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Stigmatization, Resilience, and Mental Health Among a Diverse Community Sample of Transgender and Gender Nonbinary Individuals in the U.S.

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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Acknowledgements

The authors thank the Project AFFIRM Community Advisory Board for their thoughtful contributions to this study. This study was made possible through support of the National Institute of Child Health and Human Development (R01-HD79603, Walter Bockting, PI). The opinions expressed in this manuscript are the authors’ own and do not reflect the view of the National Institutes of Health, the Department of Health and Human Services, or the United States Government. A preliminary version of this paper was presented at the meeting of the World Professional Association for Transgender Health in Buenos Aires, Argentina, November 2018.

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Correspondence to Walter O. Bockting.

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Study procedures were approved by the Institutional Review Boards of the New York State Psychiatric Institute/Columbia Psychiatry, San Francisco State University, and the University of Georgia. All participants provided written informed consent.

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Valente, P.K., Schrimshaw, E.W., Dolezal, C. et al. Stigmatization, Resilience, and Mental Health Among a Diverse Community Sample of Transgender and Gender Nonbinary Individuals in the U.S.. Arch Sex Behav 49, 2649–2660 (2020). https://doi.org/10.1007/s10508-020-01761-4

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Keywords

  • Stigma
  • Discrimination
  • Resilience
  • Transgender