Department of Family Medicine and Community Health, Medical School, University of Minnesota, Minneapolis, Minnesota, USA.
Am J Public Health. 2013 May;103(5):943-51. doi: 10.2105/AJPH.2013.301241. Epub 2013 Mar 14.
We assessed the association between minority stress, mental health, and potential ameliorating factors in a large, community-based, geographically diverse sample of the US transgender population.
In 2003, we recruited through the Internet a sample of 1093 male-to-female and female-to-male transgender persons, stratified by gender. Participants completed an online survey that included standardized measures of mental health. Guided by the minority stress model, we evaluated associations between stigma and mental health and tested whether indicators of resilience (family support, peer support, identity pride) moderated these associations.
Respondents had a high prevalence of clinical depression (44.1%), anxiety (33.2%), and somatization (27.5%). Social stigma was positively associated with psychological distress. Peer support (from other transgender people) moderated this relationship. We found few differences by gender identity.
Our findings support the minority stress model. Prevention needs to confront social structures, norms, and attitudes that produce minority stress for gender-variant people; enhance peer support; and improve access to mental health and social services that affirm transgender identity and promote resilience.
我们评估了少数群体压力、心理健康以及美国跨性别群体中一个大型、基于社区、地域多样化样本中的潜在改善因素之间的关联。
2003 年，我们通过互联网按性别分层招募了 1093 名男性到女性和女性到男性的跨性别者作为样本。参与者完成了一项在线调查，其中包括心理健康的标准化衡量指标。根据少数群体压力模型，我们评估了污名与心理健康之间的关联，并检验了韧性指标（家庭支持、同伴支持、身份自豪感）是否调节了这些关联。
受访者中有很高比例的临床抑郁（44.1%）、焦虑（33.2%）和躯体化（27.5%）。社会污名与心理困扰呈正相关。同伴支持（来自其他跨性别者）调节了这种关系。我们发现，性别认同方面的差异很小。
我们的研究结果支持少数群体压力模型。预防措施需要解决导致性别多样化人群产生少数群体压力的社会结构、规范和态度；增强同伴支持；并改善获得心理健康和社会服务的机会，以肯定跨性别认同并促进韧性。
