Gender-related minority stress and gender dysphoria: Development and initial validation of the Gender Dysphoria Triggers Scale (GDTS).

Abstract

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.