Discriminatory experiences associated with posttraumatic stress disorder symptoms among transgender adults.

Abstract

Discrimination has been shown to disproportionately burden transgender people; however, there has been a lack of clinical attention to the mental health sequelae of discrimination, including posttraumatic stress disorder (PTSD) symptoms. Additionally, few studies contextualize discrimination alongside other traumatic stressors in predicting PTSD symptomatology. The current study sought to fill these gaps. A community-based sample of 412 transgender adults (mean age 33, SD=13; 63% female-to-male spectrum; 19% people of color; 88% sampled online) completed a cross-sectional self-report survey of everyday discrimination experiences and PTSD symptoms. Multivariable linear regression models examined the association between self-reported everyday discrimination experiences, number of attributed domains of discrimination, and PTSD symptoms, adjusting for prior trauma, sociodemographics, and psychosocial co-morbidity. The mean number of discrimination attributions endorsed was 4.8 (SD=2.4) and the five most frequently reported reasons for discrimination were: gender identity and/or expression (83%), masculine and feminine appearance (79%), sexual orientation (68%), sex (57%), and age (44%). Higher everyday discrimination scores (β=0.25; 95% CL=0.21–0.30) and greater number of attributed reasons for discrimination experiences (β=0.05; 95% CL=0.01–0.10) were independently associated with PTSD symptoms, even after adjusting for prior trauma experiences. Everyday discrimination experiences from multiple sources necessitate clinical consideration in treatment for PTSD symptoms in transgender people.

Child abuse victimization among transgender and gender nonconforming people: A systematic review

“…Three studies looked at sexual minority people to determine if their CGNC was associated with childhood abuse . Half of the studies had solely transgender people as participants . Two studies compared sexual minority people to heterosexual people .…”

“…A two‐step procedure, one that first asks sex assigned at birth, then gender identity, is the current accepted method to measure transgender identity in research . Four studies followed this method . One study stated no manner in which authors identified transgender respondents .…”

“…The following studies used no specific measure to indicate child abuse but asked if the person had experienced abuse before a specific age. Participants were asked if they were physically or sexually abused before age 15 by two studies . Another study asked whether or not the participants reported child physical or sexual abuse .…”

“…Psychological symptoms were measured by 64% of the articles. These included the PTSD measures Breslau's screening form for PTSD, PC‐PTSD (Pearson's r = 0.83), and PTSD scale from the DISC . The Behaviour and Symptom Identification Scale (BASIS‐32) was used in another study .…”

Perceived distress tolerance accounts for the covariance between discrimination experiences and anxiety symptoms among sexual minority adults

“…12 A link between discrimination experiences and anxiety symptomology among sexual minorities has been largely established by data and is supported by theory. 4, 13 Previous studies have suggested that certain coping methods, including not accepting or discussing discrimination experiences with others, may be associated with elevated psychopathology, 10 though pathways are likely to be multifaceted and complex. 6 Thus, more research on explanatory mechanisms that underlie associations between discrimination experiences and anxiety symptomology is needed.…”