Gender minority stress - A critical review

Gender Minority Stress: A Critical Review

Authors and Affiliations

• Kyle K.H. Tan (School of Psychology, University of Waikato, New Zealand)

• Gareth J. Treharne (Department of Psychology, University of Otago, New Zealand)

• Sonja J. Ellis (School of Human Development and Counselling, University of Waikato, New Zealand)

• Johanna M. Schmidt (School of Social Science, University of Waikato, New Zealand)

• Jaimie F. Veale (School of Psychology, University of Waikato, New Zealand)

• Correspondence: Kyle K.H. Tan, Email: kht5@students.waikato.ac.nz

Abstract

• Higher prevalence of mental health issues among transgender and gender diverse (TGD) compared to cisgender individuals.

• Testa’s Gender Minority Stress Framework (GMSF) extends Minority Stress Theory to specifically address the experiences of TGD individuals.

• The concept of cisnormativity is emphasized, describing societal norms that marginalize TGD identities.

• The paper aims to integrate theories on minority stressors and protective factors, addressing cultural and ethnic backgrounds in TGD health disparities.

Introduction

• Transgender (Trans): Refers to individuals whose gender identity does not align with their sex assigned at birth.

• Gender Diverse: Describes individuals with non-binary gender identities, such as agender or non-binary.

• TGD individuals can identify with cultural terms that may not fit Western constructs (e.g., Samoan fa’afafine).

• Paper discusses:

  • Meyer’s model of minority stress and its relevance.

  • Effectiveness of GMSF in addressing unique TGD stressors and protective factors.

  • Use of intersectionality to explain how overlapping identities can heighten minority stress.

Mental Health Disparities

• Studies indicate TGD people face higher rates of mental health issues (e.g., anxiety prevalence among TGD as high as 68%, compared to 18% in the general population).

• Minority Stress: Defined as added stress affecting marginalized groups due to their societal position (Meyer, 2003).

• Traditional MST may inadequately address unique stressors faced by TGD individuals, necessitating the GMSF.

Gender Minority Stress Framework (GMSF)

• GMSF builds on Meyer’s Minority Stress Theory with a focus on TGD stressors.

• Stress is conceptualized through an engineering analogy, relating to the burden of social stressors.

• Distinction made between individual stressors and unique social stressors for minority groups.

• Riggs and Treharne (2017) critique Meyer's individualistic view of stress origins, emphasizing systemic factors.

Institutionalized Ideologies and Social Norms

• Reinforces that minority stress results from marginalizing societal structures that privilege cisgender identities.

• Cisnormativity: Framework establishing societal norms that reflect and privilege cisgender identities, making TGD perceptions deviant.

• Misgendering and non-affirmation are highlighted as significant stressors affecting TGD individuals.

Social Exclusion Framework

• Cisgenderism leads to social exclusion, impacting TGD access to resources and opportunities (e.g., employment, healthcare).

• Findings from the U.S. National Transgender Discrimination Survey highlight systemic barriers faced by TGD people, including denial of bathroom access.

Psychological Theoretical Frameworks

• Future implications of Meyer’s minority stress theory must consider social psychological theories and perspectives from intersectionality.

• Identity categories influence minoritized experience, reinforcing discrimination and stress based on minority identities.

Minority Stressors Identified

• Distal Stressors: External events like discrimination and victimization facing TGD individuals.

• Negative Expectations: Anticipation of future discrimination based on past experiences (statistical evidence supports heightened fears among TGD individuals).

• Internalized Transphobia: Negative societal attitudes about TGD identity lead to low self-esteem and distress among TGD individuals.

Protective Factors Against Minority Stress

• Identity Pride: Individual-level protective strategy crucial for resilience among TGD individuals.

• Social support: Community and family connections enhance coping and mitigate minority stressors.

• Cultural connectedness is essential, particularly within indigenous contexts to acknowledge experience variance.

Implications of Intersectionality

• Previous applications of MST and GMSF insufficiently represent diverse identities within TGD populations.

• Need for nuanced understanding of overlapping identities and the unique stressors they entail.

• Recognition of cultural frameworks is crucial in addressing the specific needs of TGD people.

Conclusion and Future Directions

• The GMSF framework provides valuable insight into TGD-specific stress and protective factors.

• It requires integration with cultural considerations and intersectionality for a more comprehensive understanding of TGD health disparities.

• Future research must continue to refine these frameworks and explore additional protective factors relevant to TGD identities.

Gender Minority Stress Framework: A Detailed Overview

Gender Minority Stress Framework (GMSF)

• Building on Minority Stress Theory: The GMSF enhances Meyer’s Minority Stress Theory by focusing specifically on the unique stressors faced by transgender and gender diverse (TGD) individuals. It acknowledges the significance of societal structures that privilege cisgender identities and introduces the concept of cisnormativity as a critical factor in understanding minority stress.

• Stress Conceptualization: The framework conceptualizes stress analogous to engineering principles, where stress is considered a burden that accumulates from social stressors. It differentiates between individual stressors (events affecting personal well-being) and unique social stressors (those resulting from societal prejudice and exclusion).

• Critiques of Traditional Models: The GMSF also critiques the traditional individualistic perspective of stress origins, as discussed by Riggs and Treharne (2017), emphasizing the need to address systemic factors that contribute to the experiences of TGD individuals.

Methodology

• Qualitative and Quantitative Approaches: Future research utilizing the GMSF should adopt mixed-methods approaches, including both qualitative interviews and quantitative surveys, to gather comprehensive data on the lived experiences of TGD individuals. This dual approach allows for the collection of rich, descriptive data while also facilitating broader trend analysis.

• Cultural Competence in Research: Engaging with culturally competent researchers and communities to ensure the research methods are respectful and inclusive of diverse TGD identities, particularly indigenous frameworks that may not align with Western constructs.

• Systematic Literature Review: Conducting systematic reviews of existing literature on minority stressors and protective factors specific to TGD populations to identify gaps in knowledge and stratify stressors by intersectionality (e.g., race, age, socioeconomic status).

Future Directions and Implications

• Integration of Cultural Considerations: Future studies must integrate more cultural considerations that reflect the diverse identities within TGD populations. Understanding how cultural factors interplay with minority stress can enhance the GMSF by recognizing how stressors differ across cultural contexts.

• Nuanced Understanding of Intersectionality: Research must delve deeper into how overlapping identities (e.g., race, ethnicity, sexual orientation) uniquely influence the minority stress experiences of TGD individuals. Intersectional analysis is crucial to recognizing that the lived experiences of TGD individuals are not monolithic but shaped by various social determinants.

• Exploration of Additional Protective Factors: Future investigations should explore additional protective factors that contribute to resilience among TGD individuals, such as community-building initiatives, advocacy efforts, and mental health support systems tailored to the needs of TGD populations.

• Policy Implications: The findings from research utilizing the GMSF should inform policymakers to develop inclusive policies that address the systemic barriers faced by TGD individuals, promote access to healthcare, and reduce discrimination in various aspects of life.

• Educational Programs: There is a pressing need for the development of educational programs aimed at increasing awareness and understanding of TGD issues in schools, workplaces, and healthcare settings to reduce stigma and support social inclusion.