Understanding the relationship between anti-transgender bias, non-affirmation, and post-traumatic stress: a model of internalized transphobia-mediated post-traumatic stress.

Abstract

Transgender people's increased risk for negative mental health outcomes, when compared to cisgender peers or the general public, has been well documented in the psychological literature. Researchers have begun to establish empirical support for a relationship between anti-transgender bias, non-affirmation of gender identity, internalized transphobia, and other transgender-specific minority stressors. Although little work has explored the mechanisms of this relationship, some psychologists have proposed conceptualizing these factors as potentially traumatic experiences and understanding the poor mental health outcomes as manifestations of complex posttraumatic stress. In this dissertation, I examine whether there is empirical support for this framework by evaluating the relationships between anti-transgender bias experiences, non-affirmation, internalized transphobia, and severity of symptoms of post-traumatic disorder. In Chapter 1, I review the literature on transgender mental health and conduct an in-depth exploration of the field of trauma psychology, offering critical reflections on the history of the field as well as the current etiological models of post-traumatic stress, while considering how these might apply to transgender mental health. Drawing primarily from feminist and multicultural theories of trauma, as well as theories of viii shame-based post-traumatic stress, I develop a theoretical framework supporting my model in which: a) non-affirmation and anti-transgender bias experience are related to the severity of PTSD symptoms, and b) this relationship is mediated by experiences of internalized transphobia. In Chapter 2, I discuss the methodology I utilized to assess my research questions, noting recruitment strategies, psychometric properties of measures I selected, and appropriateness of the analytic method of structural equation modeling. In Chapter 3, I present the results, which include the main findings that all hypothesized relationships were found to be significant: greater levels of non-affirmation and exposure to anti-transgender bias were related to greater levels of PTSD symptom severity, both indirectly through internalized transphobia and directly. In Chapter 4, I discuss my findings in the context of my theoretical framework and literature review, offer clinical and research implications, and caution readers about the limitations of this study.

Psychology of working counseling framework applied to a gender diverse restaurant worker during COVID‐19

“…At a point in late 2020, these experiences created, according to J, a hostile work environment that J no longer had the mental resources to manage. Despite improvements in confidence and self‐advocacy, J's mental health suffered, which is consistent with literature on the effect of transphobic bias discrimination and mental health (Barr, 2018). J began calling in sick more frequently, having panic attacks at work, and struggling to find motivation to seek additional work opportunities outside this increasingly toxic environment.…”

“…To address treatment goals 3 and 4 (improve coping with workplace discrimination, low‐SES status, and the effects of the pandemic on restaurant work), the client and counselor began regularly considering the impact of the systemic factors that affect privilege and oppression in the workplace. The counselor helped J separate symptoms related to internalized oppression (e.g., shame, related to capitalistic expectations of productivity) from other mental health symptoms (Barr, 2018; Flynn & Bhambhani, 2021). These discussions were woven into multiple sessions and helped J lessen the emotional load they were carrying.…”