The coronavirus disease 2019 (COVID-19) pandemic has disproportionately impacted people from marginalized communities, such as lesbian, gay, bisexual, transgender, and queer (LGBTQϩ) people, adding to existing social and economic inequities experienced by LGBTQϩ community members. Given the vulnerabilities of LGBTQϩ populations, it is important for researchers to identify pandemic-related stressors that may affect the psychological and physiological well-being of LGBTQϩ people and how coping and resilience strategies may mitigate or buffer the negative psychological effects of pandemicrelated stressors. The present study was conducted to identify ways that researchers and helping professionals may intervene to support LGBTQϩ people during the pandemic. The study was crosssectional and survey based, and it included 220 participants from the United States who self-identified as LGBTQϩ. Using a moderated mediation model, the researchers evaluated whether resilience moderates the association between pandemic concerns and general anxiety symptoms when anxiety is included as a mediator of the effect of pandemic concerns on physiological symptoms of distress. The primary hypothesis, that higher levels of resilience would weaken the effect of pandemic concerns on anxiety, was supported and the full model was significant, F(3, 216) ϭ 27.98, p Ͻ .001. These findings indicate that resilience buffers the negative effect of COVID-19 pandemic concerns on anxiety and other health indicators. Implications for helping professionals and advocates are discussed, particularly regarding ways that resilience may be harnessed as a way to buffer the impact of pandemic concerns on already elevated rates of distress in LGBTQϩ populations.
Public Significance StatementThis study indicates that resilience buffers the negative effect of coronavirus disease 2019 pandemic concerns on anxiety and other health indicators in a sample of lesbian, gay, bisexual, transgender, and queer (LGBTQϩ) people. The findings suggest that increasing resilience in LGBTQϩ populations may be an effective way to reduce distress resulting from the current global pandemic.
Therapists may encounter many opportunities and dilemmas when working with transgender and non-binary clients. Transgender and non-binary clients may use pronouns that are new or unfamiliar to their therapists, but little is known about the unique impact that pronoun use may have in therapy. The pronouns and preferred names that transgender and non-binary clients use may also shift during the course of the therapeutic relationship. Best practices for affirmative therapy include recognizing and validating a client's gender identity, use of gender pronouns that are congruent with a client's gender identity, and using the client's preferred or chosen name, not their birth name. These clients may present to therapy for a variety of reasons; therefore, it is important to trust the client's self-perception of their own gender identity and to not engage in harmful gatekeeping practices. Scholars have highlighted the negative emotions that individuals may experience when they are misgendered, deadnamed, invalidated, or otherwise denied access to medically appropriate care. Therapists may experience anxiety about providing care that is transgender-affirmative, which may affect the therapist-client alliance. The authors draw on their own experiences as therapists working with transgender and non-binary clients and provide recommendations and guidance for therapists.
Clinical Impact StatementThis article provides guidance and information about pronoun use, documentation, terminology, and clinical errors in an effort to support clinical work with transgender and non-binary individuals. Throughout the article, vignettes, examples, and practical applications are provided.
Nearly 50% of graduate students report experiencing emotional or psychological distress during their enrollment in graduate school. Levels of distress are particularly high for transgender and non-binary graduate students who experience daily discrimination and marginalization. Universities and colleges have yet to address and accommodate the needs and experiences of transgender and non-binary graduate students. Given the multitude of challenges these students may face, educational settings should not present additional barriers to educational success and well-being. In an effort to improve graduate education for transgender and non-binary students, we add to the existing scholarship on affirming work with transgender undergraduate students by addressing the unique concerns of graduate students. We utilize a social-ecological model to identify sources of discrimination in post-secondary education and to provide transgender- and non-binary-affirming recommendations at structural, interpersonal, and individual levels. For practitioners who wish to do personal work, we provide guidance for multicultural identity exploration. A table of recommendations and discussion of ways to implement our recommendations are provided.
Healthcare providers generally conceptualize and treat gender dysphoria as an internal concern isolated within the individual, an approach rooted in the medical model. Reaching beyond limitations of current diagnostic approaches, researchers identify at least several external factors (e.g., interpersonal, systemic, sociocultural) that are associated with minority stress and poor health reported by transgender and nonbinary (TNB) individuals. However, researchers have yet to clearly demonstrate the extent to which specific social contexts exacerbate experiences of gender dysphoria. To fill this gap, the present study provides an overview of the development and validation of the Gender Dysphoria Triggers Scale (GDTS), designed to measure how often specific social experiences trigger experiences of gender dysphoria. TNB community members, experts in TNB research, and existing research literature were consulted to construct an initial 18-item pool. Study 1 outlines an exploratory factor analysis (EFA) conducted on data from 225 participants recruited prior to the COVID-19 pandemic (between May 2019 and January 2020). Following EFA, the GDTS was reduced to 12 items (α = .85) across two factors: routine social interactions (α = .80) and healthcare experiences (α = .80). Study 2 describes a confirmatory factor analysis conducted on data from a separate sample (N = 366) recruited during the COVID-19 pandemic (between May and December 2020). Convergent and discriminant validity were analyzed. Results from both studies highlight the importance of accounting for variables external to the individual to establish holistic approaches in the treatment of gender dysphoria. Implications for assessment and treatment of gender dysphoria are discussed.
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