Adverse childhood experiences, gender non-affirmation, social support, and psychological distress in transgender and non-binary adults in the United States

Abstract

Given the higher rates of adverse childhood experiences (ACEs), discrimination, and mental health challenges experienced by gender minority populations compared to cisgender peers, the aim of this thesis is to delineate to what extent social support buffers the negative effect of ACEs and gender discrimination on the mental health of transgender and gender non-binary (TGNB) adults. The current literature lacks separation of gender minority subgroups which can result in transnormative research that does not take into account the potential differences in experience between transgender and gender non-binary populations. The present study used secondary data from the TransPop study (n = 274), the first national probability sample of transgender and gender non-binary adults in the U.S. First, ANOVAs were conducted in SPSS to assess mean differences on key variables between transgender and gender non-binary subgroups. Second, four multiple group path models based on gender minority stress theory were run in Mplus to assess if different types of social support buffer the negative impact of ACEs and discrimination (assessed by gender non-affirming interactions) on psychological distress differently for trans women, trans men, and gender non-binary groups. I found that gender non-binary folks reported significantly greater ACEs, gender non-affirmation, and psychological distress compared to both trans men and trans women, and that trans men and women reported significantly different levels of social support. Additionally, I found that gender identity moderates the association of family and significant other social support with psychological distress. This first of its kind study is an important step in validating the necessity for TGNB research to view gender minority subgroups as having unique experiences and needs. Future research should not assess trans men, trans women, and gender non-conforming folks as homogeneous groups, and helping professionals should consider the unique needs and experiences across gender minority subgroups.