Factors that drive mental health disparities and promote well-being in transgender and nonbinary people

Abstract

Transgender (or trans) is an umbrella term for individuals who experience their gender differently from what is associated with the sex they were assigned at birth. Individuals who are nonbinary experience their gender outside binary conceptions of gender. Although research has predominantly focused on negative mental health outcomes for transgender and non-binary (TNB) individuals, an emergent literature has begun to explore protective and health-promoting factors and dimensions of psychological well-being. In this Review, we discuss the sociocultural context for TNB people, beginning with a brief history of TNB identity before highlighting frameworks for understanding the higher prevalence of certain mental health concerns among TNB individuals. Next, we summarize the predictive factors associated with higher rates of depression, anxiety, suicidality, trauma-related concerns, disordered eating behaviours and substance use. We also review TNB coping, resilience and resistance to anti-trans stigma, as well as psychological well-being, flourishing and gender euphoria. Tying these topics together, we discuss affirming interventions for reducing mental health disparities and promoting psychological health in TNB individuals and communities. We conclude by discussing future research directions.

Analyzing body dissatisfaction and gender dysphoria in the context of minority stress among transgender adolescents

“…Testa et al [ 19 ] adapted Meyer’s minority stress model for transgender people stating that the chronic exposure of discrimination and hostility leads to their internalization ( Internalized Transphobia ) and eventually auto-aggression, self-depreciation and other related mental health issues. These assumptions are supported by various studies [ 20 – 22 ].…”

Health status of transgender people globally: A systematic review of research on disease burden and correlates

“…However, non-communicable chronic conditions, including age-related conditions, remain under-studied. With respect to mental health and infectious disease, disparities in outcomes such as depression, anxiety, and HIV are now well-documented across a range of settings [ 50 , 51 ]. Identifying individual, network, and structural determinants of health is critical to the development and implementation of evidence-based interventions to reduce morbidity for trans populations.…”

Public Restroom Access and Mental Health Among Gender-Minoritized Individuals in China

“…The transgender, nonbinary, and gender-diverse (henceforth, transgender) population faces unique and hostile stressors that are related to their minoritized identity . In particular, structural barriers transgender individuals face have manifested in sex-segregated public facilities, especially in public restrooms .…”

“…The transgender, nonbinary, and gender-diverse (henceforth, transgender) population faces unique and hostile stressors that are related to their minoritized identity. 1 , 2 In particular, structural barriers transgender individuals face have manifested in sex-segregated public facilities, especially in public restrooms. 3 , 4 Previous research revealed that transgender individuals whose appearance is incongruent with the ideal gender appearance often experience verbal, physical, and sexual harassment in public restrooms, 3 leading to severe physical and mental health conditions.…”