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Published in: Social Psychiatry and Psychiatric Epidemiology 7/2022

21-03-2022 | Original Paper

Prospective relationships between stigma, mental health, and resilience in a multi-city cohort of transgender and nonbinary individuals in the United States, 2016–2019

Authors: Pablo K. Valente, Jordan D. Dworkin, Curtis Dolezal, Anneliese A. Singh, Allen J. LeBlanc, Walter O. Bockting

Published in: Social Psychiatry and Psychiatric Epidemiology | Issue 7/2022

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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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Metadata
Title
Prospective relationships between stigma, mental health, and resilience in a multi-city cohort of transgender and nonbinary individuals in the United States, 2016–2019
Authors
Pablo K. Valente
Jordan D. Dworkin
Curtis Dolezal
Anneliese A. Singh
Allen J. LeBlanc
Walter O. Bockting
Publication date
21-03-2022
Publisher
Springer Berlin Heidelberg
Published in
Social Psychiatry and Psychiatric Epidemiology / Issue 7/2022
Print ISSN: 0933-7954
Electronic ISSN: 1433-9285
DOI
https://doi.org/10.1007/s00127-022-02270-6

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