Transgender and gender diverse (TGD) people face a myriad of daily stressors because of the hegemonic gender norms embedded within U.S. society. Due to these minority stressors, TGD people report elevated anxiety, depression, stress, and suicidality, among other health issues. One mechanism through which stigma may lead to these negative mental health outcomes is through increased rumination. In this intensive daily diary study with 181 TGD individuals (ages 16-40), we gathered qualitative data on their ruminative thoughts over the course of 56 days. There were a total of 2,431 responses across participants, with individuals providing a range of 1-53 responses (M = 15 responses). Using an experiential framework and an inductive approach to thematic analysis, we generated the following themes: (a) interpersonal relationships as a site of struggle, (b) fear and worry in response to contextual factors, (c) the weight of basic needs and safety, (d) gender as experienced through self and others, (e) intersections of health and rumination, and (f) the occasional reprieve. Using a deductive approach, we also placed these data within the context of Bronfenbrenner's Person-Process-Context-Time model to provide a conceptual model for future research in this area. These ruminative experiences revealed significant adversities and challenges weighing on participants' minds that spanned many areas of life. These findings also highlight the nuanced nature of rumination for TGD individuals and areas that may be overlooked in current assessments of this construct.
Public Policy Relevance StatementTransgender and gender diverse (TGD) people commonly report experiencing rumination. The content of this rumination can range from everyday stressors, like finances, to novel experiences related to gender affirmation, interpersonal rejection, political oppression, and fears for safety. aaa D espite growing recognition of the experiences of transgender and gender diverse (TGD) people (Crissman et al., 2017), general acceptance of TGD persons in mainstream society is still lacking (Norton & Herek, 2013). This unfortunate reality is evident in the widespread structural stigma that exists across the U.S., with TGD people lacking protections in areas such as housing discrimination and public accommodations, as well as efforts to ban TGD people from the military and the rolling back of health care access (White Hughto et al., 2015). This unwelcoming environment creates barriers to TGD people accessing basic needs This document is copyrighted by the American Psychological Association or one of its allied publishers.This article is intended solely for the personal use of the individual user and is not to be disseminated broadly.The authors thank the members of the Trans Health Community Advisory Board in Chicago who assisted with this project for their time, feedback, and dedicated involvement. We also would like to thank the participants who took part in this research for their time and effort.