Minority stress, mental health, and substance use in transgender youth: the moderating role of positive affect.
Benjamin Parchem, Johnny Berona, Claire A Coyne, Judith T Moskowitz, Yee-Ming Chan, Diane Ehrensaft, Robert Garofalo, Marco A Hidalgo, Johanna Olson-Kennedy, Stephen M Rosenthal, Amy C Tishelman, Diane Chen
Author Information
Benjamin Parchem: Pritzker Department of Psychiatry and Behavioral Health, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL, United States.
Johnny Berona: Pritzker Department of Psychiatry and Behavioral Health, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL, United States.
Claire A Coyne: Pritzker Department of Psychiatry and Behavioral Health, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL, United States.
Judith T Moskowitz: Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, United States.
Yee-Ming Chan: Division of Endocrinology, Boston Children's Hospital, Boston, MA, United States.
Diane Ehrensaft: Department of Pediatrics, Division of Pediatric Endocrinology, University of California San Francisco, San Francisco, CA, United States.
Robert Garofalo: Potocsnak Family Division of Adolescent and Young Adult Medicine, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL, United States. ORCID
Marco A Hidalgo: Division of Internal Medicine-Pediatrics & Preventive Medicine, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, United States.
Johanna Olson-Kennedy: Division of Adolescent and Young Adult Medicine, Children's Hospital Los Angeles, Los Angeles, CA, United States. ORCID
Stephen M Rosenthal: Department of Pediatrics, Division of Pediatric Endocrinology, University of California San Francisco, San Francisco, CA, United States.
Amy C Tishelman: Department of Psychiatry, Boston College, Chestnut Hill, MA, United States. ORCID
Diane Chen: Pritzker Department of Psychiatry and Behavioral Health, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL, United States. ORCID
OBJECTIVE: To examine the relationships between gender minority stressors and mental health outcomes among transgender and gender diverse (TGD) youth and explore the moderating role of positive affect. METHOD: Baseline data of 315 TGD youth (ages 12-20���years old) from the Trans Youth Care-United States study comprised the analytic sample. Youth completed three subscales of the Gender Minority Stress and Resilience Measure for Adolescents (GMSR-A; nondisclosure of gender identity/gender history, negative future expectations, and internalized transphobia), Beck depression Inventory-II (BDI-II), Revised Children's Manifest Anxiety Scale, Second Edition (RCMAS-2), Alcohol, Smoking and Substance Involvement Screen Test (ASSIST), and the NIH Toolbox Positive Affect survey. Regression analyses using the Hayes PROCESS macro assessed moderation effects. RESULTS: Gender minority stressors were associated with more symptoms of depression (r���=���0.29 to 0.42) and Anxiety (r���=���0.32 to 0.42) and were not significantly associated with substance use (r���=���-0.01 to 0.10). Positive affect was negatively associated with gender minority stressors (r���=���-0.19 to -0.24) and mental health/substance use outcomes (r���=���-0.16 to -0.63). Positive affect significantly buffered the association between nondisclosure of gender identity and depressive symptoms (��R2 = 0.02) and protected against the impact of internalized transphobia on Anxiety symptoms (��R2 = 0.01). CONCLUSIONS: Positive affect is a promising modifiable protective factor that buffers the negative impact of gender minority stress on the mental well-being of TGD youth. Adapting existing positive emotion interventions for TGD youth is an indicated future direction for research and clinical practice.
