Gender Minority Stress Experiences After Gender-Affirming Medical Care.

Abstract

Understanding experiences of gender minority stress after gender-affirming medical care can improve post-treatment outcomes and provide transdiagnostic interventions targets for trans and gender diverse (TGD) individuals. This study aimed to describe proximal gender minority stress after gender-affirming care, and correlate high versus low stress to patient characteristics. In a cross-sectional study, participants were recruited through healthcare providers and community outlets to complete an online questionnaire. The quartiles with highest and lowest minority stress on the Transgender Identity Survey were included for analyses and compared on demographic and validated outcome questionnaires. Participants (n = 86) frequently reported limited openness (42.4%) or support (19.7%) related to their TGD identity after medical treatments. Low proximal minority stress was associated with younger age, non-binary gender, moderate to full openness on TGD, and higher treatment satisfaction. Low minority stress was also associated with less anxiety/depression, higher self-esteem, social connectedness and life satisfaction (moderate to large effect sizes). Open-text answers suggested that minority stress experiences were heterogeneous and related to persistent gender-based distress, stressful social interactions, and/or negative treatment outcomes. Minority stress theory can provide a transdiagnostic concept to improve the wellbeing of TGD individuals after medical transition, while substantial conceptual overlap with mental health outcomes exists.