Lee Hyemin, Tomita Kevin K, Habarth Janice M, Operario Don, Yi Horim, Choo Sungsub, Kim Seung-Sup
Department of Public Health Sciences, Graduate School of Korea University, Seoul, Republic of Korea.
Counseling and Student Development Center, University of Hawai'i at Mānoa, Honolulu, HI, USA.
Int J Transgend Health. 2020 Apr 11;21(2):182-193. doi: 10.1080/26895269.2020.1745113. eCollection 2020.
Transgender people are stigmatized in South Korea (hereafter Korea), where cultural expectations of a biologically-based, binary sex and gender system present fundamental challenges to those whose gender identity does not align with their birth-assigned sex. A growing international body of literature implicates gender minority stress as a key contributor to transgender mental health disparities, but little research has been conducted on this topic in Korea. As in other cultural settings, depression and suicidality are urgent public health concerns for transgender people in Korea, primarily for those who have not initiated gender affirming medical treatment (GAMT), such as cross-sex hormone therapy. In the current study, an international and interdisciplinary team of authors apply the lens of gender minority stress to elucidate the relationships between a key facet of gender minority stress, internalized transphobia (ITP), and outcomes of depressive symptoms and suicidality. Based on a cross-sectional survey of 207 Korean transgender adults, the current study evaluates the relationships between ITP and depressive symptoms, suicidal ideation, and suicide attempts. ITP was measured with an eight-item, Korean-language questionnaire adapted from the Gender Minority Stress and Resilience Measure through a translation and back-translation process. Korean trans women and trans men mean (mean age = 26.4) were included in the analysis, most of whom had at least one experience of any GAMT. The findings of this study show that Korean transgender adults face similar public health concerns such as high prevalence of depressive symptoms, suicidal ideation, and suicide attempts. As predicted, ITP was significantly related to depressive symptoms, suicidal ideation, and suicide attempts. The authors suggest potential clinical, policy, and research applications, including institutional interventions, to address structural and cultural barriers to optimal mental health and GAMT as well as mental health interventions to reduce Korean transgender people's internalized negative beliefs about their gender identity.
在韩国，跨性别者受到污名化。在韩国，基于生理的二元性别系统的文化期望给那些性别认同与出生时被指定的性别不一致的人带来了根本性挑战。越来越多的国际文献表明，性别少数群体压力是导致跨性别者心理健康差距的关键因素，但韩国在这一主题上的研究很少。与其他文化背景一样，抑郁症和自杀倾向是韩国跨性别者紧迫的公共卫生问题，主要针对那些尚未开始性别肯定医疗（GAMT）的人，比如跨性别激素疗法。在本研究中，一个国际跨学科作者团队运用性别少数群体压力的视角，来阐明性别少数群体压力的一个关键方面——内化的恐跨症（ITP）与抑郁症状和自杀倾向结果之间的关系。基于对207名韩国跨性别成年人的横断面调查，本研究评估了ITP与抑郁症状、自杀意念和自杀未遂之间的关系。ITP通过一份八题的韩语问卷进行测量，该问卷是通过翻译和回译过程从《性别少数群体压力与复原力量表》改编而来。分析纳入了韩国跨性别女性和跨性别男性（平均年龄 = 26.4岁），其中大多数人至少有过一次任何性别肯定医疗的经历。本研究结果表明，韩国跨性别成年人面临类似的公共卫生问题，如抑郁症状、自杀意念和自杀未遂的高发生率。正如所预测的，ITP与抑郁症状、自杀意念和自杀未遂显著相关。作者们提出了潜在的临床、政策和研究应用，包括机构干预，以解决影响最佳心理健康和性别肯定医疗的结构和文化障碍，以及心理健康干预，以减少韩国跨性别者对其性别认同的内化负面信念。
