Minority stress in people who identify as transgender: testing the minority stress model

Objectives: People who identify as transgender are reported to experience high levels of mental health problems in comparison to people who do not identify as transgender. The minority stress model has been used to explain these high prevalence rates. But this model was designed to be used in lesbian, gay and bisexual (LGB) populations (Meyer, 1995, 2003). Researchers have applied some of the hypothesised processes of the model to people who identify as transgender. However, evidence testing the minority stress model in this population is limited. The model postulates that minority stress processes (namely, distal stress, internalised stigma, vigilance and concealment) lead to adverse mental health outcomes. It also states that coping and social support moderate and ameliorate the stress processes. However research on this aspect is inconclusive, with other researchers stating that coping and social support meditate the relationship between internalised stigma and psychological distress. In light of the current literature, this research aimed to test the application of the minority stress model in a sample of people who identified as transgender. It also aimed to test the moderating and mediating roles of coping and social support. Furthermore, this research endeavoured to develop an alternative model (i.e. based on the findings and the literature). Methods: A cross-sectional design was used. Participants were recruited from transgender forums, social groups, transgender events and social media. Those who identified as transgender, under the umbrella term, were invited to complete an online survey (N = 270; mean age = 27.5). The majority of participants (60.4%) described their gender identity as trans women. Results: Multiple linear regression, mediation and moderation analyses were conducted. Results showed that, individually, all the stress processes (distal stress process, internalised stigma, vigilance and concealment) were significantly associated with psychological distress. However, when assessed in combination, only certain stress processes emerged as being significant. With internalised stigma emerging as being significant in all the regression models (i.e. depression, anxiety and stress). No moderation effects were found for coping and social support. Instead, passive coping and social support were found to partially mediate the relationship between internalised stigma and psychological distress. Structural equation modelling was also used to develop hypothesised models based on this data. Conclusion: Limited support was found for the minority stress model within this sample. Hypothesised models were developed instead, to highlight the stress processes involved in depression, anxiety and stress. However, future research is warranted to test these models