Transgender and Nonbinary People's Perceptions of Their State Context, Gender Minority Stress, and Mental Health: A Mixed Methods Study

Abstract

Transgender and nonbinary (TNB) people experience gender minority stressors that adversely affect their mental health and wellbeing, all of which are shaped by sociopolitical contexts. We explored TNB participants' (N = 150) perceptions of how affirming their state was and associations with minority stress and mental health variables. Qualitative themes included: (1) Degrees of stigma depend on who you are; (2) Stigma persists even with small positive advancements; (3) Cis people take an ‘out of sight, out of mind’ approach to TNB people; and (4) It's in the air we breathe: Cissexism is an individual, cultural, and structural issue. Across states, 41.8% of participants described views towards TNB people as negative, 41.8% as mixed, 5% as positive, 3.2% as neutral, 2.5% were unsure, and 0.6% were coded as unclear. Depression, past year enacted stigma, and negative expectations were significantly higher in negative contexts than in mixed contexts. These findings suggest that stigma and marginalisation persist across contexts, including relatively supportive places, and emphasise the importance of understanding within-state variability in terms of contextual drivers of mental health. Furthermore, anti-trans political climates have significant implications for TNB people's mental health and wellbeing, as well as exposure to minority stressors.