Internalized transphobia and mental health among transgender adults: A nationwide cross-sectional survey in South Korea

Heightened vigilance and its associations with suicidal ideation and suicide attempt among 285 Korean transgender and nonbinary adults: Effect modification by connectedness to the LGBTQ+ community

INTRODUCTION

Anti-transgender stigma presents threats of discrimination to transgender and nonbinary (TGNB) individuals, prompting them to stay vigilant. Using a longitudinal data of 285 South Korean TGNB adults, we examined vigilance and its associations with suicidal ideation and suicide attempt and explored the protective role of connectedness to the lesbian, gay, bisexual, transgender, and queer (LGBTQ+) community.

METHODS

Data were collected in October 2021 (baseline) and October 2022 (follow-up). Vigilance was measured using the 4-item Heightened Vigilance Scale at baseline. At follow-up, 12-month suicidal ideation and suicide attempt, and connectedness to the LGBTQ+ community were measured.

RESULTS

Having heightened levels of vigilance was associated with increased prevalence of suicidal ideation (Prevalence Ratio [PR]: 1.33, 95% Confidence Interval [CI]: 1.09-1.62) and suicide attempt (PR: 2.18, 95% CI: 1.23-3.86), after adjusting for covariates including anti-transgender discrimination experiences and lifetime suicidality at baseline. When stratified by connectedness to the LGBTQ+ community, the associations between vigilance and suicidality remained statistically significant among those with low connectedness whereas no statistically significant association was observed among those with high connectedness.

CONCLUSION

The study provides empirical evidence for policies and interventions that ensure safety of TGNB individuals from discrimination and promote connectedness to the LGBTQ+ community to reduce the suicide risk among TGNB individuals.

Discrimination, Health, and Resistance for Thai Transgender Women

There are clear linkages between discrimination and health for people across intersections of race, ethnicity, socioeconomic status, citizenship, sexual orientation, gender identity and expression, and other social identities. Yet, less research has examined discrimination and health for transgender people outside of the USA, who can face different cultural ideals, access to resources, and social structures. How might research on discrimination and health account for the interplay of diverse social identities, micro-level experiences, meso-level settings, and macro-level structural/cultural contexts? Based on 14 months of fieldwork in Thailand and interviews with 62 participants, this article bridges the minority stress model with an ecosocial framework to analyze how Thai transgender women navigate and resist structural and everyday discrimination across a variety of settings and encounters. Incorporating minority stress theory's attention to discrimination, stigma, and stereotypes, the article demonstrates how Thai transgender women face indignity, disrespect, and dehumanization based on gender. Incorporating the ecosocial framework, the article analyzes how discriminatory structural laws, policies, and rules-as well cultural hierarchies of femininity, interpersonal relations, internalized beliefs, and commodified health/medical technologies-are pathways to Thai transgender women's health and health decision-making. By merging these theoretical frameworks, the article goes beyond an "event-focused" approach to minority stress and discriminatory encounters, instead illuminating the interconnected micro, meso, and macro levels impacting Thai transgender women's health outcomes, decision-making, and everyday life.

Translation and Evaluation of Psychometric Properties of the Persian 8-Item Internalized Transphobia (IT) Scale in Iranian Transgenders

Objective

Internalized transphobia (IT) is influenced by societal norms and expectations, and it can have significant negative effects on the well-being and mental health of transgender individuals. The aim of this study was to translate and evaluate the psychometric properties of the Persian 8-item IT scale among Iranian transgender individuals in order to enhance the quality and quantity of research in this field.

Materials and methods

This cross-sectional and methodological study utilized convenience sampling to recruit 119 transgender individuals in Mashhad, the second most populous city in Iran, in 2021. The Persian translation of the IT scale was developed using the backward-forward translation method. Subsequently, various types of validity and reliability were assessed, including content validity using the content validity index (CVI) and content validity ratio (CVR), face validity based on the impact score, construct validity through confirmatory factor analysis (CFA), internal consistency measured by Cronbach's alpha, and test-retest stability analyzed using the intraclass correlation coefficient (ICC).

Results

The CVR ranged from 0.600 to 1, the CVI ranged from 0.800 to 1, and the impact score exceeded 1.5, indicating the appropriate content and face validity of the 8-item IT scale. The construct validity analysis revealed that the questionnaire is one-dimensional. The internal consistency, as measured by Cronbach's alpha, was 0.917, and the ICC for test-retest stability was 0.871.

Conclusion

The Persian version of the IT scale demonstrated high and acceptable psychometric properties. The brevity of this scale facilitates its dissemination and utilization in clinical settings.

Gender and Sexuality Disparities in Perception, Attitude and Social Intimacy Among Sinophone Youth Toward Transgender and Gender Non-Conforming Individuals: Based on an Internet Survey

The study aims at assessing gender and sexuality characteristics (GSC) in perception, attitude, and social intimacy among Sinophone youth toward transgender and gender non-conforming (TGNC) people. Based on an internet survey with 3 825 valid questionnaires, we distinguished the general public into TGNC, cisgender heterosexual, and cisgender non-heterosexual individuals. Then we classified TGNC individuals into trans females, trans males, and non-binary/genderqueer people and cisgender individuals into cisgender females and cisgender males. The chi-square test, one-way analysis of variance (ANOVA), and multiple linear regression were used. We found that the evident gender and sexuality disparities in perception, attitude, and social intimacy toward TGNC individuals exist both in and out of TGNC individuals. Negative perceptions and attitudes as well as alienated social intimacy were most pronounced among cisgender heterosexual people (Chi-square test, one-way ANOVA, and multiple linear regression: all p < .001). Cisgender females exhibit higher levels of supportiveness compared to cisgender males. Trans females were the most positive while they also had more concerns regarding public space and gender expression-related issues. The findings are practical for community-based advocacy for raising public awareness of the presences and experiences of TGNC people in Sinophone societies.

An Analysis of the Demographics and Clinical Characteristics of Transgender and Intersex Populations in Korea: A Retrospective Study Using HIRA Database

BACKGROUND

Transgender and intersex populations have long remained under-documented in South Korea, largely due to the absence of comprehensive epidemiological data. With increasing societal acknowledgment, there's an urgent need to understand the demographics and health challenges faced by these communities.

METHODS

This retrospective, large-scale data study included people who received the F64 codes from the Korean Health Insurance Review & Assessment Service between January 2007 and December 2021. Demographics, gender-affirmative treatments, and psychiatric related medications were examined.

RESULTS

Between 2007 and 2021, 8,602 patients were diagnosed with "gender identity disorder" and 45 with "intersex." A steadily increasing annual prevalence was observed, peaking at 986 cases in 2021. The majority (79.8%) were aged between 10 and 30. Nearly half (53.2%) exhibited mental and behavioral disorders. Two-thirds had been prescribed anxiolytics or sedatives either before or after diagnosis. Merely 12.1% received hormone therapy covered by health insurance.

CONCLUSION

This is the first large-scale study highlighting the demographics and clinical characteristics of the transgender and intersex populations in Korea. The study reveals a consistent growth of these communities over the past 15 years, with a significant proportion under 30 years of age facing mental and behavioral challenges. Findings underscore the need for targeted healthcare interventions, early psychological support, and comprehensive insurance coverage tailored to the specific needs of these individuals in Korea.

Job-Seeking Experiences of Trans Adults in South Korea

Being trans is stigmatized and can make it difficult to fit into the job market in South Korean society. This study explored trans individuals' job-seeking experience and the impact of gender identity on their career choices and development using a qualitative approach. In-depth interviews were conducted with 20 trans adults with job-seeking experiences who were recruited through purposive and snowball sampling in South Korea. Ten subthemes were identified in three overarching themes: (a) limiting myself in job search; (b) challenges in the job application and interview process; and (c) having a desire to build a meaningful career. Participants limited their choices for employment in favor of gender-neutral jobs or trans-inclusive work environments. In the job-seeking process, they faced challenges due to society's rigid binary gender roles and the negative stereotypes about trans identities. Despite stress and identity-related conflict, participants expressed a desire to overcome challenges, build a meaningful career, and flourish at work without compromising their gender identity. This study highlights the experiences of trans individuals in their job-seeking journey. Psychosocial interventions and career support services could help trans individuals in the job-seeking process by identifying their unique challenges to employment and providing assistance to cope with stigma and oppression.

Does discrimination prevent transgender and gender diverse people from seeking healthcare?: A nationwide cohort study in South Korea

Introduction

Using Asia's first nationwide cohort dataset, this study aimed to assess the prevalence of anti-transgender discrimination and healthcare avoidance and delay (HAD) and examine their associations among transgender and gender diverse (TGD) adults in South Korea.

Methods

We analyzed a two-wave (2020-2021) longitudinal dataset of 190 Korean TGD adults. Anti-transgender discrimination were classified accordingly: experienced at (1) neither wave, (2) baseline (2020) only, (3) follow-up (2021) only, and (4) both waves. We also asked about HAD in the past 12 months at follow-up for both transition-related and non-transition-related healthcare services. Multivariate modified Poisson regression was used to examine the associations between anti-transgender discrimination and HAD.

Results

Of 190 participants, 102 (53.7%) experienced anti-transgender discrimination at both waves, and 130 (68.4%) reported HAD at follow-up. Compared to those without any experiences of anti-transgender discrimination, those who experienced it in both waves had a 1.78-times (95% CI: 1.21-2.63) higher prevalence of non-transition-related HAD, but not among those who experienced it in either wave. In contrast, anti-transgender discrimination was not associated with transition-related HAD.

Conclusion

In order to enhance healthcare access for transgender and gender diverse (TGD) individuals, it is necessary to implement interventions, such as anti-discrimination laws, that protect them from discrimination.

Gender Identity Change Efforts Are Associated with Depression, Panic Disorder, and Suicide Attempts in South Korean Transgender Adults

Purpose

Gender identity change efforts (GICEs), sometimes referred to as "conversion therapy," are considered pseudoscientific and unethical practices that are not supported by the existing scientific literature. However, a substantial portion of transgender people face such practices during their lives. We assessed lifetime exposure to GICEs and its associations with mental health indicators among transgender adults in South Korea.

Methods

We analyzed a nationwide cross-sectional survey of 566 Korean transgender adults conducted in October 2020. Lifetime exposure to GICEs was classified as follows: "never had GICE-related experiences," "received a referral, but did not undergo GICEs," and "undergone GICEs." We assessed mental health indicators, including past-week depressive symptoms; medical diagnosis or treatment of depression and panic disorder; and past 12-month suicidal ideation, suicide attempts, and self-harm.

Results

Of the total participants, 12.2% had "received a referral, but did not undergo GICEs," and 11.5% had "undergone GICEs." Compared with those who had "never had GICE-related experiences," participants who had "undergone GICEs" showed significantly higher prevalence of depression (adjusted prevalence ratio [aPR]=1.34, 95% confidence interval [CI]=1.11-1.61), panic disorder (aPR=2.52, 95% CI=1.75-3.64), and suicide attempts (aPR=1.73, 95% CI=1.10-2.72). However, we did not find significant associations between having "received a referral, but did not undergo GICEs" and mental health indicators.

Conclusion

Given our findings suggest that lifetime exposure to GICEs may harm transgender adults' mental health, legal restrictions should be imposed to ban GICEs in South Korea.

Internalized transphobia predicts worse longitudinal trend of body uneasiness in transgender persons treated with gender affirming hormone therapy: a 1-year follow-up study

BACKGROUND

Given the relationship between interiorized stigma and body image, it could be hypothesized that high levels of internalized transphobia (IT) might predict higher levels of body uneasiness in subjects with gender dysphoria (GD) and worse improvement of body image after gender affirming hormone therapy (GAHT).

AIM

We sought to evaluate the relationship between IT and body uneasiness in subjects with GD and the role of IT in moderating the improvement of body image after GAHT.

METHODS

In total, 200 individuals with GD performed the baseline assessment; 99 were re-evaluated 12 months after starting GAHT. At baseline participants were evaluated through a face-to-face interview and filled self-administered questionnaires to evaluate GD (Utrecht Gender Dysphoria Scale [UGDS]), IT attitudes (Attitudes Toward Transgendered Individuals [ATTI] Scale), body uneasiness (Body Uneasiness Test, part A [BUT-A]), and general psychopathology (Symptom Checklist 90-Revised [SCL 90-R]). The same questionnaires, except ATTI, were readministered at follow-ups.

OUTCOMES

Outcomes were based on measures of the associations between IT and baseline characteristics of the sample, the longitudinal trends of GD, body uneasiness, and general psychopathology; and IT as a moderator of the longitudinal trend of body uneasiness.

RESULTS

At baseline, IT correlated with lower level of education, higher GD, and more severe body uneasiness. Longitudinal analyses showed significant improvements in GD, body uneasiness, and general psychopathology during GAHT. Moderation analysis confirmed that participants with more transphobic attitudes showed less improvement after GAHT with regard to body uneasiness (bTime*ATTI = -.002, P = .040). The Johnson-Neyman technique revealed that no significant improvement in body uneasiness was found for participants with ATTI scores lower than 71.14.

CLINICAL IMPLICATIONS

The presence of IT should be investigated in subjects with GD who require gender affirming treatments to provide specific interventions aimed at targeting this dimension.

STRENGTHS AND LIMITATIONS

Strengths of this study include the mixed cross-sectional and longitudinal design and the dimensional evaluation of the investigated constructs. Limitations include the small sample size and the limited follow-up. Furthermore, the effects of gender affirming surgery were not evaluated.

CONCLUSION

The association of IT with both baseline body uneasinessand the longitudinal course of this dimension highlighted the clinical significance of body uneasiness and the importance of making continuous efforts to improve education and information to fight societal stigmas.

Psychological Adjustment Profiles of LGBTQ+ Young Adults Residing with Their Parents during the COVID-19 Pandemic: An International Study

The COVID-19 pandemic has been associated with poor mental health symptoms, particularly among vulnerable populations such as LGBTQ+ individuals. In the present study, we aimed to (i) identify different psychological adjustment profiles among LGBTQ+ young adults during the COVID-19 pandemic and compare LGBTQ+ young adults in relation to (ii) sociodemographic characteristics and COVID-19-related experiences and (iii) the internal and external protective resources associated with each adjustment profile. An online questionnaire was administered to 1699 LGBTQ+ young adults from six countries (Brazil, Chile, Italy, Portugal, Sweden, and the UK). A cluster analysis was conducted, and four profiles of psychological adjustment were identified: unchallenged, resilient, distressed, and at-risk. The at-risk cluster scored lowest in social support (particularly from family). The profiles of participants who experienced the highest levels of pandemic adversity (at-risk and resilient) comprised mostly South American participants, those under lockdown at the time of survey completion, those who self-identified as transgender and non-binary, and those with a plurisexual sexual orientation. Interventions should consider strategies to help young adults maintain support systems and reinforce the value of positive family relationships. Specific groups within the LGBTQ+ community that seem to be in a particularly vulnerable situation may need additional tailored support.

Discrimination keeps transgender people awake at night: A nationwide cross-sectional survey of 583 transgender adults in South Korea

OBJECTIVES

We sought to investigate the association between transgender identity discrimination and sleep problems among transgender people in South Korea (hereafter, Korea), and whether family support for transgender identity plays a protective role in the association.

DESIGN & SETTING

We analyzed a nationwide cross-sectional survey of 583 Korean transgender adults which was anonymously conducted through an online platform.

MEASUREMENTS

Transgender identity discrimination was assessed using a single-item question. Sleep problems were defined as having any of the following problems: poor sleep quality, short sleep duration, and use of alcohol or sleep medications to fall asleep. Family support for transgender identity was classified into 3 groups as follows: not supportive, supportive, and unaware of participants' transgender identity.

RESULTS

Of 583 participants, 383 (65.7%) experienced transgender identity discrimination over the past 12 months. Participants who experienced transgender identity discrimination were 1.48 times (95% confidence intervals [95% CI] = 1.19-1.83) more likely to have any sleep problems, compared to those who never experienced transgender identity discrimination. When stratified by family support level, the associations between transgender identity discrimination and sleep problems remained statistically significant only among those with a family unsupportive (adjusted prevalence ratio [aPR] = 1.64; 95% CI = 1.16-2.31) or unaware (aPR = 1.60; 95% CI = 1.01-2.52) of participants' transgender identity. However, the association was not statistically significant among those with a supportive family (aPR = 1.41; 95% CI = 0.96-2.07).

CONCLUSION

Given transphobic environments in Korea, legal and institutional efforts are required to reduce transgender identity discrimination (eg, anti-discrimination laws) as well as to build trans-specific family resources.

Social and contextual influences on eating pathology in transgender and nonbinary adults

Eating pathology (EP) is reported at alarmingly high rates among transgender and nonbinary (TNB) people. The present study investigates key associations between experiences that are common in TNB populations and EP. TNB individuals located within the United States (N = 212) who self-identified as currently experiencing disordered eating or an eating disorder were recruited from social media outlets and completed an online survey that included measures of EP, discrimination-based trauma symptoms, internalized transphobia, and gender dysphoria. The average age of participants was just over 27 years old (SD = 6.22) and the majority of participants (68.9%) were nonbinary. Data were analyzed using IBM SPSS version 28 and PROCESS 4.0. Discrimination trauma [β = .27, t(211) = 3.90, p < .001] and internalized transphobia [β = .21, t(211) = 3.03, p = .003] were significant predictors of EP in a multiple regression model. Additionally, internalized transphobia partially mediated the association between discrimination trauma and EP. Findings reinforce the need for trauma-informed and multiculturally competent provision of services for TNB populations presenting with eating concerns. Results also highlight the complex role that previously unexplored variables play in the etiology of EP for TNB populations. Implications and clinical recommendations are discussed.

The Transgender and Gender Diverse and Attention Deficit Hyperactivity Disorder Nexus: A Systematic Review

Introduction

Prior work suggests an increased prevalence of Attention Deficit Hyperactivity Disorder (ADHD) among transgender and/or gender diverse (TGD) individuals. This systematic review summarizes primary literature on TGD/ADHD experience.

Methods

Texts from databases, reference lists, and referral were screened per PRISMA guidelines, with author consensus.

Results

Since 2014, 17 articles have been published on the TGD/ADHD nexus. Gender-affirming care specialists authored 65%. 71% reported prevalence, per medical records. Only case reports discussed implications. None avoided deficit-framing, nor included explicit TGD/ADHD authorship.

Conclusions

The paucity of literature and lack of explicit TGD/ADHD community involvement are striking; each warrants increased attention.

An exploration of mental distress in transgender people in Ireland with reference to minority stress and dissonance theory

Introduction: Internationally mental distress is more prominent in the LGBTI community than the general population. The LGBTIreland study was set up to take stock of this in the Republic of Ireland. This paper reports on the analysis of the transgender group with reference to minority stress theory and cognitive dissonance theory. Method: An online survey was conducted addressing several aspects of mental health and distress that received responses from all groupings (n = 2,264) among which 12.3% (n = 279) identified as transgender. The survey consisted of several validated tools to measure depression, anxiety, stress (DASS-21), coping (CSES), self-esteem (RSES), alcohol and drugs misuse (AUDIT) and a variety of questions addressing demographics, experiential aspects, coping and self-related factors. Data analysis focused on predicting mental distress using DASS-general (composite of depression, anxiety and stress). Results: Transgender participants reported higher levels of mental distress, self-harm, suicidal ideation and attempts, and lower levels of self-esteem in comparison with the LGB groups, as well as the general population. Hierarchical multiple regression showed that 53% of variance in mental distress could be predicted from reduced self-esteem, the experience of harassment and not belonging in school. Furthermore, mental distress was highest among younger participants, those who were 'not out', those who had self-harmed and used avoidant coping. There was no significant difference in distress levels among those who had sought mental health support and those who had not. Conclusions: To understand mental distress in transgender people, the minority stress model is useful when taking into account both adverse external (environmental) and internal (cognitive/emotional) factors. The cognitive dissonance mechanism is essential in outlining the mechanism whereby gender incongruence is associated with psychological discomfort, low self-esteem and high mental distress.

Transgender-specific COVID-19-related stressors and their association with depressive symptoms among transgender adults: A nationwide cross-sectional survey in South Korea

Introduction

COVID-19 has disproportionately impacted marginalized groups, including transgender populations, reproducing and exacerbating inequalities and vulnerabilities that existed in those groups prior to the pandemic. This study aimed to assess the prevalence of transgender-specific COVID-19-related stressors and their association with depressive symptoms among South Korean transgender adults.

Methods

We conducted a nationwide cross-sectional study of 564 South Korean transgender adults (trans women, trans men, and nonbinary people) from October 7 to October 31, 2020. We measured four transgender-specific COVID-19-related stressors as follows: (A) had difficulty receiving gender-affirming healthcare due to economic hardship related to COVID-19, (B) had difficulty receiving gender-affirming healthcare due to limited access to hospitals under the COVID-19 situation, (C) had difficulty purchasing a public face mask due to gender information on an identification card, and (D) avoided getting a COVID-19 test in fear of unfair treatment and dirty looks due to gender identity, despite having COVID-19 symptoms. Past-week depressive symptoms were assessed using the Center for Epidemiologic Studies-Depression Scale.

Results

Of the total participants, 30.7% experienced any of the four transgender-specific COVID-19-related stressors, and 70.2% were classified as having depressive symptoms during the past week. We found statistically significant associations with depressive symptoms among participants who reported that they had difficulty receiving gender-affirming healthcare due to either economic hardship (adjusted prevalence ratio [aPR] = 1.20, 95% Confidence Interval [CI] = 1.05-1.37) or limited access to hospitals (aPR = 1.15, 95% CI = 1.00-1.32), respectively. Furthermore, those who had two or more of the four transgender-specific COVID-19-related stressors were 1.21 times (95% CI = 1.05-1.40) more likely to report depressive symptoms, compared to those who did not report any stressor.

Conclusion

Transgender-specific COVID-19-related stressors may negatively influence depressive symptoms among South Korean transgender adults. Given these findings, transgender-inclusive interventions should be implemented at the policy level during the COVID-19 pandemic in South Korea.

Transgender Adults' Public Bathroom-Related Stressors and Their Association with Depressive Symptoms: A Nationwide Cross-Sectional Study in South Korea

Purpose: This study assessed public bathroom-related stressors and examined their association with depressive symptoms, suicidal ideation, and suicide attempts among transgender individuals in South Korea. Methods: We analyzed data from a nationwide cross-sectional survey of 557 South Korean transgender adults (age range: 19-60 years) conducted in October 2020. Participants were asked nine yes/no questions about whether they have ever experienced public bathroom-related stressors within the last 12 months. The responses were classified into three categories: "never experienced," "avoidant behaviors alone," and "victimization experiences." Results: The proportions of participants who reported "avoidant behaviors alone" and "victimization experiences" related to public bathroom use were 47.0% and 23.0%, respectively. Past-week prevalence of depressive symptoms was 70.7%, and past 12-month prevalence of suicidal ideation and suicide attempts was 63.0% and 19.8%, respectively. Compared with participants who "never experienced" public bathroom-related stressors, the prevalence of depressive symptoms was statistically significantly higher among those who reported "avoidant behaviors alone" (adjusted prevalence ratio [aPR] = 1.22; 95% confidence interval [CI] = 1.07-1.40) and "victimization experiences" (aPR = 1.18; 95% CI = 1.01-1.38), after adjusting for covariates, including gender perception by others. In the same adjusted model, however, no significant associations of public bathroom-related stressors with suicidal ideation and suicide attempts were observed. Conclusions: Given these findings showing that public bathroom-related stressors may negatively influence transgender adults' depressive symptoms, efforts are necessary to ensure their safe access to public bathrooms in South Korea. Furthermore, policy-level interventions are needed to eliminate stigma against transgender individuals, given that public bathroom-related stressors could be considered an indicator of broader anti-transgender stigma.

Acoustic Measures of Brazilian Transgender Women's Voices: A Case-Control Study

Objective: This study aims to compare the acoustic vocal analysis results of a group of transgender women relative to those of cisgender women. Methods: Thirty transgender women between the ages of 19 and 52 years old participated in the study. The control group was composed of 31 cisgender women between the ages of 20 and 48 years old. A standardized questionnaire was administered to collect general patient data to better characterize the participants. The vowel /a/ sounds of all participants were collected and analyzed by the Multi-Dimensional Voice Program advanced system. Results: Statistically significant differences between cisgender and transgender women were found on 14 measures: fundamental frequency, maximum fundamental frequency, minimum fundamental frequency, standard deviation of fundamental frequency, absolute jitter, percentage or relative jitter, fundamental frequency relative average perturbation, fundamental frequency perturbation quotient, smoothed fundamental frequency perturbation quotient, fundamental frequency variation, absolute shimmer, relative shimmer, voice turbulence index (lower values in the cases), and soft phonation index (higher values in the cases). The mean fundamental frequency value was 159.046 Hz for the cases and 192.435 Hz for the controls. Conclusion: Through glottal adaptations, the group of transgender women managed to feminize their voices, presenting voices that were less aperiodic and softer than those of cisgender women.

Double jeopardy: Minority stress and the influence of transgender identity and race/ethnicity

Background: Prior research suggests transgender individuals with multiple minority statuses experience higher psychological stress compared to their singly disadvantaged counterparts, and both Black, Indigenous, People of Color (BIPOC), and transgender minorities experience more frequent and severe forms of discrimination than White and cisgender individuals. Aims: This study aims to examine racial/ethnic differences in gender-related discrimination and psychological distress within a sample of transgender individuals. Methods: Using data from a convenience sample of 99 self-identified transgender adults recruited through North American LGBTQ organizations, data were analyzed to determine the relationship between race/ethnicity, gender minority stress, and psychological distress. Results: When White and BIPOC participants are compared, no significant group differences were found in levels of gender discrimination or victimization. However, some individual racial/ethnic groups reported significantly higher or lower scores and results indicate that changes in reported gender minority stress are in fact positively correlated with reported psychological distress. Conclusion: This research highlights that BIPOC are a heterogeneous group; by solely examining race/ethnicity as a binary variable, studies mask potential important differences among different groups.