Microaggressions, internalized oppression, mental health, and suicidality in disabled transgender and gender nonbinary individuals.

Stephanie L Cull, Paul B Perrin, Eric G Benotsch, B Ethan Coston, Mia E Dini, Kevin W Allison
Author Information
  1. Stephanie L Cull: Department of Psychology, Virginia Commonwealth University.
  2. Paul B Perrin: School of Data Science, University of Virginia. ORCID
  3. Eric G Benotsch: Department of Psychology, Virginia Commonwealth University.
  4. B Ethan Coston: Department of Psychology, Virginia Commonwealth University.
  5. Mia E Dini: School of Data Science, University of Virginia.
  6. Kevin W Allison: Department of Psychology, Virginia Commonwealth University.

Abstract

PURPOSE/OBJECTIVE: Transgender/gender nonbinary (TGNB) and disabled individuals commonly experience microaggressions that can lead to depression, anxiety, and suicidality; yet, limited research has explored the intersections of disabled and TGNB identities. This study explored hypothesized pathways leading from microaggressions through internalized oppression and mental health to suicidal ideation in a sample of disabled TGNB individuals.
RESEARCH METHOD/DESIGN: Disabled TGNB individuals ( = 289) completed an online survey assessing the constructs under scrutiny. The study performed multiple mediation path analyses to identify direct and indirect effects of each aspect of the hypothesized model.
RESULTS: Fifty-seven percent of the sample had clinically significant anxiety symptoms and 71% depression symptoms; 47% experienced suicidal ideation in the past month and 93% during their lifetime. Suicide attempt rates were 3% for the past 3 months and 52% lifetime. Within the good-fitting path model, cisgenderist microaggressions had a direct effect on internalized cisgenderism. Disability microaggressions had direct effects on internalized ableism and mental health symptoms. Internalized ableism had direct effects on mental health symptoms and suicidal ideation. Internalized ableism mediated the relationship between disability microaggressions and mental health symptoms, mental health symptoms mediated the relationship between internalized ableism and suicidal ideation, and both internalized ableism and mental health symptoms mediated the relationship between disability microaggressions and suicidal ideation.
CONCLUSIONS/IMPLICATIONS: Rehabilitation clinicians working with disabled TGNB individuals should consider the intersections of both systems of oppression (ableism and cisgenderism) and how microaggressions impact internalized oppression, mental health, and suicide. (PsycInfo Database Record (c) 2025 APA, all rights reserved).

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Created with Highcharts 10.0.0mentalhealthmicroaggressionsinternalizedsymptomsableismTGNBdisabledindividualssuicidalideationoppressiondirecteffectsmediatedrelationshipnonbinarydepressionanxietysuicidalityexploredintersectionsstudyhypothesizedsamplepathmodelpastlifetimecisgenderismInternalizeddisabilityPURPOSE/OBJECTIVE:Transgender/gendercommonlyexperiencecanleadyetlimitedresearchidentitiespathwaysleadingRESEARCHMETHOD/DESIGN:Disabled=289completedonlinesurveyassessingconstructsscrutinyperformedmultiplemediationanalysesidentifyindirectaspectRESULTS:Fifty-sevenpercentclinicallysignificant71%47%experiencedmonth93%Suicideattemptrates3%3months52%Withingood-fittingcisgenderisteffectDisabilityCONCLUSIONS/IMPLICATIONS:RehabilitationcliniciansworkingconsidersystemsimpactsuicidePsycInfoDatabaseRecordc2025APArightsreservedMicroaggressionstransgendergender

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