Centering transgender and gender nonconforming people of color in the study of minority stress, transition-related factors, and mental health.

Distal stressors were directly related to anxiety in TGNC people of color.

• Direct effect of distal stressors on anxiety: β = 0.42, 95% CI = 0.26, 0.58
• Indirect effect of distal stressors on anxiety (through proximal stressors): β = 0.16, 95% CI = 0.07, 0.26
• Path analysis was conducted using structural equation modeling
• Sample consisted of 149 TGNC POC U.S. adults surveyed via online cross-sectional survey
• Anxiety was measured using the Generalized Anxiety Disorder-7 (GAD-7)

Distal stressors were directly and indirectly related to depression in TGNC people of color.

• Direct effect of distal stressors on depression: β = 0.43, 95% CI = 0.26, 0.60
• Indirect effect of distal stressors on depression (through proximal stressors): β = 0.14, 95% CI = 0.04, 0.23
• Depression was measured using the Patient Health Questionnaire-9 (PHQ-9)
• Distal stressors were measured using the LGBT People of Color Microaggressions Scale
• Proximal stressors were measured using the Gender Minority Stress and Resilience Measure

Intersectional distal stress was not directly related to gender congruence but was indirectly related through proximal stressors.

• Indirect effect of distal stressors on gender congruence through proximal stressors: β = -0.16, 95% CI = -0.27, -0.05
• No significant direct relationship between intersectional distal stress and gender congruence was found
• Gender congruence was measured using the Gender Congruence and Life Satisfaction Scale (GCLS)
• Authors cautioned interpretation given low reliability of the GCLS

A large majority of TGNC POC participants desired legal name and gender marker changes, but fewer than 60% who wanted changes were able to obtain them.

• 91.3% of participants desired a legal name change
• 98% desired a gender marker change
• Less than 60% of those who wanted document changes were able to obtain them
• Participants who had incongruent documents reported negative outcomes as a result

The majority of TGNC POC participants who desired gender-affirming hormone therapy were able to obtain it, but a notable proportion were not.

• 78.2% of those who wanted gender-affirming hormone therapy were able to obtain it
• The subsample who wanted hormone therapy was n = 55
• This implies approximately 21.8% who desired hormone therapy were unable to access it

The study used a sample of TGNC people of color to address a gap in the literature, as most prior studies on the Gender Minority Stress Model have utilized White TGNC samples.

• The online cross-sectional survey included n = 149 TGNC POC U.S. adults
• Few prior studies have examined the intersectionality of racial-minority related stress within the Gender Minority Stress Model
• The Gender Minority Stress Model outlines adverse mental and physical health outcomes due to gender-minority stress
• Measures included demographics, transition experiences, intersectional distal stressors, proximal stressors, gender congruence, depression, and anxiety