Schrager Sheree M, Goldbach Jeremy T, Wood Jules K, O'Brien Rory P, Dunlap Shannon L, Rhoades Harmony
Office of Graduate Studies and Research, California State University-Dominguez Hills, Carson, CA, United States.
Sexuality, Health and Gender Center, George Warren Brown School of Social Work, Washington University in St Louis, Saint Louis, MO, United States.
Front Psychol. 2024 Sep 19;15:1448706. doi: 10.3389/fpsyg.2024.1448706. eCollection 2024.
Transgender and nonbinary adolescents (TNBA) may experience gender dysphoria arising from incongruities between their body and their gender. Prior dysphoria measures have largely focused on clinical diagnosis with little regard to comparability of forms for people assigned male or female at birth, overall psychometric performance, or applicability to nonbinary populations. This study develops and validates the Transgender Adolescent Stress Survey-Dysphoria (TASS-D), intended to address these gaps.
The current study recruited a U.S. national sample of TNBA ( = 444, aged 12-17; 65.5% White, 9.5% Black, 9.5% Latine, 15.5% other ethnicity; 34.7% transmasculine, 17.3% transfeminine, 38.3% nonbinary, 9.5% agender). The item pool was developed from life history calendars, a modified Delphi process, and cognitive interviews with TNBA. Scale development included factor analysis, item response theory modeling, measurement invariance testing, and reliability analyses. Associations were examined between the TASS-D and existing measures of gender dysphoria (convergent validity), gender minority stress (divergent validity), and behavioral health outcomes (criterion validity).
TASS-D and its subscales (body distress and gender expression burden) were significantly and strongly associated with gender dysphoria; significantly but weakly associated with gender minority stress; and significantly associated with most indicators of psychological distress including depressive, anxiety, and posttraumatic stress symptoms, suicidal behaviors and nonsuicidal self-injury.
The TASS-D is a reliable and valid measure of gender dysphoria for TNBA, offering notable benefits over existing measures: It is psychometrically sound, inclusive of all gender identities, and does not assume that respondents identify binarily or desire medical transition as a terminal goal.
跨性别和非二元性别青少年（TNBA）可能会因身体与性别之间的不一致而经历性别焦虑。先前的性别焦虑测量方法主要集中在临床诊断上，很少考虑出生时被指定为男性或女性的人的量表形式可比性、整体心理测量性能或对非二元性别群体的适用性。本研究开发并验证了跨性别青少年压力调查问卷 - 性别焦虑量表（TASS - D），旨在填补这些空白。
本研究招募了一个美国全国性的TNBA样本（n = 444，年龄在12 - 17岁；65.5%为白人，9.5%为黑人，9.5%为拉丁裔，15.5%为其他种族；34.7%为跨性别男性，17.3%为跨性别女性，38.3%为非二元性别，9.5%为无性别）。条目池是根据生活史日历、改良的德尔菲法以及对TNBA的认知访谈开发的。量表开发包括因子分析、项目反应理论建模、测量不变性检验和信度分析。研究了TASS - D与现有的性别焦虑测量方法（收敛效度）、性别少数群体压力（区分效度）和行为健康结果（效标效度）之间的关联。
TASS - D及其子量表（身体困扰和性别表达负担）与性别焦虑显著且强烈相关；与性别少数群体压力显著但微弱相关；与大多数心理困扰指标显著相关，包括抑郁、焦虑和创伤后应激症状、自杀行为和非自杀性自伤。
TASS - D是一种用于TNBA的可靠且有效的性别焦虑测量工具，与现有测量方法相比具有显著优势：它在心理测量上是合理的，涵盖所有性别认同，并且不假定受访者具有二元性别认同或期望医疗过渡作为最终目标。
