Abstract
Purpose: To close gaps in transgender health research, we mapped trends in gender affirmation processes (i.e., social, legal, and psychological transitions) that are unique among nonbinary (NB) transgender adults when compared with transgender women (TW) and transgender men (TM).Methods: Data were drawn from the Columbia Trans Empowerment Survey (N=707), an online national study conducted between 2014 and 2015 in the United States. We used one-way analysis of variance tests, chi-square tests, Kruskal–Wallis tests, and post hoc analyses to estimate differences in gender affirmation processes and transgender congruence between: (1) NB adults, n=271, 38%; (2) TW, n=291, 41%; and (3) TM, n=145, 21%. We then identified bivariate correlations between variables of interest.Results: In the full sample (n=707), we found significant positive bivariate correlations between pursuing gender affirmation and transgender congruence. In terms of demographics, NB participants were significantly more likely to be queer (42.1%), polyamorous (25.5%), unemployed (44.8%), and younger (median=22) than TW and TM. They also reported taking significantly fewer gender affirmation processes, with significant differences between the three groups in terms of particular experiences. The NB participants also reported significantly lower rates of transgender congruence, specifically lower appearance congruence though similar gender identity acceptance.Conclusion: The NB transgender adults in this sample report unique identity-related characteristics, including significantly lower rates of medical/social transition as well as decreased transgender congruence. These data are among the first to describe unique pathways by which NB adults, TW, and TM may pursue gender affirmation and interact with providers as they navigate congruence, transition, and well-being.
Highlights
Recent studies have begun to explore the critical role of gender affirmation processes in promoting mental health and mitigating the impact of minority stress among transgender and nonbinary (TNB) adults.[1,2] For example, TNB adults in a recent study who changed their legal name and/or gender marker reported improved psychological outcomes.[2]
Purpose: To close gaps in transgender health research, we mapped trends in gender affirmation processes that are unique among nonbinary (NB) transgender adults when compared with transgender women (TW) and transgender men (TM)
NB participants were significantly more likely to identify as queer (v2 = 164.565, degrees of freedom [df] = 10, p < 0.001), polyamorous (v2 = 27.173, df = 2, p < 0.001), and unemployed (w2 = 11.882, df = 4, p = 0.018) compared with TW and TM despite similar levels of education
Summary
Recent studies have begun to explore the critical role of gender affirmation processes (i.e., social, medical, and legal steps that people take to actualize one’s gender identity) in promoting mental health and mitigating the impact of minority stress among transgender and nonbinary (TNB) adults.[1,2] For example, TNB adults in a recent study who changed their legal name and/or gender marker reported improved psychological outcomes.[2] Similar results have evidenced benefits of medical[3] and social[4] gender affirmation, including increased transgender congruence (i.e., comfort with one’s gender identity and external appearance), and improved psychological outcomes.[5] For many TNB people, these processes reduce dysphoria and are critical to survival. Binary, linear models of gender affirmation are limited a Aaron S.
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