Discrimination and Sleep Health Among Transgender Women of Color in New York City: Cross-Sectional and Longitudinal Associations From the TURNNT Cohort Study.

Objectives. To determine whether discrimination is associated with sleep health among transgender women of color. Methods. We included 269 participants from the Trying to Understand Relationships, Networks, and Neighborhoods Among Transgender Women of Color (TURNNT) Cohort Study in New York City in a cross-sectional analysis and 179 in a longitudinal analysis of the association between discrimination and sleep duration, quality, and latency. Results. Median sleep duration was 6 hours per night, with 65% of participants reporting poor sleep in the past month. Nearly two thirds experienced moderate or high levels of discrimination. Cross sectionally, high discrimination was associated with a 14% greater risk of poor sleep quality relative to low discrimination (prevalence ratio [PR] = 1.14). Longitudinally, high discrimination was associated with a 15% higher risk of poor sleep (PR = 1.15) and an average of 43 minutes less per night. Conclusions. Transgender women of color generally do not receive an adequate amount of sleep, and that sleep is often of poor quality. Those who experience higher rates of discrimination are particularly vulnerable to poor sleep health. Public Health Implications. Effort should be focused on reducing antitransgender discrimination and developing interventions to mitigate the negative impact of discrimination on sleep health among transgender populations. (Am J Public Health. Published online ahead of print August 7, 2025:e1-e10. https://doi.org/10.2105/AJPH.2025.308208).