In the latest research from the Journal of Pediatric Psychology, psychology researchers conducted a topical review of studies on minority stressors that contribute to psychosocial and physical health disparities in transgender and gender-expansive adolescents (TGE).
The article introduces the “minority stress framework” model which explains how TGE individuals are subjected to “unique stressors” as a minority group in a society not culturally aligned with gender affirmation, which puts this group at a disproportionate risk for negative physical and psychosocial outcomes.
The two types of stressors discussed, distal and proximal, are used to confer risks for negative health outcomes. Distal stressors are objective and related to external experiences such as peer discrimination, non affirmation, and victimization. Proximal stressors, on the other hand, are subjective or internal experiences and may include internalized transphobia, identity concealment, and fear of discrimination, rejection and, victimization.
In the objective or distal stressor studies, findings report that school-based peer victimization increases substance abuse among TGEs, leading to increased health and behavior risks. Additionally, peer victimization leads to higher depression and suicide rates and increased absenteeism and dropout rates, resulting in economic disparities among this group. TGE youth are also at a higher risk of mental health disorders and homelessness.
Proximal stressor studies on TGE adolescents are admittedly scarce, and psychologists implore that more research is needed to examine the effects of its impact on psychosocial and physical outcomes. Among the literature that is available, however, higher levels of depression and anxiety disorders are associated with TGE adolescents that have internalized transphobia.
An important aspect of the minority stress model is that of resilience as a foundational and proactive approach to stressors. Self-acceptance, community, and peer connections, and positive self-identification, along with strong familial structural systems can foster positive coping mechanisms and create a sense of belonging and acceptance for TGE adolescents, helping them to navigate discrimination and rejection.
Additionally, healthcare professionals who offer inclusive medical care can contribute to supportive environments and improved psychological outcomes for TGE adolescents. And, as the researchers point out, these healthcare professionals can serve as advocates for this vulnerable population by confirming gender affirmation practices as the standard of care.
Health Disparities in Transgender and Gender Expansive Adolescents: A Topical Review From a Minority Stress Framework
Alexandria M Delozier, PhD, Rebecca C Kamody, PhD, Scott Rodgers, MD, Diane Chen, PhD
Journal of Pediatric Psychology, July 2020