CLINICAL CONSIDERATIONS WHEN USING THE MMPI-2 WITH TRANSGENDER CLIENTS

Despite the cultural prevalence of transgender identities, only recently have researchers begun to address the health disparities that negatively impact this population. Theories of minority stress propose that social stigma accounts for the elevated rates of mental and physical health problems observed among transgender people, and that this stigma is associated with a disproportionate level of interpersonal and systematic discrimination. In 2015, the American Psychological Association released a set of guidelines specifically highlighting the need for research that will help facilitate more accurate distinctions between psychopathology and the consequences of oppression. Despite being the most commonly used psychological assessment tool in the United States, the current project is the only known study to examine relationships between MMPI-2 score profiles, supplemental mental health-related tests, and gender-based discrimination. Method: Twenty eight transgender individuals’ scores on MMPI-2 clinical Scales 4 (psychopathic deviate) and 8 (schizophrenia) were compared with supplemental measures of psychopathy (Triarchic Psychopathy Measure; TriPM), schizophrenia (PRIME Screen for schizophrenia; PS-R), and a measure of gender-specific adversity (Gender Minority Stress and Resilience Measure; GMSR). Results: Results from a one-sample t tests revealed that participants’ scores were significantly elevated compared to normative data on each of the 10 clinical Scales. Stepwise linear regressions also indicated that elevations on Scales 4 and 8 appear to be associated with Harris-Lingoes subscales Pd5, Pd3, and Pd1 (Scale 4) and Sc2 and Sc3 (Scale 8). Additionally, neither Scale 4 nor Scale 8 was significantly correlated with supplemental measures used to assess psychopathy (TriPM) or schizophrenia (PS-R). Significant positive correlations were observed, however, between both Scales 4 and 8, and a measure of gender-based discrimination in the GMSR. Another significant positive correlation was observed between Scale 4 and a measure of experiences with gender-based victimization. Conclusion: Results from this study suggests Scales 4 and 8 on the MMPI-2 may be more predictive of experiences with gender-discrimination and/or victimization than of schizophrenia or psychopathy for transgender test-takers. As a result, clinicians are encouraged to develop gender-affirmative clinical competencies when assessing transgender clients and take into account multiple sources of information that may be particularly relevant for transgender clients (including experiences with gender-related discrimination and victimization) prior to formulating diagnoses and treatment plans