Ünsal Banu C, Demetrovics Zsolt, Reinhardt Melinda
Doctoral School of Psychology, ELTE Eötvös Loránd University, Budapest, Hungary.
Institute of Psychology, ELTE Eötvös Loránd University, Budapest, Hungary.
Arch Sex Behav. 2025 May 7. doi: 10.1007/s10508-025-03147-w.
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.
尽管远端（即歧视、受害、排斥和不被肯定）和近端（即内化的恐跨症、消极期望和身份隐瞒）性别少数群体压力源与跨性别者的内化（即抑郁、焦虑、自杀倾向）和外化（即物质使用）心理健康结果相关，但它们与两种不同类型结果的关联方式有所不同。一般心理过程（即绝望感）可以解释少数群体压力源与心理健康之间关联背后的机制。因此，本研究旨在检验完整的性别少数群体压力模型，以及少数群体压力源通过绝望感对跨性别者心理健康结果产生的直接和间接影响。数据通过在线方式从205名跨性别成年人（年龄在18 - 74岁之间；M = 29.49，SD = 10.24）的便利样本中收集，其中72人（35.1%）为跨性别男性，52人（25.4%）为跨性别女性，81人（39.5%）为非二元性别个体。结构方程模型的结果表明，除了抑郁外，远端压力源直接预测心理健康结果。内化的恐跨症和消极期望通过绝望感对抑郁、焦虑以及过去一年和一生的自杀倾向产生正向间接影响。身份隐瞒通过绝望感对抑郁、焦虑和过去一年的自杀倾向产生负向间接影响。对于物质使用，绝望感不是一个显著的中介变量。不过，身份隐瞒介导了远端压力源与物质使用之间的联系。研究结果表明，绝望感是跨性别者内化症状的一个重要促成因素，使其成为改善跨性别者心理健康干预措施的一个目标。身份隐瞒对两种心理健康结果的改善作用应在进一步研究中加以考虑和检验。
