Utrecht Gender Dysphoria Scale - Gender Spectrum (UGDS-GS): Construct validity among transgender,nonbinary, and LGBQ samples

Abstract

Background: Researchers combined both versions of the original Utrecht Gender Dysphoria Scale (UGDS) to create a single gender spectrum version (UGDS-GS) which measures dissatisfaction with gender identity and expression over time as well as comfort with affirmed gender identity.

Aim: This study examined the construct validity of the newly revised, UGDS-GS.

Method: Tests of measurement invariance were conducted in stages to assess measurement invariance of the UGDS-GS across three groups: cisgender, binary transgender, and nonbinary/genderqueer.

Results: Findings indicate that the UGDS-GS functions acceptably in all three gender groups (configural and metric invariance). Also, across binary transgender and nonbinary/genderqueer groups, the measure functions very similarly with all four types of invariance. Item level findings highlight the specificity of the measure to distinguish experiences of binary transgender and nonbinary/genderqueer persons differently from cisgender LGBQ individuals.

Conclusions: The UGDS-GS demonstrates a large degree of invariance across binary transgender, nonbinary/genderqueer, and cisgender LGBQ subgroups; and therefore, findings indicate this revision to be a substantial improvement. This 18-item self-report, Likert-type scale measure is a) inclusive of all gender identities and expressions (e.g., transfeminine spectrum, transmasculine spectrum, genderqueer, nonbinary, cisgender); b) appropriate for use longitudinally from adolescence to adulthood; and c) administered at any point in the social or medical transition process, if applicable, or in community-based research focused on gender dysphoria that examines cisgender and transgender persons.     

“I love you as both and I love you as neither”: Romantic partners’ affirmations of nonbinary trans individuals

Abstract

Background: Transgender microaffirmations are subtle endorsements of a person’s gender identity through both verbal acknowledgements and behavioral gestures. Microaffirmations positively impact individuals who identify as transgender by acknowledging their gender identity and by communicating a sense of support and validation.

Aims: This study focuses on microaffirmations specifically directed toward nonbinary transgender individuals within romantic relationships.

Methods: Participants included 161 adults who identified as nonbinary: 85 who identified as gender nonconforming and 76 who identified as agender. These participants were either currently in a romantic relationship or had been in a romantic relationship within the past 5 years. Participants completed an online survey and provided examples of the microaffirmations they experienced from their romantic partners.

Results: Responses were analyzed via thematic analysis, resulting in four overarching themes: (1) Identity Validations, acknowledgement and acceptance of nonbinary identity; (2) Identity Endorsements, active endorsements of nonbinary through language or behavior; (3) Active Learning, self-education about nonbinary identities; and (4) Active Defense, interruptions of others’ negative actions directed at nonbinary partners.

Discussion: Discussion of the results focuses on understanding how microaffirmations operate to complicate binary notions of gender/sex and positively influence nonbinary transgender individuals in interpersonal relationships.     

Mental health and quality of life in non-binary transgender adults: a case control study

Abstract

Background: The social challenges that non-binary people experience, due in part to social intolerance and the lack of validation of non-binary gender identities, may affect the mental health and quality of life of this population. However, studies that have distinguished between non-binary and binary transgender identities are lacking.

Aim: To compare the mental health and quality of life of a community sample of non-binary transgender adults with controls (binary transgender people and cisgender people) matched on sex assigned at birth.

Method: A total of 526 participants were included. Ninety-seven were classified as non-binary and were compared with two control groups: 91 people classified as binary and 338 cisgender people. Only transgender people not on gender affirming hormone treatment or who had not undergone gender affirming surgery were included. Participants were invited to complete an online survey that included mental health and quality of life measures.

Results: Non-binary people reported significantly better mental health than binary transgender people, but worse than cisgender people. Overall, there were no significant differences in quality of life between non-binary and binary transgender participants assigned male at birth and transgender females, but non-binary assigned males at birth had better scores on the psychological and social domains of quality of life than transgender males. Quality of life was better across all domains in cisgender people than transgender groups.

Conclusion: There is an inequality with regard to mental health and quality of life between non-binary (and binary) transgender people and the cisgender population that needs to be addressed. The better mental health scores in non-binary people may reflect lower levels of body dissatisfaction among the non-binary population. Mental health problems and poor quality of life are likely to have social causes and hence legislative measures and broader government-led inclusive directives should be put in place to recognize and to validate non-binary identifying people.     

Non-binary and binary transgender youth: Comparison of mental health,self-harm,suicidality, substance use and victimization experiences

ABSTRACT

?Background: Little research has compared the mental health and victimization experiences of non-binary youth depending on their sex assigned at birth (SAAB), or compared these two groups with binary transgender youth.

Aims: To compare mental health, self-harm and suicidality, substance use and victimization experiences between non-binary and binary transgender young adults, both male assigned at birth (MAAB) and female assigned at birth (FAAB).

Methods: Online survey data from 677 participants from the “Youth Chances” community study of 16 to 25 year olds in the United Kingdom was analyzed, comparing across binary participants (transgender females (n = 105) and transgender males (n = 210)) and non-binary participants (MAAB (n = 93) and FAAB (n = 269)).

Results: Female SAAB participants (binary and non-binary) were more likely to report a current mental health condition and history of self-harm than male SAAB participants (binary and non-binary). Similarly, female SAAB participants (binary and non-binary) were more likely to report childhood sexual abuse than male SAAB participants (binary and non-binary); the reverse pattern was found for lifetime physical assault relating to being LGBTQ. Non-binary MAAB participants were less likely than the other groups to report past suicide attempts and previous help-seeking for depression/anxiety. Binary participants reported lower life satisfaction than non-binary participants. For all four groups, mental health problems, self-harm, suicidality, alcohol use and victimization experiences were generally higher than that of youth in general population studies.

Conclusions: These findings highlight the importance of considering both non-binary versus binary gender identity and SAAB in relation to mental health problems, self-harm, suicidality and substance use in transgender youth. The roles of sexual abuse, other abuse and discrimination in contributing to increased rates of mental illness and self-harm in non-binary and binary transgender individuals, particularly those who were assigned female at birth, relative to those assigned male, require investigation.     

Transactional pathways of transgender identity development in transgender and gender-nonconforming youth and caregiver perspectives from the Trans Youth Family Study

Background: A growing body of research has examined transgender identity development, but no studies have investigated developmental pathways as a transactional process between youth and caregivers, incorporating perspectives from multiple family members. The aim of this study was to conceptualize pathways of transgender identity development using narratives from both transgender and gender-nonconforming (TGN) youth and their cisgender (nontransgender) caregivers.

Methods: The sample included 16 families, with 16 TGN youth, ages 7 to 18 years, and 29 cisgender caregivers (N = 45 family members). TGN youth represented multiple gender identities, including trans boy (n = 9), trans girl (n = 5), gender-fluid boy (n = 1), and girlish boy (n = 1). Caregivers included mothers (n = 17), fathers (n = 11), and one grandmother. Participants were recruited from LGBTQ community organizations and support networks for families with transgender youth in the Midwest, Northeast, and South regions of the United States. Each family member completed a one-time, in-person semistructured qualitative interview that included questions about transgender identity development.

Results: Analyses revealed seven overarching themes of transgender identity development, which were organized into a conceptual model: Trans identity development, sociocultural influences/societal discourse, biological influences, family adjustment/impact, stigma/cisnormativity, support/resources, and gender affirmation/actualization.

Conclusions: Findings underscore the importance of assessing developmental processes among TGN youth as transactional, impacting both youth and their caregivers.     

Supporting families of transgender children/youth: Parents speak on their experiences,identity, and views

ABSTRACT

Background: Transgender children/youth demonstrate the best possibility for resilience and positive mental health when they are part of an affirming and supportive family. To optimize families in supporting transgender children/youth, parents/caregivers need to be supported. Transgender children/youth and their families regularly navigate a myriad of challenges through society.

Aims: Within the extant literature on transgender children and youth, relatively little attention is focused on the experiences of parents/caregivers and how their close family relationships are affected. The present qualitative study addresses this gap in knowledge through its exploration of the experiences, identities, and views of parents/caregivers of transgender children/youth.

Method: The study is longitudinal and this article represents the first wave. Fourteen parents of 12 transgender children/youth, aged 6–17, participated in in-depth semistructured interviews. Participants were recruited via social media and at an on-site conference for transgender youth and their families. All children/youth had socially transitioned. Those who were eligible for puberty suppression and/or hormone therapy were receiving those. The interviews were inductively coded for themes by two coders using the constant comparative method.

Results: Participants' reports on their experiences yielded three themes: (1) transgender issues as the family's focus; (2) proactivity, child-focused: preemptive actions to prevent adverse consequences; and (3) self-care. These themes included subthemes on effective coping strategies to mitigate struggles. Three themes related to participants' identity and views emerged: (1) identity reformation, (2) self-evaluation, and (3) views of future. These themes included subthemes that reflected how participants viewed themselves, their child, and the future.

Discussion: A transgender identity in one family member affects all household members. Parents/guardians may experience guilt and self-doubt over decisions. Factors that may improve outcomes with extended family and schools include families' preemptive dissemination of information on transgender identities and explicating expectations of respect and nonintrusion. Ingrained traditions may force life-altering decisions.     

The Genderqueer Identity (GQI) Scale: Measurement and validation of four distinct subscales with trans and LGBQ clinical and community samples in two countries

ABSTRACT

Background: Non-binary gender measurement has grown out of a need for accurate representation in scholarship and public health services available to a diverse gender population.

Aims: The Genderqueer Identity Scale (GQI) was developed to allow for a multidimensional assessment of genderqueer identity, including non-binary identity, socially constructed versus essentialist gender, theoretical awareness of gender concepts, and gender fluidity. The GQI was designed to assess gender identity across a full spectrum of gender, at any age after mid-adolescence, and at various stages of gender identity development, including prior to, during, and after a gender transition, where applicable. Two of the GQI subscales focus on intrapersonal processes, while two focus on interpersonal processes.

Methods: The measure was piloted and refined across four distinct samples: a U.S. university based LGBT sample, consecutive clinical referrals at the Center of Expertise on Gender Dysphoria in Amsterdam, the Netherlands, a Dutch LGB community sample, and an online survey forum (LGBTQ).

Results: The first exploratory factor analysis identified minor potential adjustments, which were refined and retested. Researchers evaluated and cross-validated the hypothesized factor structure and determined that the three factor GQI subscales and the unidimensional Gender Fluidity measure yielded internally consistent and valid scores among transgender individuals seeking clinical treatment and LGB individuals within a community setting. The exploratory and confirmatory factor analyses provide evidence of good reliability, construct validity, and internal consistency of all four subscales.

Discussion: The subscales were appropriate across a spectrum of gender identities and can be taken in the same form over time and across gender transition statuses, making them suitable for clinical evaluation and community based longitudinal research with trans-identified or gender nonconforming persons. The development of the GQI fills critical gaps in gender-related measurement including the ability to assess multiple dimensions of gender identity, and to assess gender identity across time.     

I'm more driven now: Resilience and resistance among transgender and gender expansive youth and young adults experiencing homelessness

ABSTRACT

Background: Little is known about the resilience strategies of transgender and gender expansive youth and young adults (YYA) experiencing homelessness. In addition to difficulties accessing trans-affirming supports and services, transgender and gender expansive YYA must contend with structural constraints and oppressive messages about who they are and who they can become. Despite these challenges, transgender and gender expansive YYA experiencing homelessness are finding innovative ways to resist the multiple and overlapping institutionalized challenges they face.

Methods: This qualitative study examined the ways a group of transgender and gender expansive YYA demonstrate resilience and resist dominant narratives about what it means to be young, transgender and experiencing homelessness.

Results: Two primary themes were identified through which transgender and gender expansive YYA experiencing homelessness demonstrated resilience in the midst of structural constraints and oppressive narratives about who they are and who they can become: personal agency and future orientation. Participants exercised personal agency through self-definition and making their own choices. They oriented themselves to future possibilities through positive meaning-making and re-visioning the meaning of home. Participants engaged in these acts of resilience and resistance despite receiving negative messages about themselves.

Conclusions: Study findings illustrate the capacity of transgender and gender expansive YYA experiencing homelessness to reframe their challenges as positive experiences, integral to the people they have become or will be in the future. Findings point to the need to expand conceptualizations about people experiencing homelessness, and to utilize a strengths-based framework in practice and research.     

Gender congruence and body satisfaction in nonbinary transgender people: A case control study

Abstract

Background: Binary transgender people access gender affirming medical interventions to alleviate gender incongruence and increase body satisfaction. Despite the increase in nonbinary transgender people, this population are less likely to access transgender health services compared to binary transgender people. No research has yet understood why by exploring levels of gender congruence and body satisfaction in nonbinary transgender people.

Objective: The aim of this study was to compare levels of gender congruence and body satisfaction in nonbinary transgender people to controls [binary transgender people and cisgender (nontrans) people].

Method: In total, 526 people from a community sample in the UK took part in the study (97 nonbinary, 91 binary, and 338 cisgender identifying people). Participants were asked to complete an online survey about gender congruence and body satisfaction.

Results: There were differences in gender congruence and body satisfaction between nonbinary and binary transgender people. On sex-specific parts of the body (i.e., chest, genitalia, and secondary sex characteristics), nonbinary transgender people reported significantly higher levels of gender and body satisfaction compared to binary transgender people. However, there was no difference in congruence and satisfaction with social gender role between the two transgender groups (nonbinary and binary). Cisgender people reported significantly higher levels of gender congruence and body satisfaction compared to transgender people (nonbinary and binary).

Conclusions: There are differences in gender congruence and body satisfaction between nonbinary and binary transgender people. Nonbinary individuals may be less likely to access transgender health services due to experiencing less gender incongruence and more body satisfaction compared to binary transgender people. Transgender health services need to be more inclusive of nonbinary transgender people and their support and treatment needs, which may differ from those who identify within the binary gender system.     

Beyond Male and Female: Poststructuralism and the Spectrum of Gender

ABSTRACT

Transgender explodes the notion that male and female are discrete categories. Transgender people change sex or inhabit third (or multiple) sex, androgynous, or fluid identities. I theorize this by developing and then critiquing poststructuralist transgender theory. A poststructuralist theory of transgender disassociates sex and gender, models both as constructed, and emphasizes the technologisation and commodification of the body. Poststructuralist accounts can, however, entail denial of bodily limitations, erase transgender people's subjective experience, and overlook social and political factors, such as the importance of gender categories as a basis for identity politics. I argue for the deconstruction of gender binaries to be combined with the development of a gender-pluralist, flexible, model of gender. This points to the replacement of bipolar models of gender with a gender spectrum, with important implications for conceptualizing gender. My analysis is based on empirical research with a range of transgender people.     

Queer ethics and fostering positive mindsets toward non-binary gender,genderqueer, and gender ambiguity

Abstract

Background: Alongside the growth in visibility of gender identities and presentations such as genderqueer, non-binary and gender neutral, there is ridicule and backlash in wider culture, as well as more subtle invisibility and misgendering. While there exists social psychology research about negative and positive attitudes to trans people, this is restricted to those whose gender identity is at odds with their sex assigned at birth, and who identify with binary gender. Social psychology has extended to the more subtle workings of transphobia, but there is little consideration of the distinctiveness of attitudes and responses to those whose genders cannot be attributed in binary ways, and thus how these may be challenged.

Methods: In keeping with the methods of social theory, this article brings together a diverse and complementary range of conceptual fields in new ways to diagnose a novel cause and solution to these negative attitudes. Using queer theory, feminist ethics, and empirical studies in post-tolerance sociology and social psychology, it argues that negative social responses to genderqueerness stem not only from overt prejudice in the form of transphobia but from binary genderism, the conviction that there are only two genders.

Results and conclusion: This article proposes fostering greater diversity-literacy and empathy for difference as a more effective approach than minority identity-based ‘prejudice reduction’ approaches. A norm-critical approach to deconstructing gender norms is proposed, thus fostering positive attitudes to genderqueerness. It is therefore demonstrated how best to foster enabling social contexts for genderqueerness, with positive implications for the physical and social health and wellbeing of gender variant people. This approach can be applied in organizations, institutions, and by service providers who interact with genderqueer individuals, in that it can inform a shift to approaching diversity positively in ways that are not restricted to pre-determined and binary identity categories.     

Why Can’t You Just Pick One? The Stigmatization of Non-binary/Genderqueer People by Cis and Trans Men and Women: An Empirical Test of Norm-Centered Stigma Theory

Non-binary and genderqueer identities often resonate with people whose genders are outside the man-woman dichotomy, fluid, androgynous, and/or variant. Yet the gender binary system remains the unwavering norm, often placing non-binary and genderqueer people on the margins of social acceptability, and surprisingly little research has investigated those who stigmatize non-binary/genderqueer people. The current study utilizes Worthen’s (2020) Norm-Centered Stigma Theory (NCST) and nationally representative data collected from U.S. online panelists (n?=?3009: 1419 cis men, 1461 cis women, 74 trans women, 55 trans men) to investigate how norms (cisnormativity) and gender identity axes of social power (man/woman, cis/trans, and intersecting cis/trans-man/woman identities) relate to the stigmatization of non-binary/genderqueer people. Overall findings indicate that (a) cisnormativity is integral to understanding non-binary/genderqueer stigma, (b) the stigmatizer’s gender identity axes of social power are essential to explore as related to both cisnormativity and non-binary/genderqueer stigma, and (c) cisgender women are significantly different from others when it comes to both cisnormativity and non-binary/genderqueer stigma. Overall, the results underscore the significance of focusing on the unique complexities involved in the stigmatization of non-binary/genderqueer people and work toward dismantling such negativities.

     

Falling outside of the ‘nice little binary box’: a psychoanalytic exploration of the non-binary gender identity

The non-binary gender identity has recently emerged on the landscape of gender variance. It captures individuals who may experience a gender identity that is neither exclusively male nor female, is a combination of male and female or is between or beyond genders. The availability of literature exploring the non-binary gender experience is somewhat limited. Consequently, our understanding of the development of ‘self’ amongst such individuals seems to lag behind that of other gender variant identity, in particular the binary transgender identity. A psychoanalytically informed qualitative research design was used to explore the psychological realities of 6 individuals, aged between 19 and 29 years, who identified as gender fluid, genderqueer, polygender, non-binary Trans person, non-binary trans guy and non-binary gender. Analysis focused upon the integration of conscious and unconscious material in order to provide some insight into the participants’ internal world and object-relating. Three core themes emerged from the data: ‘A developing gender identity’, ‘Correct and incorrect language’ and ‘Being seen and unseen’. These themes, as well as the heterogeneity and complexity of non-binary gender identity, are explored within the discussion, with some implications around our clinical and wider cultural response to people who identify themselves in this way.     

Internalized transphobia and mental health among transgender adults: A nationwide cross-sectional survey in South Korea

Abstract

Introduction: 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.

Methods: 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.

Results: 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.

Conclusion: 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.     

Narrative and discursive perspectives on athletic identity: Past,present, and future

ObjectivesThe dominant role-based conceptualisations of athletic identity have recently been challenged in favour of theoretical perspectives that view identity as a complex cultural construction. In the present study, we analysed empirical studies on athletic identity positioned in narrative and discursive approaches to gain an insight into the use and subsequent contribution of these approaches to knowledge production in this research topic.Design and methodA total of 23 articles, of which 18 narrative studies and five discursive studies, were identified in a systematic literature search. We used the meta-study method to analyse these studies in terms of basic assumptions, methodologies, and findings.ResultsEarly narrative studies focused on biographical disruption in career termination and/or severe injury, whereas more recent studies examined the impact of different identity narratives on athletes' well-being and career decisions. Discursive studies examined the multiple ways in which dominant understandings of gender, age, and the athletic body are (re)produced and normalised within sporting cultures and institutions and can act to constrain athletes to certain identities and practices. Both approaches highlighted that elite sport culture offers limited narrative resources or subject positions for athletes, and can endanger athletes' well-being if they are unable to comply with dominant ideals of being an athlete.ConclusionsNarrative and discursive approaches have advanced understandings of the constitutive role of sporting culture in athletic identity formation. Future research should continue exploring athletic identity in various physical cultural contexts and seek to identify alternative narratives and discourses that may enable athletes to construct more adaptive identities.