Legal gender marker and name change is associated with lower negative emotional response to gender-based mistreatment and improve mental health outcomes among trans populations.

Arjee Restar,Aaron Breslow,Sean Cahill,Jaclyn M.W Hughto,Matthew Mimiaga,Harry Jin,Sari L Reisner

doi:10.1016/j.ssmph.2020.100595

Abstract

BackgroundIn recent years, Massachusetts (MA) and Rhode Island (RI) joined a growing list of states allowing residents to easily change the gender marker and name on government-identification (ID) documents. This was an important change for transgender and gender diverse (trans) residents, who face frequent mistreatment and thus for whom legal gender affirmation is critical. Little is known about associations between legal gender affirmation and psychological outcomes.MethodsWe examined associations between legal gender affirmation (i.e., having changed gender marker/name on neither, one, or both a passport and state ID), upsetting responses to gender-based mistreatment, and mental health outcomes in a sample of trans MA and RI residents. Analyses controlled for gender identity, age, race/ethnicity, education, employment, income, and insurance status.FindingsLegal gender affirmation was significantly associated with lower reports of depression, anxiety, somatization, global psychiatric distress, and upsetting responses to gender-based mistreatment.ConclusionsThese data provide corroborate recent studies suggesting having pursued legal gender affirmation may be protective. Findings bolster calls to increase structural support for trans individuals, including enactment of state policies easing legal gender affirmation.

Highlights

Myriad studies have documented elevated rates – and socially determined predictors – of adverse psychosocial health outcomes among transgender and gender diverse adults
Across countless studies with diverse samples, a consis tently identified mechanism propagating associations between gender-based mistreatment and stress is the process by which trans people must contend with stigma: the emotional responses trans people have in the face of multiple manifestations of gender minority stress (Bockting, Miner, Swinburne Romine, Hamilton, & Coleman, 2013; Clements-Nolle, Marx, & Katz, 2006; James et al, 2016; Reisner, Radix, & Deutsch, 2016a; Reisner, White, Mayer, & Mimiaga, 2014)
To fill gaps in the literature, the goal of the current study is to examine associations of legal name/gender marker changes with key psycho logical outcomes disproportionately elevated among trans individuals (i. e., experiences of emotionally upsetting response to gender-based mistreatment, depressive symptoms, anxiety symptoms, somatization, and global psychiatric distress) among trans people living in MA and Rhode Island (RI)

Summary

Introduction

Myriad studies have documented elevated rates – and socially determined predictors – of adverse psychosocial health outcomes among transgender and gender diverse (trans) adults (for a review, see Reisner et al, 2016b). One potential protective factor for trans in dividuals may be gender affirmation (Glynn et al, 2016), or pursuing steps to achieve private and public recognition of one’s gender identity (White Hughto, Rood, Gunn, & Pantalone, 2020). Though the processes required to make such changes vary by state, limited data from recent cross-sectional studies suggest having pursued legal gender affirmation may be associated with lower reported rates of adverse psychological outcomes (Reisner et al, 2016b). Massachusetts (MA) and Rhode Island (RI) joined a growing list of states allowing residents to change the gender marker and name on government-identification (ID) documents This was an important change for transgender and gender diverse (trans) residents, who face frequent mistreatment and for whom legal gender affirmation is critical. Findings bolster calls to increase structural support for trans individuals, including enactment of state policies easing legal gender affirmation

Objectives

Methods

Discussion

Conclusion