University of Southern California, Los Angeles, USA.
San Francisco Department of Public Health, CA, USA.
J Interpers Violence. 2021 Mar;36(5-6):2633-2655. doi: 10.1177/0886260518760015. Epub 2018 Mar 11.
Psychological processes may mediate the relationship between minority stress and mental health though limited data exist showing this pathway among trans women. Trans women's degree of satisfaction with their body is associated with mental health outcomes. This study used a model of minority stress to explore for indirect effects on the association between transphobia-based victimization and anxiety and depression through one's degree of body satisfaction. Analysis also explored for racial differences. Transgender women ( = 233) were recruited in 2013 using respondent-driven sampling. Sociodemographics, transphobia-based victimization experiences such as having been physically abused, body satisfaction, and mental health were measured. Analyses assessed for direct and indirect associations while controlling for gender confirmation therapies (i.e., cross-sex hormone therapy and gender confirmation surgeries) and racial identity; 57% reported depression and 42.1% reported anxiety diagnoses. Participants averaged nearly three of six assessed violence experiences. More than 20% reported low body satisfaction. Contrary to authors' expectations, those reporting African American and Other racial identity experienced less transphobia-based violence than whites. Transphobia-based violence was significantly associated with anxiety, depression, and body satisfaction. Body satisfaction was associated with mental health diagnoses. Bootstrapping revealed significant indirect and total effects. Body satisfaction mediated the relationship between transphobia-based violence and mental health. Clinical intervention that promotes body satisfaction including access to gender confirmation therapies, especially hormone therapy, may prevent negative mental health outcomes among trans women. Individual intervention, however, is not a panacea for structural discrimination. Attention to structural interventions that reduce gender minority stressors including transphobia-based violence is necessary.
心理过程可能在少数群体压力与心理健康之间起中介作用，但目前仅有有限的数据表明跨性别女性存在这种途径。跨性别女性对自己身体的满意度与心理健康结果有关。本研究采用少数群体压力模型，通过一个人的身体满意度，探索跨性别恐惧症相关受害与焦虑和抑郁之间关联的间接影响。分析还探讨了种族差异。2013 年，通过回应者驱动抽样法招募了 233 名跨性别女性。测量了社会人口统计学特征、跨性别恐惧症相关受害经历（如身体虐待）、身体满意度和心理健康。分析评估了直接和间接关联，同时控制了性别确认治疗（即跨性别激素治疗和性别确认手术）和种族认同；57%的人报告有抑郁症状，42.1%的人报告有焦虑症诊断。参与者平均经历了近三分之六的暴力评估经历。超过 20%的人报告身体满意度较低。与作者的预期相反，报告非裔美国人和其他种族认同的人经历的跨性别恐惧症相关暴力比白人少。跨性别恐惧症相关暴力与焦虑、抑郁和身体满意度显著相关。身体满意度与心理健康诊断有关。引导发现存在显著的间接和总效应。身体满意度中介了跨性别恐惧症相关暴力与心理健康之间的关系。促进身体满意度的临床干预，包括获得性别确认治疗，特别是激素治疗，可能会预防跨性别女性的负面心理健康结果。然而，个体干预并不是解决结构性歧视的万能药。有必要关注减少性别少数群体压力源的结构性干预措施，包括跨性别恐惧症相关暴力。
