Transgender clients frequently experience multiple types of violence (Mizock & Lewis, 2008), including interpersonal (violence that occurs between, at least, two people), self-directed (violence that is self-inflicted), and collective (violence that is inflicted by larger groups of people/institutions; Krug et al., 2002). Transgender clients who experience any of these types of violence are at a higher risk for developing psychiatric symptoms that may require the attention of a mental health care provider (Mizock & Lewis, 2008). Thus, it is crucial that clinicians understand how transgender clients respond to such violence and how these reactions relate to the clinical needs of transgender clients (Lev, 2004). In this article, we will summarize and cluster the types of violence that have been documented in the transgender literature. We will then highlight PTSD and complex PTSD as conceptual frameworks for working with transgender clients. Furthermore, we will examine how the binary notion of gender ignores ways in which race, class, and other identities interact with gender and make recommendations for how clinicians can affirm multiple identities as a way to minimize psychological distress following a traumatic event (Roen, 2006). We will also highlight clinical guidelines and provide feminist and multicultural recommendations for working with transgender clients.

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Transgender individuals have frequent experiences of trauma, often related to societal prejudice, hatred, or intolerance, because of their gender identity (Mizock & Lewis, 2008;Richmond, Burnes, & Carroll, 2012;Singh & Burnes, 2010). Therefore, there is a critical need for clinicians to focus on specialized, trauma-focused practice and research with transgender individuals. Researchers designed and implemented an exploratory investigation of the trauma experiences of transgender individuals described utilizing constructivist grounded theory (Charmaz, 2000). Fourteen transgender-identified diverse participants completed a semistructured interview about their experiences and perceptions of safety, wellness, and identity. Five intersecting themes and a corresponding theoretical model for participants in this study were identified in the data. Implications for research, practice, training, and advocacy, as well as the study's limitations, are discussed.

Popular measures of masculinity and femininity ideologies have been validated primarily with cisgender (cis) samples. The present study assessed the measurement equivalence/invariance (ME/I) of two versions of the Male Role Norms Inventory (MRNI; Short and Very Brief Forms), and the Femininity Ideology Scale-Short Form, across gender broadly conceived to include cis, transgender (trans), and nonbinary gender identities. Participants (N = 1233, 34.3 % trans) were recruited from community and college samples in the United States. Correlated factors models of the MRNI-SF and FIS-SF evidenced the best fit to data in the total sample. The MRNI-SF only provided a good fit for cis individuals, and some items from the MRNI-VB and the FIS-SF were significant sources of local misfit among trans and non-binary participants. After removing these items, however, acceptable fit was achieved for each gender group. Multigroup confirmatory factor analyses (CFA's) revealed (a) broad support for configural invariance for the MRNI-VB (9/9 gender comparisons) and the FIS-SF (8/9), as well as general support for metric invariance for the MRNI-VB (7/9) and the FIS-SF (7/9). More advanced levels of invariance (scalar and residuals) were generally not supported for the MRNI-VB but were supported for the FIS-SF. The effect size of measurement non-invariance among all possible gender comparisons was generally small, with a few exceptions. Finally, analysis of variance (ANOVAS) revealed that cis men endorsed traditional gender ideologies to the greatest extent, followed by cis women, followed by trans participants. The results are discussed in relationship to prior literature, future research directions, applications to practice, and limitations.

Objective:The purpose of this study was to assess the direct and indirect relationships between the endorsement of traditional masculinity ideology (TMI) and self-reported health status through potential mediating variables of expectations of benefits from health risk behaviors and actual health risk behaviors. In addition, the objective was to test the moderating effect of gender identity, broadly defined (including cisgender and transgender men and women and nonbinary persons). Method: Participants (N ϭ 1233; 34.3% transgender) participated in an online survey, responding to measures of TMI, expectations of benefits, health behaviors, health status, and demographics. Data were analyzed using conditional process modeling. Results: TMI was positively and directly associated with general health status for self-identified men (regardless of their sex assigned at birth), and with mental health for both men and women, but was not associated with physical health for persons of any gender identity. TMI was positively and directly associated with expectations of benefits for both men and women. Expectations of benefits from engaging in health risk behaviors was positively associated with health risk behaviors, and health risk behaviors had a large negative association with health status, for people of all gender identities. Conclusions: TMI may be a general and mental health protective factor for self-identified men, and a mental health protective factor for women, regardless of assigned sex at birth.