish speakers, yet greater housing stability was also associated with lower probability of reporting transactional sex. Housing stability evidenced both a risk and protective role for Spanish-speaking transgender women, which highlight the importance of this basic health need.