The Role of Gender Affirmation in Psychological Well-Being Among Transgender Women

Abstract

High prevalence of psychological distress, including greater depression, lower self-esteem, and suicidal ideation, has been documented across numerous samples of transgender women and has been attributed to high rates of discrimination and violence. According to the gender affirmation framework (Sevelius, 2013), access to sources of gender-affirmative support can offset such negative psychological effects of social oppression. However, critical questions remain unanswered in regards to how and which aspects of gender affirmation are related to psychological well-being. The aims of this study were to investigate the associations between three discrete areas of gender affirmation (psychological, medical, and social) and participants' reports of psychological well-being. A community sample of 573 transgender women with a history of sex work completed a one-time self-report survey that assessed demographic characteristics, gender affirmation, and mental health outcomes. In multivariate models, we found that social, psychological, and medical gender affirmation were significant predictors of lower depression and higher self-esteem while no domains of affirmation were significantly associated with suicidal ideation. Findings support the need for accessible and affordable transitioning resources for transgender women in order to promote better quality of life among an already vulnerable population. As the gender affirmation framework posits, the personal experience of feeling affirmed as a transgender person results from individuals' subjective perceptions of need along multiple dimensions of gender affirmation. Personalized assessment of gender affirmation may thus be a useful component of counseling and service provision for transgender women. Transgender women (i.e., individuals assigned a male sex at birth who identify as female, male-to-female, transgender women) are a group at elevated risk of adverse health outcomes (Institute of Medicine, 2011). Numerous studies have reported higher prevalence of psychological distress, including depressive symptoms, low self-esteem, and suicidal ideation in community samples of transgender women (MacCarthy, Reisner, Nunn, PerezBrumer, & Operario, 2015;Operario & Nemoto, 2010). Due to their gender identity or expression, transgender people experience high levels of gender-based social oppression, or transphobia, including everyday discrimination, family rejection, and hate crimes (Bazargan & Galvan, 2012;Bradford, Reisner, Honnold, & Xavier, 2012;Koken, Bimbi, & Parsons, 2009;Lombardi, Wilchins, Priesing, & Malouf, 2002;Nuttbrock et al., 2010). Scholars have proposed that adverse mental health outcomes in transgender populations are a result of this gender-specific social oppression (Bockting, Miner, Swinburne Romine, Hamilton, & Coleman, 2013;Goldblum et al., 2012;Haas et al., 2010;Nuttbrock et al., 2013;Reisner, Gamarel, Dunham, Hopwood, & Hwahng, 2013). Additionally, the traditional sexism and denigration against women and individuals demonstrating characteristics d...

(Dis)Owning Exotic: Navigating Race, Intimacy, and Trans Identity

“…As a result, it is not surprising that trans women have a notably higher prevalence of depression, lower self‐esteem, and higher rates of suicidal ideation than the general population (Glynn et al. ). At the same time, however, trans men have been found to experience lower levels of depression while in relationships compared to those who are not (Meier et al.…”

“…For some trans women, pursuing relationships with (cisgender) men who embody hegemonic masculinity provides a means of affirming femininity or what some scholars refer to as gender affirmation (Abelson ; Glynn et al. ; Sevelius ). In fact, this is even echoed by the men who date trans women, who believe transgender women have a greater investment in performing hyperfemininity, particularly a femininity these men enjoy and are sexually attracted to (Operario et al.…”

Trans People, Transitioning, Mental Health, Life, and Job Satisfaction

“…Trans people experience marginalisation, societal biases, family rejection, and violations of human and political rights in health care, education, employment, housing and legal systems (Drydakis, 2017a;b;. These can result in lower human capital, higher unemployment and poverty rates, homelessness, and adverse health and mental health outcomes including higher rates of depression and self-harming than cis people (OECD, 2019;Drydakis, 2017a;b, 2016;Glynn et al, 2016;Köllen, 2016;White Hughto et al, 2015;Bevan, 2015;Trevor and Boddy, 2013;Dhejne et al, 2011).…”

“…even murder, as well as suffering from depression and experiencing suicidal thoughts related to lack of acceptance and internalization of stigma(OECD, 2019;Glynn et al, 2016;Köllen, 2016;Reisner et al, 2016;White Hughto et al, 2015;Norton and Herek;2013;Sears and Mallory, 2011; Grant et al., 2010 Gerhardstein andAnderson, 2010). These adverse circumstances can negatively impact on trans people's identity, health, mental health and well-being(OECD, 2019;Köllen, 2016;Sevelius, 2013).…”

“…These adverse circumstances can negatively impact on trans people's identity, health, mental health and well-being(OECD, 2019;Köllen, 2016;Sevelius, 2013). Stigma prevention programmes and coping intervention strategies, and accessible and affordable transitioning resources have been found to hold promise for reducing the corresponding adverse health-related effects of transphobia(White Hughto et al, 2015;Glynn et al, 2016).…”