The present study aimed to expand current understandings of gender dysphoria by explicating the social context in which it is experienced and by centering the analysis on the lived experience of trans individuals. Data were collected online from a nonclinical sample composed of 610 transgender participants.Participants answered 2 open-ended prompts to describe their gender dysphoria as experienced in a social context. Thematic analysis was used to code the data and determine main themes. Four socially salient themes emerged regarding gender dysphoria: 1) External Triggers; 2) Internal Processing; 3) Interruption of Social Functioning; and 4) Moderated by Transition. When describing their experiences, participants identified external triggers for dysphoria that were social in nature as well as internal processes that occurred in response to those triggers. Often this led to an interruption of social functioning. For some of our participants, gender dysphoria was moderated by transition. Results of the present study suggest that trans individuals' experience of gender dysphoria is greatly impacted by social context. Discussion focuses on the way the present findings may be best understood in relation to the literature on minority stress. Consideration of gender dysphoria as a proximal stressor may help to conceptually disaggregate gender dysphoria from psychological stress in the way we frame mental health considerations for trans individuals.

Negative experiences in healthcare settings have been linked to decreased treatment satisfaction and reduction of future help-seeking behaviors among transgender individuals. The present study used gender-identity based microaggressions as a model for understanding the client–therapist relationship. Using a qualitative approach, we investigated instances of microaggressions from mental health providers as experienced by 91 adults who identified as transgender or gender diverse. Participants completed an online survey and described instances of microaggressions directed towards them from mental health providers. Thematic analysis resulted in four therapy-salient themes: Lack of Respect for Client Identity, Lack of Competency, Saliency of Identity, and Gatekeeping. Our discussion of the results focuses on the examination of microaggressions as ethical guideline violations. We discuss methods to improve the practical application of ethical standards to counseling with transgender clients. Implications for practice, training, and future research are also discussed.

The minority stress model describes the unique stressors that impact sexual and gender minorities above and beyond general stressors and includes both external (distal) and internal (proximal) sources of stress. Proximal stressors are the thoughts and feelings that are elicited and maintained because of direct and indirect experiences with prejudice events and are typically conceptualized to include anticipated stigma, internalized transphobia, and gender identity concealment. Recently, gender dysphoria has been proposed as a proximal stressor due to its interactive nature with both external triggers and mental health symptoms. However, gender dysphoria has not been tested empirically in prior published models of gender minority stress. Trans and nonbinary participants (N ϭ 297) over the age of 18 were recruited via postings on social networking websites. Participants identified as trans feminine (n ϭ 128), trans masculine (n ϭ 110), nonbinary (n ϭ 49), and agender (n ϭ 10), and ranged in age from 18 to 67 (M ϭ 28, SD ϭ 9.42). Through a confirmatory factor analysis, it was shown that internalized transphobia, anticipated stress, gender identity concealment, and gender dysphoria reflect the latent factor proximal stress. Findings from this study suggest that gender dysphoria should be understood as a proximal stressor. As such, clinical interventions that target how individuals internalize experiences in a cisnormative society could have a positive impact on the severity of gender dysphoria. Additionally, modeling gender dysphoria as a proximal stressor can help future research disaggregate gender dysphoria from negative mental health symptoms such as anxiety or rumination. Public Significance StatementThe present study provides empirical support for gender dysphoria as a proximal stressor from the framework of the gender minority stress model. By focusing on gender dysphoria as a proximal stressor, the proposed work shifts the theoretical framework from an essentialist view that stresses pathology and diagnosis to one that emphasizes social context. This shift has significant implications for the way we understand physical and mental health disparities for trans and nonbinary individuals and for the way in which we conceptualize treatment and clinical practice.

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Little is known about how immigrant Latinx transgender people experience support from their communities in the U.S. and back in their country of origin. The present study aimed to understand how immigrant Latinx transgender people reported support within their communities. A community sample of 18 immigrant Latinx transgender people in a large metropolitan city in Florida participated in semi-structured interviews. Thematic analysis revealed four themes depicting the varying levels of support that participants received within their communities in the U.S., including: (a) neighborhood belonging, (b) organizations as a source of well-being, (c) friends as a source of protection and safety, and (d) supporting undocumented individuals. In addition, three themes emerged about participants' experiences of discrimination and oppression within their communities, including: (a) discrimination and violence, (b) police profiling and restriction of public space, and (c) lack of safety for undocumented individuals. Participants also shared narratives about the perceived level of community support they received in the U.S. versus in their countries of origin. Drawing on gender minority stress and intersectionality, the community experiences of immigrant Latinx transgender people are examined and interpreted to provide important research, advocacy, and practice implications. Public Significance StatementLittle is known about how communities serve as a source of support and oppression to immigrant Latinx transgender people in the U.S. and in their countries of origin. The current study explorers the role that communities play in the well-being and oppression of immigrant Latinx transgender people.