Gender Minority Stressors, Hopelessness, and Their Associations with Internalizing and Externalizing Mental Health Outcomes in a Hungarian Trans Adult Sample.

Although distal (i.e., discrimination, victimization, rejection, and nonaffirmation) and proximal (i.e., internalized transphobia, negative expectations, and identity nondisclosure) gender minority stressors are associated with internalizing (i.e., depression, anxiety, suicidality) and externalizing (i.e., substance use) mental health outcomes of trans individuals, how they are related to two distinct types of outcomes differs. General psychological processes (i.e., hopelessness) could explain the mechanisms behind the minority stressors-mental health association. Accordingly, this study aimed to test the complete gender minority stress model and the direct and indirect effects of minority stressors via hopelessness on mental health outcomes in trans individuals. Data were collected online from a convenience sample of 205 trans adults (18-74 years; M = 29.49, SD = 10.24), 72 (35.1%) of whom were trans men, 52 (25.4%) were trans women, and 81 (39.5%) were non-binary individuals. Results from structural equation modeling showed that distal stressors directly predicted mental health outcomes, except for depression. Internalized transphobia and negative expectations had positive indirect effects on depression, anxiety, and past-year and lifetime suicidality via hopelessness. Identity nondisclosure had negative indirect effects on depression, anxiety, and past-year suicidality through hopelessness. For substance use, hopelessness was not a significant mediator. Still, identity nondisclosure mediated distal stressors-substance use link. Findings suggest that hopelessness is a significant contributor to internalizing symptoms of trans individuals, making it a target for interventions to improve the mental health of trans people. The ameliorative impact of identity nondisclosure on both types of mental health outcomes should be considered and examined in further studies.