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Caba AE, Christophe NK, Renley BM, Simon KA, Feinstein BA, Eaton LA, Watson RJ. Measurement invariance of the LGBT People of Color Microaggressions Scale among LGBTQ+ youth. J Res Adolesc 2024. [PMID: 38616300 DOI: 10.1111/jora.12937] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/14/2023] [Revised: 10/16/2023] [Accepted: 03/15/2024] [Indexed: 04/16/2024]
Abstract
The LGBT People of Color Microaggressions Scale (LGBT-PCMS) is a widely used measure of intersectional microaggression experiences among sexual and gender minority people of color. Although it is widely used-and increasingly used in adolescent and young adult samples-it is unknown whether the LGBT-PCMS demonstrates similar measurement properties across subgroups of sexual and gender minority youth of color (SGMYOC). Among 4142 SGMYOC (ages 13-17) we found evidence for either partial or full scalar invariance (item loadings and intercepts were generally equal) across sexual orientation, race-ethnicity, and gender identity groups for all three subscales. Specific patterns of invariance and noninvariance across groups, as well as implications for the use of the LGBT-PCMS and its subscales among SGMYOC are discussed.
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Affiliation(s)
- Antonia E Caba
- Department of Human Development and Family Sciences, University of Connecticut, Storrs Mansfield, Connecticut, USA
| | | | - Benton M Renley
- Department of Human Development and Family Sciences, University of Connecticut, Storrs Mansfield, Connecticut, USA
| | - Kay A Simon
- Department of Family Social Science, University of Minnesota, Minneapolis, Minnesota, USA
| | - Brian A Feinstein
- Department of Psychology, Rosalind Franklin University of Medicine and Science, North Chicago, Illinois, USA
| | - Lisa A Eaton
- Department of Human Development and Family Sciences, University of Connecticut, Storrs Mansfield, Connecticut, USA
| | - Ryan J Watson
- Department of Human Development and Family Sciences, University of Connecticut, Storrs Mansfield, Connecticut, USA
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2
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Abstract
Tucking is the gender-affirming practice of putting the penis and scrotum between the buttocks and moving the testes up into the inguinal canals. Our study explores tucking and health effects among transfeminine adults (n=79). Most (74.7%) had practiced tucking and among them, 67.2% had tucked ≥7 years. When tucking, the majority (84.5%) tucked daily and almost half (44.8%) ≥17 h/day. Half (50.0%) reported concern about the health effects of tucking. Itching, rash, and testicular pain were the most commonly reported health effects. Health care providers should use a harm reduction approach in addressing tucking-related concerns and supporting patients who tuck.
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Affiliation(s)
- Mannat Malik
- Department of Health Behavior, University of North Carolina Gillings School of Global Public Health, Chapel Hill, North Carolina, USA
| | - Erin E Cooney
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Jean-Michel Brevelle
- Center for HIV/STI Integration and Capacity, Maryland Department of Health, Baltimore, Maryland, USA
| | - Tonia Poteat
- Department of Social Medicine, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, North Carolina, USA
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3
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Chan RCH, Suen YT, Leung JSY. Gender identity differences in the experiences of family stressors and violence among transgender and non-binary individuals in China. Fam Process 2024. [PMID: 38169124 DOI: 10.1111/famp.12958] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/03/2022] [Revised: 10/30/2023] [Accepted: 11/27/2023] [Indexed: 01/05/2024]
Abstract
Emerging research has demonstrated that transgender and non-binary (TNB) individuals face an elevated risk of experiencing family rejection and violence. However, there remains a significant knowledge gap regarding how TNB individuals manage stressors and their gender identity within the family context, particularly in regions where TNB individuals are highly stigmatized and where legal protections against family violence are lacking. The present study represents one of the first pioneering efforts to provide large-scale quantitative data examining the experiences of family stressors, the management of gender identity and expression, and family violence among TNB individuals in China. A national sample of 1063 TNB individuals in China was involved in the study. They completed questionnaires about their experiences of family stressors and violence. The results indicated that 76.0% of TNB individuals reported having encountered at least one form of violence perpetrated by their family members. Transfeminine individuals were more likely to report experiencing emotional and physical abuse, whereas transmasculine individuals were more likely to be subjected to gender identity and/or expression change efforts. Family stressors, including family non-acceptance and the pressure to marry and reproduce, were positively associated with non-disclosure of gender identity, the suppression of gender expression, and family violence. The findings underscore the substantial burden of family violence borne by TNB individuals in China, which warrants immediate legal, institutional, and social responses. Trans-inclusive family violence prevention and intervention are urgently needed, with a focus on Chinese cultural factors and gender identity differences in violence screening and risk assessment.
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Affiliation(s)
- Randolph C H Chan
- Department of Social Work, The Chinese University of Hong Kong, Shatin, Hong Kong
| | - Yiu Tung Suen
- Gender Studies Programme, The Chinese University of Hong Kong, Shatin, Hong Kong
| | - Janice Sin Yu Leung
- Gender Studies Programme, The Chinese University of Hong Kong, Shatin, Hong Kong
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4
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Gould WA, MacKinnon KR, Lam JSH, Enxuga G, Abramovich A, Ross LE. Detransition Narratives Trouble the Simple Attribution of Madness in Transantagonistic Contexts: A Qualitative Analysis of 16 Canadians' Experiences. Cult Med Psychiatry 2023:10.1007/s11013-023-09838-0. [PMID: 37737532 DOI: 10.1007/s11013-023-09838-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 08/28/2023] [Indexed: 09/23/2023]
Abstract
Emerging evidence suggests that transgender individuals are more likely than cisgender peers to receive a diagnosis with a primary mental disorder. Attributions of madness, though, may serve the social function of dismissing and discrediting transgender individual's self-perceptions. The narratives of individuals who stop or reverse an initial gender transition who also identify as living with mental health conditions can sometimes amplify these socio-political discourses about transgender people. Through a critical mental health lens, this article presents a qualitative analysis of 16 individuals who stopped or reversed a gender transition and who also reported a primary mental health condition. Semi-structured, virtual interviews were conducted with people living in Canada. Applying constructivist grounded theory methodology, and following an iterative, inductive approach to analysis, we used the constant comparative method to analyse these 16 in-depth interviews. Results show rich complexity such that participants narrated madness in nuanced and complex ways while disrupting biased attitudes that madness discredited their thoughts and feelings, including prior gender dysphoria. Instead, participants incorporated madness into expanding self-awareness and narrated their thoughts and feelings as valid and worthy. Future research must consider provider's perspectives, though, in treating mad individuals who detransitioned, since alternate gender-affirming care models may better support the identification and wellness of care-seeking individuals who may be identified (in the past, present, or future) as mad.
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Affiliation(s)
- Wren Ariel Gould
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
- School of Social Work, York University, Toronto, ON, Canada
| | - Kinnon R MacKinnon
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada.
- School of Social Work, York University, Toronto, ON, Canada.
| | - June Sing Hong Lam
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
- Institute for Evaluative Clinical Sciences (ICES), Toronto, ON, Canada
- Department of Psychiatry, Faculty of Medicine, University of Toronto, Toronto, ON, Canada
- Centre for Addiction and Mental Health, General and Health Systems Psychiatry Division, Toronto, ON, Canada
| | - Gabriel Enxuga
- School of Social Work, York University, Toronto, ON, Canada
| | - Alex Abramovich
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
- Department of Psychiatry, Faculty of Medicine, University of Toronto, Toronto, ON, Canada
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, ON, Canada
- Centre for Addiction and Mental Health, Institute for Mental Health Policy Research, Toronto, ON, Canada
| | - Lori E Ross
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
- Department of Psychiatry, Faculty of Medicine, University of Toronto, Toronto, ON, Canada
- Institute of Medical Science, University of Toronto, Toronto, ON, Canada
- Health Systems & Health Equity Research Group, Centre for Addiction and Mental Health, Toronto, ON, Canada
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Johns MM, Gordon AR, Andrzejewski J, Harper CR, Michaels S, Hansen C, Fordyce E, Dunville R. Differences in Health Care Experiences among Transgender and Gender Diverse Youth by Gender Identity and Race/Ethnicity. Prev Sci 2023; 24:1128-1141. [PMID: 37086334 DOI: 10.1007/s11121-023-01521-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/26/2023] [Indexed: 04/23/2023]
Abstract
Transgender and gender diverse (TGD) youth experience significant risk for negative health outcomes, yet few studies exist that address TGD youth's experiences of health care. This paper explores the equitable access and utilization of health care in a sample of TGD youth of diverse gender and racial/ethnic identities. Data for this analysis are from the TGD subsample (n = 1415) of the 2018 Survey of Today's Adolescent Relationships and Transitions (START) Project. We assessed five health care experiences: being insured, having a current health care provider, being out to one's provider, believing your provider was knowledgeable about transgender issues, and barriers to accessing care due to gender identity/expression. We examined the proportion of TGD youth who reported each of these outcomes and within-group differences by gender identity and race/ethnicity using descriptive statistics, logistic regression, and predicted probabilities. When differences were examined by gender identity, barriers to equitable care were consistently more present among transgender females than youth of other gender identities. There were few significant differences by race/ethnicity; however, dual referent models demonstrated barriers to equitable care were particularly evident among Black and Hispanic transgender women. We discuss these findings through the lens of intersectionality and highlight the importance of research and intervention work focused on reducing barriers to equitable care for TGD youth.
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Affiliation(s)
- Michelle M Johns
- Division of Adolescent and School Health, Centers for Disease Control and Prevention, Atlanta, GA, USA.
- NORC at the University of Chicago, 1447 Peachtree Street NE, Suite 700, Atlanta, GA, 30309, USA.
| | - Allegra R Gordon
- Boston University School of Public Health, Boston, MA, USA
- Harvard Medical School, Boston, MA, USA
| | - Jack Andrzejewski
- San Diego Joint Doctoral Program in Public Health, San Diego State University, University of California, San Diego, CA, USA
| | - Christopher R Harper
- Division of Violence Prevention, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Stuart Michaels
- NORC at the University of Chicago, 1447 Peachtree Street NE, Suite 700, Atlanta, GA, 30309, USA
| | - Christopher Hansen
- NORC at the University of Chicago, 1447 Peachtree Street NE, Suite 700, Atlanta, GA, 30309, USA
| | - Erin Fordyce
- NORC at the University of Chicago, 1447 Peachtree Street NE, Suite 700, Atlanta, GA, 30309, USA
| | - Richard Dunville
- NORC at the University of Chicago, 1447 Peachtree Street NE, Suite 700, Atlanta, GA, 30309, USA
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6
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Amos N, Hill AO, Jones J, Melendez-Torres GJ, Carman M, Lyons A, Bourne A. Affirming educational and workplace settings are associated with positive mental health and happiness outcomes for LGBTQA + youth in Australia. BMC Public Health 2023; 23:1421. [PMID: 37488585 PMCID: PMC10367347 DOI: 10.1186/s12889-023-16034-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2022] [Accepted: 05/31/2023] [Indexed: 07/26/2023] Open
Abstract
BACKGROUND Affirming socio-cultural settings are essential for protecting the mental health and wellbeing of lesbian, bisexual or pansexual, trans and gender diverse, asexual and queer (LGBTQA +) youth. However, limited research has explored the role of affirming educational and workplace settings, as reported by LGBTQA + youth themselves, with respect to their mental health and wellbeing. Moreover, existing research maintains a focus on mitigating poor mental health outcomes, with little attention to positive wellbeing outcomes among LGBTQA + youth. METHODS Using data from the largest national survey of LGBTQA + youth aged 14-21 in Australia, multivariable regression analyses were conducted to explore associations between affirming educational and workplace settings and psychological distress and subjective wellbeing among 4,331 cisgender and 1,537 trans and gender diverse youth. Additionally, a series of multivariable regression analyses were conducted to explore individual sociodemographic traits that are associated with reporting affirming educational or workplace settings. RESULTS Both cisgender and trans or gender diverse participants who reported that their education institution or workplace were affirming of their LGBTQA + identity reported lower levels of psychological distress as well as higher levels of subjective happiness. Additionally, affirming environments were not experienced equally across all subsections of LGBTQA + youth, with reporting of an affirming educational or workplace setting differing most noticeably across gender, type of educational institution and residential location. CONCLUSION The findings demonstrate that affirming educational and workplace settings can result not only in better mental health, but also greater levels of subjective happiness among LGBTQA + youth. The outcomes illustrate the importance of ensuring all LGBTQA + youth are afforded the opportunity to thrive in environments where they feel validated and confident to express their identities. The findings further highlight a need to target education institutions and workplaces to ensure the implementation of policies and practices that promote not just inclusion of LGBTQA + youth but affirmation of their identities.
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Affiliation(s)
- Natalie Amos
- Australian Research Centre in Sex, Health and Society, La Trobe University, Building NR6, Bundoora, VIC, 3086, Australia.
| | - Adam O Hill
- Australian Research Centre in Sex, Health and Society, La Trobe University, Building NR6, Bundoora, VIC, 3086, Australia
- Graduate School of Public Health, St Luke's International University, Tokyo, Japan
| | - Jami Jones
- Australian Research Centre in Sex, Health and Society, La Trobe University, Building NR6, Bundoora, VIC, 3086, Australia
| | | | - Marina Carman
- Australian Research Centre in Sex, Health and Society, La Trobe University, Building NR6, Bundoora, VIC, 3086, Australia
| | - Anthony Lyons
- Australian Research Centre in Sex, Health and Society, La Trobe University, Building NR6, Bundoora, VIC, 3086, Australia
| | - Adam Bourne
- Australian Research Centre in Sex, Health and Society, La Trobe University, Building NR6, Bundoora, VIC, 3086, Australia
- Kirby Institute, UNSW Sydney, Wallace Wurth Building, High Street, Kensington, NSW, 2052, Australia
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7
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Stults CB, Gao S, Brandt SA, Taber JL, Lynn SG, Kaczetow W, Lee G, Cruise A, Krause KD. Intimate Partner Violence and Mental Health Among Transgender and Gender Diverse Young Adults. J Fam Violence 2023:1-15. [PMID: 37358980 PMCID: PMC10220337 DOI: 10.1007/s10896-023-00579-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 05/18/2023] [Indexed: 06/28/2023]
Abstract
Purpose Research indicates that multiple forms of intimate partner violence (IPV) may be prevalent among transgender and gender diverse (TGD) people, including general forms of IPV (psychological, physical, sexual), as well as identity-specific forms (transgender-related IPV (T-IPV), identity abuse (IA)). Studies also suggest that IPV is associated with negative mental health outcomes in TGD populations, including depression, anxiety, and posttraumatic stress disorder (PTSD). However, little is known about IPV and its association with mental health among TGD young adults. This is noteworthy, as this is a key developmental period for many TGD individuals. Methods Thus, the present study sought (1) to estimate the lifetime and past-year prevalence of several forms of general and identity-specific IPV among a sample of (N = 200) TGD young adults in New York City and (2) to assess the associations between IPV with recent symptoms of depression, anxiety, and PTSD. To address the study aims, a cross-sectional quantitative survey was conducted between July 2019 and March 2020. Results Regarding lifetime IPV, IA was most prevalent (57.0%), followed by sexual (40.0%), physical (38.5%), T-IPV (35.5%), and psychological IPV (32.5%). Regarding past-year IPV, psychological IPV was most common (29.0%), followed by IA (27.5%), physical (20.0%), T-IPV (14.0%), and sexual IPV (12.5%). Results of hierarchical regression models indicate that lifetime IA was related to depression, anxiety, and PTSD, while past-year T-IPV was only associated with depression. Conclusions Taken together, these findings suggest that IPV is highly prevalent among TGD young adults and that IPV - especially identity-specific forms - warrants additional attention from researchers, healthcare professionals, and policymakers, as it may place this population at risk for negative mental health outcomes.
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Affiliation(s)
- Christopher B. Stults
- Department of Psychology, Baruch College, City University of New York, 55 Lexington Ave, New York, NY 10010 USA
- Department of Psychology, The Graduate Center, City University of New York, New York, USA
| | - Stan Gao
- Department of Psychology, Baruch College, City University of New York, 55 Lexington Ave, New York, NY 10010 USA
| | | | - Jamie L. Taber
- Department of Psychology, Baruch College, City University of New York, 55 Lexington Ave, New York, NY 10010 USA
- Department of Psychology, The Graduate Center, City University of New York, New York, USA
| | - Savannah G. Lynn
- Department of Psychology, Baruch College, City University of New York, 55 Lexington Ave, New York, NY 10010 USA
| | - Walter Kaczetow
- Department of Psychology, The Graduate Center, City University of New York, New York, USA
| | - Gabin Lee
- Department of Psychology, Baruch College, City University of New York, 55 Lexington Ave, New York, NY 10010 USA
| | - Andrew Cruise
- Department of Psychology, Baruch College, City University of New York, 55 Lexington Ave, New York, NY 10010 USA
| | - Kristen D. Krause
- Department of Urban-Global Public Health, School of Public Health, Rutgers University, Newark, USA
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Motley DN, Forberg P, Pagkas-bather J, Bouris A, Schneider J. From Trauma to Transformation: the Role of the Trauma Surgeon in the Care of Black Transgender Women. Curr Trauma Rep 2023. [DOI: 10.1007/s40719-023-00254-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/19/2023]
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9
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Cascalheira CJ, Choi NY. Transgender Dehumanization and Mental Health: Microaggressions, Sexual Objectification, and Shame. The Counseling Psychologist 2023; 51:532-559. [PMID: 37091226 PMCID: PMC10118059 DOI: 10.1177/00110000231156161] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/17/2023]
Abstract
Using structural equation modeling in a national, nonprobabilistic sample of 292 transgender women and men, this project extends the pantheoretical dehumanization framework by testing direct and indirect relations between dehumanization (i.e., a higher-order construct from experiences of transgender microaggressions and sexual objectification), internalization processes (i.e., internalized transnegativity, self-objectification), shame, and general mental health. The model explained 55% of the variance in general mental health. Direct relations between dehumanization and all internalization processes were positive and significant. Internalized transnegativity and shame were significant, negative, direct predictors of mental health, but neither dehumanization nor self-objectification were significant direct predictors of transgender mental health. Both self-objectification and internalized transnegativity directly predicted more feelings of shame. However, only shame yielded a significant indirect pathway from dehumanization to mental health. The indirect relations from self-objectification and internalized transnegativity to mental health through shame were significant. We discuss research, advocacy, and clinical implications.
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Levitt HM, Kehoe KA, Hand AB. Beyond minority stress: Toward a multidimensional psychology of trans/nonbinary gender. Curr Opin Psychol 2023; 49:101515. [PMID: 36525910 DOI: 10.1016/j.copsyc.2022.101515] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2022] [Revised: 11/08/2022] [Accepted: 11/09/2022] [Indexed: 11/17/2022]
Abstract
Although research that documents minority stress caused to LGBTQ + people supports needed advocacy, it can concomitantly cause harm to communities by portraying them as depleted and powerless. This review article assesses if and how researchers who study minority stress also center interpersonal functions of gender expression that are agentic for trans/nonbinary (TNB) people. These functions were coded in the qualitative research related to minority stress for TNB people over the last five years. Findings revealed that while most interpersonal functions of gender were described rarely, especially those associated with TNB communities of color, damage-centered perspectives were common. Damage-centered perspectives were common. We charge the field to expand its scope of inquiry, center functionalist and agency-focused research, and to develop a multidimensional psychology of gender.
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Affiliation(s)
- Heidi M Levitt
- University of Massachusetts Boston, 100 Morrissey Blvd, Dept. of Psychology, Boston, MA, 02125, USA.
| | - Kelsey A Kehoe
- University of Massachusetts Boston, 100 Morrissey Blvd, Dept. of Psychology, Boston, MA, 02125, USA
| | - Ally B Hand
- University of Massachusetts Boston, 100 Morrissey Blvd, Dept. of Psychology, Boston, MA, 02125, USA
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Nagoshi JL, Nagoshi CT, Pillai VK. Transgender theory revisited: Current applications to transgender issues. Curr Opin Psychol 2023; 49:101546. [PMID: 36641832 DOI: 10.1016/j.copsyc.2022.101546] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2022] [Revised: 12/10/2022] [Accepted: 12/12/2022] [Indexed: 12/24/2022]
Abstract
In addition to social determinants and cognitive constructions of social identities emphasized by earlier theoretical frameworks, transgender theory emphasizes the importance of physical embodiment in gender and sexual identity, as well as the integration of embodied experiences with the self and socially constructed aspects of identity through the lived experiences of those with fluid, often intersecting identities. The present paper considers important recent topics in research on transgender identities through the lens of this theory, including embodiment in understanding fluid gender and sexual identities, the intersectionality of multiple oppressed social identities, barriers to healthcare for transgender individuals, and ethical issues with regard to social policies impacting transgender individuals and with regard to media portrayals of and research on such individuals.
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Affiliation(s)
- Julie L Nagoshi
- Southwest Interdisciplinary Research Center, Arizona State University, Phoenix, AZ 85004, USA.
| | - Craig T Nagoshi
- Department of Psychology, University of Texas at Arlington, Arlington, TX 76019, USA
| | - Vijayan K Pillai
- School of Social Work, University of Texas at Arlington, Arlington, TX 76019, USA
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12
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Antebi-Gruszka N, Cain D, Millar BM, Parsons JT, Rendina HJ. Stress-Related Growth Among Transgender Women: Measurement, Correlates, and Insights for Clinical Interventions. J Homosex 2022; 69:1679-1702. [PMID: 33989133 DOI: 10.1080/00918369.2021.1921511] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
Although transgender women (TGW), and especially TGW of color, are disproportionately exposed to discrimination and violence, many of them experience stress-related growth. However, little is known about the experience of stress-related growth and its correlates among TGW. Using data from a racially-diverse sample of 210 TGW, the short version of the Stress-Related Growth Scale was modified to assess growth as a result of coming to terms with one's transgender identity among TGW. The psychometric properties of the modified scale were examined, along with its associations with various cognitive, emotional, and social factors. A confirmatory factor analysis revealed a unidimensional factor, along with excellent reliability. A stepwise regression revealed that positive reappraisal, internal locus of control, social support, and emotional expression were associated with greater stress-related growth. Findings suggest that cognitive, emotional, and social resources are related to stress-related growth in TGW. Interventions to foster stress-related growth among TGW are discussed.
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Affiliation(s)
| | - Demetria Cain
- Department of Psychology, Hunter College of the City University of New York, New York, New York, USA
| | - Brett M Millar
- Department of Psychology, Hunter College of the City University of New York, New York, New York, USA
| | | | - H Jonathon Rendina
- Department of Psychology, Hunter College of the City University of New York, New York, New York, USA
- Health Psychology and Clinical Science Doctoral Program, The Graduate Center of the City University of New York, New York, New York, USA
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13
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Valente PK, Dworkin JD, Dolezal C, Singh AA, LeBlanc AJ, Bockting WO. Prospective relationships between stigma, mental health, and resilience in a multi-city cohort of transgender and nonbinary individuals in the United States, 2016-2019. Soc Psychiatry Psychiatr Epidemiol 2022; 57:1445-1456. [PMID: 35312828 DOI: 10.1007/s00127-022-02270-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/19/2021] [Accepted: 03/08/2022] [Indexed: 02/06/2023]
Abstract
PURPOSE Gender-based stigma is a fundamental cause of mental health disparities among transgender and non-binary (TGNB) individuals, while resilience factors may be protective. We examined prospective relationships between gender-based enacted stigma, psychological distress, and resilience factors among TGNB individuals. METHODS Between 2016 and 2017, we enrolled 330 TGNB individuals in three metropolitan areas in the U.S. in a prospective cohort study focused on gender identity development, risk, and resilience across the lifespan. Using multilevel regression, we examined prospective associations between enacted gender-based stigma and psychological distress (measured by the Global Severity Index/BSI-18), and examined transgender pride and social support as moderators, adjusting for age, sex assigned at birth, race/ethnicity, education, and income. RESULTS Our sample was diverse in age (M = 34.4, range 16-87) and race/ethnicity (56.4% non-White). Over 2 years of follow-up, there was a decrease in reported gender-based stigma (b = - 0.61, p < 0.001) and transgender pride (b = - 0.14, p = 0.003), increase in social support (b = 0.21, p < 0.001), and no change in psychological distress. In adjusted analyses, gender-based stigma was positively associated with psychological distress (b = 1.10, p < 0.001) and social support was negatively associated with psychological distress (b = - 2.60, p < 0.001). Transgender pride moderated the relationship between stigma and psychological distress (p < 0.01), such that the association was stronger for lower levels of transgender pride. CONCLUSIONS Our study provides longitudinal evidence for the deleterious role of gender-based stigma among TGNB individuals. Future interventions should consider fostering transgender pride and social support to promote mental health and mitigate negative effects of gender-based stigma.
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Affiliation(s)
- Pablo K Valente
- Department of Behavioral and Social Sciences, Brown University School of Public Health, 121 South Main Street, 4th Floor, Providence, RI, 02912, USA
| | - Jordan D Dworkin
- Division of Gender, Sexuality, and Health, New York State Psychiatric Institute/Columbia Psychiatry, 1051 Riverside Drive, Unit 15, New York, NY, 10032, USA
| | - Curtis Dolezal
- Division of Gender, Sexuality, and Health, New York State Psychiatric Institute/Columbia Psychiatry, 1051 Riverside Drive, Unit 15, New York, NY, 10032, USA
| | - Anneliese A Singh
- Tulane University School of Social Work, 127 Elk Place, New Orleans, LA, 70112, USA
| | - Allen J LeBlanc
- Health Equity Institute, San Francisco State University, 1600 Holloway Ave, San Francisco, CA, 94132, USA
| | - Walter O Bockting
- Division of Gender, Sexuality, and Health, New York State Psychiatric Institute/Columbia Psychiatry, 1051 Riverside Drive, Unit 15, New York, NY, 10032, USA.
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Turner CM, Arayasirikul S, Wilson EC. Disparities in HIV-related risk and socio-economic outcomes among trans women in the sex trade and effects of a targeted, anti-sex-trafficking policy. Soc Sci Med 2020; 270:113664. [PMID: 33485007 DOI: 10.1016/j.socscimed.2020.113664] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Revised: 12/15/2020] [Accepted: 12/27/2020] [Indexed: 10/22/2022]
Abstract
INTRODUCTION Marginalization of sex work presents numerous risks for trans women (TW) engaged in the sex trade, including criminalization, traumatization, and contracting HIV. We identified socio-economic and HIV risk disparities among trans women sex workers and others who do sex work (TWSW/OWSW), and evaluated these disparities for TWSW/OWSW compared to TW not engaged in sex work from pre- and post-implementation of the US 2018 "Allow States and Victims to Fight Online Sex Trafficking Act" and "Stop Enabling Sex Traffickers Act" (FOSTA-SESTA). METHODS We analyzed 429 trans women (TW) from the Trans*National cohort study (2016-2019). Generalized estimating equations (GEE) characterized differences in socio-economic and HIV risk outcomes for TWSW/OWSW compared to TW not engaged in sex work over the study period. Adjusted, pre-to-post law changes in these outcomes for TWSW/OWSW versus TW not engaged in sex work were compared using difference-in-differences GEE regression analyses. RESULTS Over 18 months, TWSW/OWSW had higher adjusted odds of being unstably housed, having income from criminalized sources, experiencing transphobic hate crimes, experiencing discrimination from police/courts, being incarcerated, meeting sex partners in the street/public settings, meeting sex partners on Craigslist or other online forums (except dating apps), or engaging in condomless anal intercourse, (p < 0.01 for all comparisons); TWSW/OWSW also had a higher mean number of income sources (p = 0.03). One difference-in-differences analysis showed additive interaction: the adjusted mean number of income sources reported by TWSW/OWSW compared to those not engaged in sex work decreased from pre-to post-FOSTA-SESTA (from 1.79 to 1.48 for TWSW/OWSW and from 1.52 to 1.47 for TW not engaged in sex work; p = 0.01). CONCLUSIONS Disparities in socio-economic and HIV-related risk outcomes exist for TWSW/OWSW in San Francisco. There is an urgent need for comprehensive, long-term follow-up data of TW to accurately analyze policy effects, especially given the recent enactment of a number of other policies targeting TW.
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Affiliation(s)
- Caitlin M Turner
- Trans Research Unit for Equity, Center for Public Health Research, San Francisco Department of Public Health, San Francisco, CA, USA; Department of Epidemiology and Biostatistics, University of California, San Francisco, San Francisco, CA, USA.
| | - Sean Arayasirikul
- Trans Research Unit for Equity, Center for Public Health Research, San Francisco Department of Public Health, San Francisco, CA, USA; Department of Pediatrics, School of Medicine, University of California, San Francisco, San Francisco, CA, USA
| | - Erin C Wilson
- Trans Research Unit for Equity, Center for Public Health Research, San Francisco Department of Public Health, San Francisco, CA, USA; Department of Epidemiology and Biostatistics, University of California, San Francisco, San Francisco, CA, USA
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Valente PK, Schrimshaw EW, Dolezal C, LeBlanc AJ, Singh AA, Bockting WO. Stigmatization, Resilience, and Mental Health Among a Diverse Community Sample of Transgender and Gender Nonbinary Individuals in the U.S. Arch Sex Behav 2020; 49:2649-2660. [PMID: 32577926 PMCID: PMC7494648 DOI: 10.1007/s10508-020-01761-4] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/04/2019] [Revised: 06/02/2020] [Accepted: 06/04/2020] [Indexed: 05/24/2023]
Abstract
Transgender and gender nonbinary (TGNB) individuals were recently designated a health disparity population by the U.S. National Institutes of Health. We examined the effect of gender-related discrimination and resilience factors on the mental health of a community sample diverse in gender identity, age, and race/ethnicity. We report on the baseline data of a longitudinal study of transgender identity development across the lifespan with 330 TGNB individuals recruited through venue-based recruitment in three major metropolitan areas in the U.S. Mean age of participants was 34.4 years (SD = 13.7). Structured interviews collected self-report data on sociodemographics, gender-related discrimination, mental health, and resilience. We used hierarchical regression to examine the association between gender-related discrimination and psychological distress (BSI-18) and tested the moderating effect of family support, transgender community connectedness, gender literacy, and transgender activism on this relationship. In adjusted analyses, gender-related discrimination was positively associated with psychological distress. Family support was negatively associated with psychological distress. Contrary to our expectations, gender literacy and transgender activism were positively associated with psychological distress, while no significant relationship was found for transgender community connectedness. Family support, transgender community connectedness, gender literacy, and transgender activism did not moderate the effect of gender-related discrimination on psychological distress. Future mental health interventions should consider leveraging family support among TGNB individuals. Longitudinal studies are needed to better understand the role of gender literacy and activism with respect to mental health and development of identity and resilience among TGNB people.
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Affiliation(s)
- Pablo K Valente
- Program for the Study of LGBT Health, New York State Psychiatric Institute, Columbia Psychiatry with the Columbia University School of Nursing, 722 W 168th Street, 3rd Floor, New York, NY, 10032, USA
- Department of Sociomedical Sciences, Mailman School of Public Health, Columbia University, New York, NY, USA
- Department of Behavioral and Social Sciences, School of Public at Health at Brown University, Providence, RI, USA
| | - Eric W Schrimshaw
- Department of Sociomedical Sciences, Mailman School of Public Health, Columbia University, New York, NY, USA
| | - Curtis Dolezal
- Program for the Study of LGBT Health, New York State Psychiatric Institute, Columbia Psychiatry with the Columbia University School of Nursing, 722 W 168th Street, 3rd Floor, New York, NY, 10032, USA
| | - Allen J LeBlanc
- Health Equity Institute, San Francisco State University, San Francisco, CA, USA
| | - Anneliese A Singh
- Counseling and Human Developing Services, University of Georgia, Athens, GA, USA
| | - Walter O Bockting
- Program for the Study of LGBT Health, New York State Psychiatric Institute, Columbia Psychiatry with the Columbia University School of Nursing, 722 W 168th Street, 3rd Floor, New York, NY, 10032, USA.
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Chen EC, Boyd DM, Cunningham CA. Demarginalizing Stigmatized Identities of Transgender and Gender Nonconforming Individuals Through Affirmative Group Therapy. Int J Group Psychother 2020; 70:552-578. [PMID: 38449163 DOI: 10.1080/00207284.2020.1755291] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Drawing from the existing literature on minority stress and stigma, this article highlights challenges - psychological, social, and interpersonal - confronting transgender and gender nonconforming (TGNC) individuals in relation to their gender identity and expression. TGNC individuals are at risk for poor health due to societal stigma and stressors they face as a gender minority group. Further, TGNC individuals may experience stigma in different shapes and forms; specifically, stigma may occur as enacted, felt, internalized, and anticipated stigma. In maintaining an identity that is socially devalued but often invisible to others, TGNC individuals confront additional challenges in negotiating the risks and benefits of disclosing their stigmatized identity. Affirmative group therapy is proposed as a strength-based and social justice-oriented approach for demarginalizing TGNC individuals' stigmatized identity. Group therapists are called on to address how forms of stigma impact TGNC individuals within and outside of the group, provide validation and space for practicing disclosure, highlight their strengths and resilience, and serve as social justice advocates.
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Abstract
Though the Supreme Court of the U.S. legalized same-sex marriage in 2015, heterosexism and transphobia has continued to manifest through many systems in the US - from lack of federal protection in employment non-discrimination laws to polices that prohibit transgender people from using bathroom and public facilities that match their gender identities. Heterosexist and transphobic discrimination have also persisted through interpersonal interactions - ranging from more overt forms (e.g., hate crimes, bullying) to more subtle forms of discrimination, otherwise known as microaggressions. Since 2008, there have been hundreds of articles written on microaggressions, with dozens focusing specifically on experiences of lesbian, gay, bisexual, transgender, and queer (LGBTQ) people. Qualitative and quantitative studies have revealed that LGBTQ people who experience microaggressions have reported negative outcomes like depression, low self-esteem, and trauma. This special issue aims to further Microaggression Theory by providing theoretical and empirical papers that focus on the manifestation and impact of microaggressions on LGBTQ people. Using an interdisciplinary approach, articles range in topic from intersectional identities, to health and psychological outcomes, to advancing research methods. Future studies regarding microaggressions and LGBTQ people are discussed- highlighting the influence of the changing landscape of heterosexism and transphobia within general society, as well as new dynamics that have formed and developed within LGBTQ communities.
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Affiliation(s)
- Kevin L Nadal
- a John Jay College of Criminal Justice , City University , New York , New York, USA
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