Spanish Adaptation of a Measure of Internalized Transphobia: Validation of the Transgender Identity Survey

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This study aimed to adapt and validate a Spanish version of the Transgender Identity Survey (TIS) to assess internalized transphobia in Spanish-speaking transgender and gender non-conforming (TGNC) individuals. The sample consisted of 207 TGNC Spanish-speaking adults who completed the TIS, along with measures of self-esteem and body image. Translation, adaptation, and validation analyses of the TIS were carried out. A reduced version of the original scale composed of 15 items in a one-dimension to assess internalized transphobia was obtained through Exploratory Factor Analysis (EFA). Validity evidence based on the internal structure was tested through Confirmatory Factor Analysis (CFA). The scale showed adequate reliability values (α = .890; Ω = .892). Correlations between TIS, self-esteem and body image reported convergent validity evidence. The Spanish version of the TIS provides a useful, reliable, and valid instrument for both research and clinical areas, supporting interventions aimed at reducing internalized stigma and promoting well-being and self-acceptance in the gender-diverse community. Biological sciences/Psychology/Human behaviour Health sciences/Health care/Quality of life internalized transphobia TIS TGNC gender identity validation Introduction In recent years, there has been an increase in visibility and social awareness of transgender and gender non-conforming (TGNC) people. 1 Nevertheless, they continue to experience discrimination, harassment, and social prejudice. 2 , 3 TGNC individuals belong to a minority social group, as they depart from prescribed heteronormative cultural norms in terms of gender expression, roles, and identity 4 which results in higher levels of social stress and worse physical and mental health compared to their cisgender counterparts. 5 – 8 According to Zheng et al., 9 community connectedness and pride are unrelated to mental health problems. One of the most useful theoretical frameworks for understanding the life experiences of TGNC individuals concerning stigma, stress, and health is the minority stress theory (MST). 10 , 11 According to this theory, minority social groups -such as TGNC- experience chronic and socially based stress from the stigmatizing social contexts in which they live. Recently, the MST has been clinically extended, recognizing that minority stressors do not have the same impact on all individuals. The psychological mediation framework (PMF) has defined two types of stressors: distal and proximal. Distal stressors are objective, that is, discrimination, victimization, rejection, or non-affirmation, and affect health through the mediating action of proximal stressors. Proximal stressors are internal or subjective experiences, among which internalized transphobia is the most damaging. 12 , 13 Internalized transphobia arises when TGNC people accept as true all those prejudices, stereotypes, and negative attitudes present in the general population and minimize, devalue, and denigrate their own identity. 14 , 15 According to Bockting, 16 this situation could cause the person who identifies as TGNC to feel rejection towards self (i.e., internalized vertical transphobia) and even towards other gender variant individuals (i.e., internalized horizontal transphobia). Bockting et al. 17 proposed that internalized transphobia can manifest itself as a feeling of pride in one's transgender identity while making an effort to hide one's identity by trying to pass socially as a cisgender person. Other indicators include alienation or disengagement and rejection of other transgender people, as well as feelings of shame about their gender identity, gender expression or transition process. 17 Self-esteem and body image are considered relevant concepts in the lives of TGNC people. 18 Austin and Goodman, 19 as well as Sánchez and Vilain, 20 found that internalized transphobic stigma could be affected by self-esteem and body image. 21 , 22 Self-esteem refers to a person's global evaluation and feelings of worth. 23 Body image could be defined as a multidimensional construct related to the perceptions, emotions, and behaviours the person shows related to physical appearance. 24 Given the implications of internalized transphobia and its relationship with other variables, it is necessary to address this phenomenon, and it is essential to carry out an adequate psychological measurement of it. According to the scientific literature, in Spain, there are instruments to evaluate the experiences of discrimination and social violence or experienced transphobia; however, there are no instruments translated and adapted to the Spanish-speaking population to examine internalized transphobia specifically. Likewise, worldwide, there are few tools to evaluate this construct specifically. Only Bockting et al. 17 have developed an instrument to assess internalized transphobia, and it was designed to evaluate the US transgender population. The Transgender Identity Survey (TIS) is made up of 26 items divided into four components: the feeling of pride (item e.g., "Being perceived as transgender by others is okay for me"), passing or socially passing by a cisgender person (e.g., "I cannot be happy unless I am perceived as a cisgender woman or man"), alienation or disengagement and/or rejection of other TGNC people (e.g., "I feel isolated and separate from other transgender people"), and feelings of shame (e.g., "Being transgender makes me feel like a freak"). The TIS has previously shown good psychometric properties, adequate internal consistency reliability (α = .90), test-retest reliability (.93), and evidence of construct validity. 17 Therefore, the main objective of this study is to adapt the Transgender Identity Survey (TIS) 17 to the TGNC Spanish population and provide validity evidence. To that purpose, first, the items were translated and adapted into Spanish. Second, the items of the original version and the internal consistency reliability were examined. Third, the factorial structure of the instrument was examined through Exploratory Factor Analysis (EFA) and Confirmatory Factor Analysis (CFA) to provide evidence of internal validity. Then, the correlations between TIS, self-esteem, and body image were analyzed to test external validity. Finally, the reliability of the internal consistency of the Spanish final version was examined. Materials and methods This research satisfies the ethical requirements following the principles reflected in the Declaration of Helsinki in 2013 and the Organic Law on Protection of Personal Data and Guarantee of Digital Rights 3/2018 to ensure that the study complies with the legal, methodological, and ethical aspects of investigations that involve interventions in human beings. This study was previously approved by the Ethics Committee of the Universidad Loyola Andalucía. This is a quantitative, cross-sectional, and psychometric study designed to adapt and validate a psychological measurement instrument. It was conducted between September and December of 2023. Participants The sample consisted of 207 TGNC Spanish adults aged between 18 and 63 years ( M = 25.11, SD = 8.16). 35.7% identified themselves as transgender men, 15.9% as transgender women, 23.7% as transsexual men, 9.7% as transsexual women, and 15% as nonbinary TGNC people. Table 1 presents the sociodemographic characteristics of the sample. Instruments Sociodemographic questionnaire. It includes ad hoc items about sex assigned at birth, self-identification/gender identity, nationality, age, work, studies, socioeconomic status, completion of the transition, the vital moment in which the transition took place, psychological care received, and sexual orientation. Transgender Identity Survey (TIS). 17 As previously commented, the original version consists of 26 items regarding feelings in the past three months about the TGNC identity. It uses a 7-point Likert-type scale (from 1 = totally disagree to 7 = totally agree). Higher scores indicate a higher level of internalized transphobia. Rosenberg’s Self-esteem Scale. 23,25 It is composed of 10 items that evaluate feelings of satisfaction about themselves. It uses a 4-point Likert-type scale (1 = strongly agree, 4 = strongly disagree). Higher scores indicate a higher level of self-esteem. In the present study, internal consistency Cronbach’s alpha value was .89. Body Appreciation Scale-2 (BAS-2). 26,27 It consists of 10 items that evaluate perceptions of body image. It uses a 5-point Likert-type scale (from 1 = never to 5 = always). Higher scores indicate a more positive perception of self-body image. In the present study, Cronbach’s alpha value was .95. Procedure Three professionals translated into Spanish the original TIS scale. It was evaluated by two experts of British nationality fluent in both English and Spanish who carried out the reverse translation. Then, a pilot study was carried out in which six TGNC people participated. They were asked for their opinions about understanding each item, whether the content was inclusive and any aspect that generated confusion. The adaptation was presented to a committee of four sexologists who offered their comments and suggested possible improvements. After the requested corrections, the Spanish version of the TIS was obtained. The sample was evaluated with an online survey using the Qualtrics platform. The recruitment was carried out through contact with associations of TGNC people, disseminating the research survey among their members and key informants. The snowball sampling allowed contact through social networks. The questionnaire included informed consent with information about the study, confidentiality, voluntariness, anonymity, and data protection. We confirmed that informed participant consent was obtained. There were no compensations for participation. Data analysis First, items analysis and reliability of the Spanish adaptation of the 26-item original TIS were carried out. The scale's internal consistency was analyzed considering Cronbach's alpha value, the alpha when each item was eliminated, and the correlation between the items and the total scale. Furthermore, the McDonald’s omega value was calculated. Second, validity evidence based on the internal structure of the scale was analyzed by conducting Exploratory Factor Analysis (EFA) and Confirmatory Factor Analysis (CFA). The following indices were considered: Chi-square (χ²), Comparative Fit Index (CFI), Goodness of Fit Index (GFI) (acceptable fit when CFI, GFI > .85; good fit > .90), Root Mean Square Error of Approximation (RMSEA) and Standardized Root Mean-Square Residual (SRMR) (acceptable fit when RMSEA <.10; good fit when RMSEA, SRMR < .06). 28-30 The robust maximum likelihood method was used. Items analysis and reliability of the obtained version were examined. Finally, correlations between TIS, self-esteem, and perception of body image were examined for the total sample and for subsamples based on gender self-identification. Results High mean scores were observed in the total score of the adapted version of 26 items of the TIS ( M = 119.25, SD = 22.21, min. 29 – max. 161), that is, the presence of high levels of TI in the sample. The initial Spanish version of the TIS presented adequate reliability values (α = .87). The McDonald’s omega for the 26-item scale was .88. The results showed that the reliability of the scale increased when items 1, 12, and 24 were eliminated (α-i = .88). By eliminating these items, at this time of the study, the scale was composed of 23 items (see Table 2). To verify whether the structure of the data on the scale was adequate for its factorial analysis, the Kaiser‒Meyer‒Olkin test (KMO = .88) and the significance of the Bartlett test of sphericity ( p <. 001) were considered. The EFA provided the existence of five dimensions on the scale. The factor loadings of each item in these factors suggested eliminating items 5, 6, 9, and 26 because they loaded in two different factors, and the difference between the loads was <.15. At this step, one of the factors was removed. The distribution of the remaining 19 items was as follows: Factor 1: 2, 3, 4, 8, 10, 11, 13, 14, 15, 16, 17, 18, 20, 21 and 23; Factor 2: 19 and 25. Factor 3: 22; and Factor 4: 7. Following previous recommendations, 31 we decided to eliminate factors 2, 3, and 4 due to the small number of items included and because they were not well determined and might affect the stability of the final factorial solution. Thus, the final TIS scale was a reduced version comprising 15 items (2, 3, 4, 8, 10, 11, 13, 14, 15, 16, 17, 18, 20, 21, and 23) and belonging to one dimension (see Table 3). The indices from the CFA showed that the reduced version of the TIS had an acceptable fit: ꭓ 2 = 250.11, p < .001; CFI = .86; GFI = .96; RMSEA = .09 (.07-.10); SRMR = .06. The 15 items of the Spanish version of the TIS were answered using the entire 7-point Likert-type response scale (from a minimum of 1 to a maximum of 7), indicating that these response options are adequate. The highest mean scores were observed for items 12 ( M = 5.59) and 8 ( M = 5.51). Item 10 obtained the lowest mean score ( M = 3.7). We also considered skewness and kurtosis (see Table 2). High mean total scores were observed for the Spanish 15-item version ( M = 73.20, SD = 17.76, min. 15 – max. 105). Furthermore, this reduced version presented good reliability values; Cronbach’s alpha was .890, and McDonald’s omega was .892. The scores of the Spanish version of the TIS for the total sample were correlated with self-esteem ( r = .47 and p <.001) and body image ( r =.47 and p <.001), providing evidence of convergent validity (see Table 4). Also, significant differences were found ( p = 0.009) in the levels of self-esteem between the self-identification of gender identity reported by transsexual men ( M = 30.53; SD = 5.40) and transsexual women ( M = 31.70; SD = 7.55). Thus, we decided to analyze the correlations by subsamples according to this gender self-identification. Positive and significant correlations were found between TIS and self-esteem in all groups except for transgender women (Table 4). Discussion The main objective of the present study was to adapt and validate the Transgender Identity Survey (TIS) 17 in the TGNC Spanish population to provide a comprehensive assessment of internalized transphobia. Findings showed that the obtained Spanish version of the TIS has adequate reliability and validity evidence. The Spanish version of the TIS reduced the scale from the original. The psychometric analysis yielded a reduced version composed of 15 out of the 26 original items, clustered into one dimension. The total score ranges between 15 and 105 points, which could be interpreted as the minimum and maximum level of internalized transphobia (see Appendix 1). Although there are differences in the internal structure of the instrument when comparing the Spanish version with the US original version, being the adapted scale shorter than the original created by Bockting et al., 17 both versions have demonstrated good psychometric properties. The specific sociodemographic characteristics of the sample and possible cultural differences between countries may influence the perceptions of transphobia 17 and support the differences. Regarding the internal consistency of the scale, the unidimensional structure shows adequate reliability considering Cronbach’s alpha and McDonald’s omega values (.89). These indices are similar to those reported for the original structure (.90). Regarding evidence of convergent validity, contrary to expectations, and surprisingly, TIS was positively associated with self-esteem and body image. Internalized transphobia is a reality that can affect an important part of the TGNC collective today, evidenced by the high scores obtained by the Spanish version of the TIS scale. It is well established that members of oppressed or minority groups often receive negative social messages that minimize, devalue, or denigrate their identities. 15 , 32 , 33 Several authors 19 , 22 , 34 , 35 have pointed out the importance of and relationship between self-esteem and body image in TGNC identities. The results of self-esteem should be interpreted with caution because, as indicated by Vosvik and Stem, 36 despite its popularity, research on self-esteem in LGTBIQA + populations is limited and shows contradictory results. 37 , 38 This may be partly due to the diversity of identities and forms of expression within the TGNC population, which could explain our results. 20 In general, self-esteem in studies of TGNC people has focused on variables, including social support, 39 – 41 and belonging to the TGNC community. In this sense, the feeling of belonging to the community moderates the impact that one's status has on self-esteem, psychosocial functioning, and well-being. 42 Thus, it has been suggested that when dealing with minority stress, a connection with other individuals stigmatized by the same characteristic is a protective factor. 20 , 43 Therefore, belonging to the TGNC community implies a greater perception of social support and the possibility of living one's identity in a tolerant and respectful environment, 44 , 45 aspects that contribute to pleasing self-esteem. It should be remembered that the participants in the present study were contacted through associations and snowball sampling, which means that the participants were mostly part of the TGNC community. Regarding the social discrimination experienced by TGNC people, transgender women suffer the highest rates of discrimination and victimization. 35 This fact could explain why we found positive correlations and significance between TIS and self-esteem in all groups except the group of transgender women. Finally, Tabaac et al. 21 point out that self-esteem and body image are closely related, so when one increases or decreases, the other variable behaves similarly. Thus, in TGNC identities, studies indicate that body image and its relationship with self-esteem is mediated by physical changes (e.g., hormonal or reassignment surgery) that would allow them to "pass" socially as a cisgender person, that is, without a physical appearance that betrays their TGNC identity. 46 , 47 Thus, self-esteem will improve as the perception of their body image adjusts to what is socially expected for a cisgender person. Limitations and Future Research Some limitations have been identified in this study. Quota sampling is a non-probabilistic sampling method, therefore the extent to which the results can be generalized is modest. Data were collected online, which made it difficult to control variables such as social desirability that may have influenced the responses. The terminology used for recruiting the sample may have different connotations for individuals. Alternative terms for gender identification were advertised (transgender man, transgender woman, transsexual man, transsexual woman, and non-binary TGNC people); however, these identities are not equally represented within our sample. Also, the specific sociodemographic characteristics of the sample could affect the findings, again, the generalization of the results to the general population should be done with caution. Finally, some indices from CFA were not as good as expected to confirm the fit of the unidimensional model obtained. Future research should replicate this study in larger samples to support the adapted version of the TIS obtained. Using different samples for AFE and CFA could improve the results. Other data analyses, such as measurement invariance, could provide more information about the validity evidence of the instrument. Furthermore, future research should consider other sociodemographic characteristics as well as psychological variables as factors that could affect the construct of internalized transphobia. Conclusions The Spanish version of the TIS provides a valuable tool for understanding and addressing the extent to which TGNC people have internalized societal prejudice and discrimination in Spanish-speaking contexts. By offering a culturally specific and validated measure, it facilitates research and intervention to promote self-acceptance and psychological well-being within this population. This scale not only contributes to generating knowledge about internalized transphobia at a national level but also serves as a crucial resource for improving clinical care and community support for TGNC individuals in Spanish-speaking countries. Declarations Acknowledgments We would like to thank all the participants who generously contributed their time and effort to this study. We are deeply grateful for your participation. Author Contribution Statement IB: data curation; formal analysis; writing – original draft AIAR: conceptualization; formal analysis; writing – review and editing LE: conceptualization; formal analysis; writing – review and editing Funding No funding was received. Ethical Approval This study was previously approved by the Ethics Committee of the Universidad Loyola Andalucía. Competing Interests No competing potential or actual, financial, or other interests exist. References Campbell M, Hinton JDX, Anderson JR. 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Available from: https://transpulseproject.ca/wp-content/uploads/2012/10/Impacts-of-Strong-Parental-Support-for-Trans-Youth-vFINAL.pdf [Last accessed: December 14, 2023] Healy KZ. Internalized Transphobia, Minority Stress, and Collective Self-Esteem. Diss. The Ohio State University, 2011. Testa RJ, Habarth J, Peta J, et al. Development of the gender minority stress and resilience measure. Psychol Sex Orientat Gend Divers 2015;2(1):65–77. https://doi.org/10.1037/sgd0000081 Singh AA, Hays DG, Watson LS. Strength in the face of adversity: Resilience strategies of transgender individuals. J Couns Dev 2011;89(1):20–27. https://doi.org/10.1002/j.1556-6678.2011.tb00057.x Frost DM, Meyer IH. Measuring community connectedness among diverse sexual minority populations. J Sex Res 2012;49(1):36–49. https://doi.org/10.1080/00224499.2011.565427 Owen-Smith AA, Gerth J, Sineath RC, et al. Association between gender confirmation treatments and perceived gender congruence, body image satisfaction, and mental health in a cohort of transgender individuals. J Sex Med 2018;15(4):591–600. https://doi.org/10.1016/j.jsxm.2018.01.017 van de Grift TC, Cohen-Kettenis PT, Steensma TD, et al. Body satisfaction and physical appearance in gender dysphoria. Arch Sex Behav 2016;45(3):575–585. https://doi.org/10.1007/s10508-015-0614-1 Tables Table 1 Sociodemographic characteristics of the sample. Variables n % Sex assigned at birth Female Male 165 62 70.05 29.95 Occupation Employment Unavailable Unemployment 79 97 31 38.16 46.86 14.98 Studies No qualification Primary Lower secondary Upper secondary University Post-secondary non-tertiary education Short-cycle tertiary education 6 8 32 38 71 21 31 2.90 3.86 15.45 18.35 34.30 10.14 15.00 Socioeconomic level High Medium Low 9 126 72 4.35 60.87 34.78 Transitioning Yes No 183 24 88.41 11.59 Initiation of the transition Childhood Adolescence Adulthood No reported 5 92 86 24 2.42 44.44 41.55 11.59 Previously psychology therapy Yes No 144 63 69.57 30.43 Sexual orientation Exclusively heterosexual Predominantly heterosexual, only incidentally homosexual Predominantly heterosexual, but more than incidentally homosexual Bisexual, equally heterosexual and homosexual Predominantly homosexual, but more than incidentally heterosexual Predominantly homosexual, only incidentally heterosexual Exclusively homosexual Asexual 69 27 6 60 14 8 20 3 33.33 13.05 2.90 28.99 6.76 3.86 9.66 1.45 Table 2 Descriptive statistics analysis of the Spanish 15-item version of the Transgender Identity Survey. Original version Spanish version M SD Min Max Skewness Kurtosis rit α-i TIS 1 3.91 1.88 1 7 -.06 -.94 .14 .88 TIS 2 1 4.78 1.83 1 7 -.42 -.94 .54 .87 TIS 3 2 4.22 2.08 1 7 .09 -1.39 .61 .86 TIS 4 3 4.75 1.91 1 7 -.23 -1.26 .62 .86 TIS 5 5.16 1.74 1 7 -.64 -.64 .37 .87 TIS 6 5.45 1.78 1 7 -1.00 -.20 .52 .87 TIS 7 3.25 1.70 1 7 .20 -.60 .34 .87 TIS 8 4 5.36 1.74 1 7 -.74 -.73 .74 .86 TIS 9 4.72 1.84 1 7 -.34 -.93 .42 .87 TIS 10 5 5.31 1.85 1 7 -.84 -.45 .50 .87 TIS 11 6 4.67 1.87 1 7 -.24 -1.14 .52 .87 TIS 12 3.86 1.89 1 7 -.03 -1.11 .03 .88 TIS 13 7 5.34 1.57 1 7 -.74 -.30 .39 .87 TIS 14 8 5.51 1.65 1 7 -.92 -.21 .56 .87 TIS 15 9 5.03 1.93 1 7 -.48 -1.29 .39 .87 TIS 16 10 3.70 2.14 1 7 .29 -1.31 .61 .86 TIS 17 11 4.67 1.99 1 7 -.31 -1.12 .55 .87 TIS 18 12 5.59 1.80 1 7 -1.05 -.31 .66 .86 TIS 19 5.61 1.51 1 7 -1.06 .64 .38 .87 TIS 20 13 4.57 2.00 1 7 -.21 -1.26 .38 .87 TIS 21 14 4.97 1.83 1 7 -.41 -1.15 .44 .87 TIS 22 5.05 1.85 1 7 -.70 -.65 .27 .87 TIS 23 15 4.74 2.00 1 7 -.32 -1.25 .59 .87 TIS 24 3.95 1.85 1 7 .06 -.82 .03 .88 TIS 25 4.28 1.68 1 7 -.23 -.65 .28 .87 TIS 26 5.48 1.56 1 7 -.96 .47 .29 .87 Note. Items from the 15-item Spanish version are in bold. M : mean; SD : Standard deviation; rit : item-total correlation; α-i: Cronbach’s alpha if item deleted Table 3 Factor loading of the items from the reduced 15-item Spanish version of the Transgender Identity Survey. Items Factor 1 TIS 1 (2) .57 TIS 2 (3) TIS 3 (4) .68 .70 TIS 4 (8) .80 TIS 5(10) .57 TIS 6(11) .62 TIS 7 (13) .47 TIS 8 (14) .64 TIS 9 (15) .48 TIS 10 (16) .69 TIS 11 (17) .65 TIS 12 (18) .71 TIS 13 (20) .48 TIS 14 (21) .52 TIS 15 (23) .67 Note . TIS = Transgender Identity Survey. Numbered items from the original version in brackets. Table 4 Correlation between Transgender Identity Survey, self-esteem and body image for the total sample and correlation between Transgender Identity Survey and self-esteem for subsamples based on self-identification of gender identity. TIS Total Transgender man Trans man Transgender woman Trans woman Non-binary Self-esteem .47*** .51*** .51*** .33 .56* .48** Body image .47*** Note. ***p < .001, **p < .01, *p < .05 Additional Declarations There is NO conflict of interest to disclose. Cite Share Download PDF Status: Published Journal Publication published 11 Feb, 2026 Read the published version in International Journal of Impotence Research → Version 1 posted Editorial decision: revise 16 Sep, 2025 Review # 2 received at journal 18 Aug, 2025 Reviewer # 2 agreed at journal 17 Aug, 2025 Review # 1 received at journal 12 Aug, 2025 Reviewer # 1 agreed at journal 31 Jul, 2025 Reviewers invited by journal 23 Jul, 2025 Submission checks completed at journal 22 Jul, 2025 Editor assigned by journal 21 Jul, 2025 First submitted to journal 21 Jul, 2025 You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. 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The psychological mediation framework (PMF) has defined two types of stressors: distal and proximal. Distal stressors are objective, that is, discrimination, victimization, rejection, or non-affirmation, and affect health through the mediating action of proximal stressors. Proximal stressors are internal or subjective experiences, among which internalized transphobia is the most damaging.\u003csup\u003e\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e,\u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e\u003c/sup\u003e\u003c/p\u003e\u003cp\u003eInternalized transphobia arises when TGNC people accept as true all those prejudices, stereotypes, and negative attitudes present in the general population and minimize, devalue, and denigrate their own identity.\u003csup\u003e\u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e,\u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e\u003c/sup\u003e According to Bockting,\u003csup\u003e\u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e\u003c/sup\u003e this situation could cause the person who identifies as TGNC to feel rejection towards self (i.e., internalized vertical transphobia) and even towards other gender variant individuals (i.e., internalized horizontal transphobia).\u003c/p\u003e\u003cp\u003eBockting et al.\u003csup\u003e\u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e\u003c/sup\u003e proposed that internalized transphobia can manifest itself as a feeling of pride in one's transgender identity while making an effort to hide one's identity by trying to pass socially as a cisgender person. Other indicators include alienation or disengagement and rejection of other transgender people, as well as feelings of shame about their gender identity, gender expression or transition process.\u003csup\u003e\u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e\u003c/sup\u003e\u003c/p\u003e\u003cp\u003eSelf-esteem and body image are considered relevant concepts in the lives of TGNC people.\u003csup\u003e\u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e\u003c/sup\u003e Austin and Goodman,\u003csup\u003e\u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e19\u003c/span\u003e\u003c/sup\u003e as well as S\u0026aacute;nchez and Vilain,\u003csup\u003e\u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e20\u003c/span\u003e\u003c/sup\u003e found that internalized transphobic stigma could be affected by self-esteem and body image.\u003csup\u003e\u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e21\u003c/span\u003e,\u003cspan citationid=\"CR22\" class=\"CitationRef\"\u003e22\u003c/span\u003e\u003c/sup\u003e Self-esteem refers to a person's global evaluation and feelings of worth.\u003csup\u003e\u003cspan citationid=\"CR23\" class=\"CitationRef\"\u003e23\u003c/span\u003e\u003c/sup\u003e Body image could be defined as a multidimensional construct related to the perceptions, emotions, and behaviours the person shows related to physical appearance.\u003csup\u003e\u003cspan citationid=\"CR24\" class=\"CitationRef\"\u003e24\u003c/span\u003e\u003c/sup\u003e\u003c/p\u003e\u003cp\u003eGiven the implications of internalized transphobia and its relationship with other variables, it is necessary to address this phenomenon, and it is essential to carry out an adequate psychological measurement of it. According to the scientific literature, in Spain, there are instruments to evaluate the experiences of discrimination and social violence or experienced transphobia; however, there are no instruments translated and adapted to the Spanish-speaking population to examine internalized transphobia specifically. Likewise, worldwide, there are few tools to evaluate this construct specifically.\u003c/p\u003e\u003cp\u003eOnly Bockting et al.\u003csup\u003e\u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e\u003c/sup\u003e have developed an instrument to assess internalized transphobia, and it was designed to evaluate the US transgender population. The Transgender Identity Survey (TIS) is made up of 26 items divided into four components: the feeling of pride (item e.g., \"Being perceived as transgender by others is okay for me\"), passing or socially passing by a cisgender person (e.g., \"I cannot be happy unless I am perceived as a cisgender woman or man\"), alienation or disengagement and/or rejection of other TGNC people (e.g., \"I feel isolated and separate from other transgender people\"), and feelings of shame (e.g., \"Being transgender makes me feel like a freak\"). The TIS has previously shown good psychometric properties, adequate internal consistency reliability (α\u0026thinsp;=\u0026thinsp;.90), test-retest reliability (.93), and evidence of construct validity.\u003csup\u003e\u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e\u003c/sup\u003e\u003c/p\u003e\u003cp\u003eTherefore, the main objective of this study is to adapt the Transgender Identity Survey (TIS)\u003csup\u003e\u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e\u003c/sup\u003e to the TGNC Spanish population and provide validity evidence. To that purpose, first, the items were translated and adapted into Spanish. Second, the items of the original version and the internal consistency reliability were examined. Third, the factorial structure of the instrument was examined through Exploratory Factor Analysis (EFA) and Confirmatory Factor Analysis (CFA) to provide evidence of internal validity. Then, the correlations between TIS, self-esteem, and body image were analyzed to test external validity. Finally, the reliability of the internal consistency of the Spanish final version was examined.\u003c/p\u003e"},{"header":"Materials and methods","content":"\u003cp\u003eThis research satisfies the ethical requirements following the principles reflected in the Declaration of Helsinki in 2013 and the Organic Law on Protection of Personal Data and Guarantee of Digital Rights 3/2018 to ensure that the study complies with the legal, methodological, and ethical aspects of investigations that involve interventions in human beings. This study was previously approved by the Ethics Committee of the Universidad Loyola Andaluc\u0026iacute;a.\u003c/p\u003e\n\u003cp\u003eThis is a quantitative, cross-sectional, and psychometric study designed to adapt and validate a psychological measurement instrument. It was conducted between September and December of 2023. \u0026nbsp;\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cem\u003eParticipants\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003eThe sample consisted of 207 TGNC Spanish adults aged between 18 and 63 years (\u003cem\u003eM\u003c/em\u003e = 25.11, \u003cem\u003eSD\u003c/em\u003e = 8.16). 35.7% identified themselves as transgender men, 15.9% as transgender women, 23.7% as transsexual men, 9.7% as transsexual women, and 15% as nonbinary TGNC people. Table 1 presents the sociodemographic characteristics of the sample.\u003cem\u003e\u0026nbsp;\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eInstruments\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eSociodemographic questionnaire. It includes \u003cem\u003ead hoc\u003c/em\u003e items about sex assigned at birth, self-identification/gender identity, nationality, age, work, studies, socioeconomic status, completion of the transition, the vital moment in which the transition took place, psychological care received, and sexual orientation.\u003c/p\u003e\n\u003cp\u003eTransgender Identity Survey (TIS).\u003csup\u003e17\u003c/sup\u003e As previously commented, the original version consists of 26 items regarding feelings in the past three months about the TGNC identity. It uses a 7-point Likert-type scale (from 1 = totally disagree to 7 = totally agree). Higher scores indicate a higher level of internalized transphobia.\u003c/p\u003e\n\u003cp\u003eRosenberg\u0026rsquo;s Self-esteem Scale.\u003csup\u003e23,25\u003c/sup\u003e It is composed of 10 items that evaluate feelings of satisfaction about themselves. It uses a 4-point Likert-type scale (1 = strongly agree, 4 = strongly disagree). Higher scores indicate a higher level of self-esteem. In the present study, internal consistency Cronbach\u0026rsquo;s alpha value was .89.\u003c/p\u003e\n\u003cp\u003eBody Appreciation Scale-2 (BAS-2).\u003csup\u003e26,27\u003c/sup\u003e It consists of 10 items that evaluate perceptions of body image. It uses a 5-point Likert-type scale (from 1 = never to 5 = always). Higher scores indicate a more positive perception of self-body image. In the present study, Cronbach\u0026rsquo;s alpha value was .95.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eProcedure\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThree professionals translated into Spanish the original TIS scale. It was evaluated by two experts of British nationality fluent in both English and Spanish who carried out the reverse translation. Then, a pilot study was carried out in which six TGNC people participated. They were asked for their opinions about understanding each item, whether the content was inclusive and any aspect that generated confusion. The adaptation was presented to a committee of four sexologists who offered their comments and suggested possible improvements. After the requested corrections, the Spanish version of the TIS was obtained.\u003c/p\u003e\n\u003cp\u003eThe sample was evaluated with an online survey using the Qualtrics platform. The recruitment was carried out through contact with associations of TGNC people, disseminating the research survey among their members and key informants. The snowball sampling allowed contact through social networks. The questionnaire included informed consent with information about the study, confidentiality, voluntariness, anonymity, and data protection. We confirmed that informed participant consent was obtained. There were no compensations for participation. \u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eData analysis\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eFirst, items analysis and reliability of the Spanish adaptation of the 26-item original TIS were carried out. The scale\u0026apos;s internal consistency was analyzed considering Cronbach\u0026apos;s alpha value, the alpha when each item was eliminated, and the correlation between the items and the total scale. Furthermore, the McDonald\u0026rsquo;s omega value was calculated.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eSecond, validity evidence based on the internal structure of the scale was analyzed by conducting Exploratory Factor Analysis (EFA) and Confirmatory Factor Analysis (CFA). The following indices were considered: Chi-square (\u0026chi;\u0026sup2;), Comparative Fit Index (CFI), Goodness of Fit Index (GFI) (acceptable fit when CFI, GFI \u0026gt; .85; good fit \u0026gt; .90), Root Mean Square Error of Approximation (RMSEA) and Standardized Root Mean-Square Residual (SRMR) (acceptable fit when RMSEA \u0026lt;.10; good fit\u0026nbsp;when\u0026nbsp;RMSEA, SRMR \u0026lt; .06).\u003csup\u003e28-30\u003c/sup\u003e The robust maximum likelihood method was used. Items analysis and reliability of the obtained version were examined. Finally, correlations between TIS, self-esteem, and perception of body image were examined for the total sample and for subsamples based on gender self-identification.\u0026nbsp;\u003c/p\u003e"},{"header":"Results","content":"\u003cp\u003eHigh mean scores were observed in the total score of the adapted version of 26 items of the TIS (\u003cem\u003eM\u003c/em\u003e = 119.25, \u003cem\u003eSD\u003c/em\u003e = 22.21, min. 29 \u0026ndash; max. 161), that is, the presence of high levels of TI in the sample. The initial Spanish version of the TIS presented adequate reliability values (\u0026alpha; = .87). The McDonald\u0026rsquo;s omega for the 26-item scale was .88. The results showed that the reliability of the scale increased when items 1, 12, and 24 were eliminated (\u0026alpha;-i = .88). By eliminating these items, at this time of the study, the scale was composed of 23 items (see Table 2).\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eTo verify whether the structure of the data on the scale was adequate for its factorial analysis, the Kaiser‒Meyer‒Olkin test (KMO = .88) and the significance of the Bartlett test of sphericity (\u003cem\u003ep\u003c/em\u003e \u0026lt;. 001) were considered. The EFA provided the existence of five dimensions on the scale. The factor loadings of each item in these factors suggested eliminating items 5, 6, 9, and 26 because they loaded in two different factors, and the difference between the loads was \u0026lt;.15. At this step, one of the factors was removed. The distribution of the remaining 19 items was as follows: Factor 1: 2, 3, 4, 8, 10, 11, 13, 14, 15, 16, 17, 18, 20, 21 and 23; Factor 2: 19 and 25. Factor 3: 22; and Factor 4: 7. Following previous recommendations,\u003csup\u003e31\u003c/sup\u003e we decided to eliminate factors 2, 3, and 4 due to the small number of items included and because they were not well determined and might affect the stability of the final factorial solution.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eThus, the final TIS scale was a reduced version comprising 15 items (2, 3, 4, 8, 10, 11, 13, 14, 15, 16, 17, 18, 20, 21, and 23) and belonging to one dimension (see Table 3). The indices from the CFA showed that the reduced version of the TIS had an acceptable fit: ꭓ\u003csup\u003e2\u003c/sup\u003e = 250.11, \u003cem\u003ep\u003c/em\u003e \u0026lt; .001; CFI = .86; GFI = .96; RMSEA = .09 (.07-.10); SRMR = .06.\u003c/p\u003e\n\u003cp\u003eThe 15 items of the Spanish version of the TIS were answered using the entire 7-point Likert-type response scale (from a minimum of 1 to a maximum of 7), indicating that these response options are adequate. The highest mean scores were observed for items 12 (\u003cem\u003eM\u003c/em\u003e = 5.59) and 8 (\u003cem\u003eM\u003c/em\u003e = 5.51). Item 10 obtained the lowest mean score (\u003cem\u003eM\u003c/em\u003e = 3.7). We also considered skewness and kurtosis (see Table 2). High mean total scores were observed for the Spanish 15-item version (\u003cem\u003eM\u003c/em\u003e = 73.20, SD = 17.76, min. 15 \u0026ndash; max. 105). Furthermore, this reduced version presented good reliability values; Cronbach\u0026rsquo;s alpha was .890, and McDonald\u0026rsquo;s omega was .892.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eThe scores of the Spanish version of the TIS for the total sample were correlated with self-esteem (\u003cem\u003er\u003c/em\u003e = .47 and \u003cem\u003ep\u003c/em\u003e \u0026lt;.001) and body image (\u003cem\u003er\u003c/em\u003e =.47 and \u003cem\u003ep\u003c/em\u003e \u0026lt;.001), providing evidence of convergent validity (see Table 4). Also, significant differences were found (\u003cem\u003ep\u003c/em\u003e = 0.009) in the levels of self-esteem between the self-identification of gender identity reported by transsexual men (\u003cem\u003eM\u003c/em\u003e = 30.53; \u003cem\u003eSD\u003c/em\u003e = 5.40) and transsexual women (\u003cem\u003eM\u003c/em\u003e = 31.70; \u003cem\u003eSD\u003c/em\u003e = 7.55). Thus, we decided to analyze the correlations by subsamples according to this gender self-identification. Positive and significant correlations were found between TIS and self-esteem in all groups except for transgender women (Table 4).\u0026nbsp;\u003c/p\u003e"},{"header":"Discussion","content":"\u003cp\u003eThe main objective of the present study was to adapt and validate the Transgender Identity Survey (TIS)\u003csup\u003e\u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e\u003c/sup\u003e in the TGNC Spanish population to provide a comprehensive assessment of internalized transphobia. Findings showed that the obtained Spanish version of the TIS has adequate reliability and validity evidence.\u003c/p\u003e\u003cp\u003eThe Spanish version of the TIS reduced the scale from the original. The psychometric analysis yielded a reduced version composed of 15 out of the 26 original items, clustered into one dimension. The total score ranges between 15 and 105 points, which could be interpreted as the minimum and maximum level of internalized transphobia (see Appendix 1).\u003c/p\u003e\u003cp\u003eAlthough there are differences in the internal structure of the instrument when comparing the Spanish version with the US original version, being the adapted scale shorter than the original created by Bockting et al.,\u003csup\u003e\u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e\u003c/sup\u003e both versions have demonstrated good psychometric properties. The specific sociodemographic characteristics of the sample and possible cultural differences between countries may influence the perceptions of transphobia\u003csup\u003e\u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e\u003c/sup\u003e and support the differences.\u003c/p\u003e\u003cp\u003eRegarding the internal consistency of the scale, the unidimensional structure shows adequate reliability considering Cronbach\u0026rsquo;s alpha and McDonald\u0026rsquo;s omega values (.89). These indices are similar to those reported for the original structure (.90).\u003c/p\u003e\u003cp\u003eRegarding evidence of convergent validity, contrary to expectations, and surprisingly, TIS was positively associated with self-esteem and body image. Internalized transphobia is a reality that can affect an important part of the TGNC collective today, evidenced by the high scores obtained by the Spanish version of the TIS scale. It is well established that members of oppressed or minority groups often receive negative social messages that minimize, devalue, or denigrate their identities.\u003csup\u003e\u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e,\u003cspan citationid=\"CR32\" class=\"CitationRef\"\u003e32\u003c/span\u003e,\u003cspan citationid=\"CR33\" class=\"CitationRef\"\u003e33\u003c/span\u003e\u003c/sup\u003e Several authors\u003csup\u003e\u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e19\u003c/span\u003e,\u003cspan citationid=\"CR22\" class=\"CitationRef\"\u003e22\u003c/span\u003e,\u003cspan citationid=\"CR34\" class=\"CitationRef\"\u003e34\u003c/span\u003e,\u003cspan citationid=\"CR35\" class=\"CitationRef\"\u003e35\u003c/span\u003e\u003c/sup\u003e have pointed out the importance of and relationship between self-esteem and body image in TGNC identities.\u003c/p\u003e\u003cp\u003eThe results of self-esteem should be interpreted with caution because, as indicated by Vosvik and Stem,\u003csup\u003e\u003cspan citationid=\"CR36\" class=\"CitationRef\"\u003e36\u003c/span\u003e\u003c/sup\u003e despite its popularity, research on self-esteem in LGTBIQA\u0026thinsp;+\u0026thinsp;populations is limited and shows contradictory results.\u003csup\u003e\u003cspan citationid=\"CR37\" class=\"CitationRef\"\u003e37\u003c/span\u003e,\u003cspan citationid=\"CR38\" class=\"CitationRef\"\u003e38\u003c/span\u003e\u003c/sup\u003e This may be partly due to the diversity of identities and forms of expression within the TGNC population, which could explain our results.\u003csup\u003e\u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e20\u003c/span\u003e\u003c/sup\u003e In general, self-esteem in studies of TGNC people has focused on variables, including social support,\u003csup\u003e\u003cspan additionalcitationids=\"CR40\" citationid=\"CR39\" class=\"CitationRef\"\u003e39\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR41\" class=\"CitationRef\"\u003e41\u003c/span\u003e\u003c/sup\u003e and belonging to the TGNC community. In this sense, the feeling of belonging to the community moderates the impact that one's status has on self-esteem, psychosocial functioning, and well-being.\u003csup\u003e\u003cspan citationid=\"CR42\" class=\"CitationRef\"\u003e42\u003c/span\u003e\u003c/sup\u003e\u003c/p\u003e\u003cp\u003eThus, it has been suggested that when dealing with minority stress, a connection with other individuals stigmatized by the same characteristic is a protective factor.\u003csup\u003e\u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e20\u003c/span\u003e,\u003cspan citationid=\"CR43\" class=\"CitationRef\"\u003e43\u003c/span\u003e\u003c/sup\u003e Therefore, belonging to the TGNC community implies a greater perception of social support and the possibility of living one's identity in a tolerant and respectful environment,\u003csup\u003e\u003cspan citationid=\"CR44\" class=\"CitationRef\"\u003e44\u003c/span\u003e,\u003cspan citationid=\"CR45\" class=\"CitationRef\"\u003e45\u003c/span\u003e\u003c/sup\u003e aspects that contribute to pleasing self-esteem. It should be remembered that the participants in the present study were contacted through associations and snowball sampling, which means that the participants were mostly part of the TGNC community.\u003c/p\u003e\u003cp\u003eRegarding the social discrimination experienced by TGNC people, transgender women suffer the highest rates of discrimination and victimization.\u003csup\u003e\u003cspan citationid=\"CR35\" class=\"CitationRef\"\u003e35\u003c/span\u003e\u003c/sup\u003e This fact could explain why we found positive correlations and significance between TIS and self-esteem in all groups except the group of transgender women. Finally, Tabaac et al.\u003csup\u003e\u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e21\u003c/span\u003e\u003c/sup\u003e point out that self-esteem and body image are closely related, so when one increases or decreases, the other variable behaves similarly.\u003c/p\u003e\u003cp\u003eThus, in TGNC identities, studies indicate that body image and its relationship with self-esteem is mediated by physical changes (e.g., hormonal or reassignment surgery) that would allow them to \"pass\" socially as a cisgender person, that is, without a physical appearance that betrays their TGNC identity.\u003csup\u003e\u003cspan citationid=\"CR46\" class=\"CitationRef\"\u003e46\u003c/span\u003e,\u003cspan citationid=\"CR47\" class=\"CitationRef\"\u003e47\u003c/span\u003e\u003c/sup\u003e Thus, self-esteem will improve as the perception of their body image adjusts to what is socially expected for a cisgender person.\u003c/p\u003e\u003cp\u003e\u003cb\u003eLimitations and Future Research\u003c/b\u003e\u003c/p\u003e\u003cp\u003eSome limitations have been identified in this study. Quota sampling is a non-probabilistic sampling method, therefore the extent to which the results can be generalized is modest. Data were collected online, which made it difficult to control variables such as social desirability that may have influenced the responses. The terminology used for recruiting the sample may have different connotations for individuals. Alternative terms for gender identification were advertised (transgender man, transgender woman, transsexual man, transsexual woman, and non-binary TGNC people); however, these identities are not equally represented within our sample.\u003c/p\u003e\u003cp\u003eAlso, the specific sociodemographic characteristics of the sample could affect the findings, again, the generalization of the results to the general population should be done with caution. Finally, some indices from CFA were not as good as expected to confirm the fit of the unidimensional model obtained.\u003c/p\u003e\u003cp\u003eFuture research should replicate this study in larger samples to support the adapted version of the TIS obtained. Using different samples for AFE and CFA could improve the results. Other data analyses, such as measurement invariance, could provide more information about the validity evidence of the instrument. Furthermore, future research should consider other sociodemographic characteristics as well as psychological variables as factors that could affect the construct of internalized transphobia.\u003c/p\u003e"},{"header":"Conclusions","content":"\u003cp\u003eThe Spanish version of the TIS provides a valuable tool for understanding and addressing the extent to which TGNC people have internalized societal prejudice and discrimination in Spanish-speaking contexts. By offering a culturally specific and validated measure, it facilitates research and intervention to promote self-acceptance and psychological well-being within this population. This scale not only contributes to generating knowledge about internalized transphobia at a national level but also serves as a crucial resource for improving clinical care and community support for TGNC individuals in Spanish-speaking countries.\u003c/p\u003e"},{"header":"Declarations","content":"\u003cp\u003e\u003cstrong\u003eAcknowledgments\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eWe would like to thank all the participants who generously contributed their time and effort to this study. We are deeply grateful for your participation.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAuthor Contribution Statement\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eIB: data curation; formal analysis; writing \u0026ndash; original draft\u003c/p\u003e\n\u003cp\u003eAIAR: conceptualization; formal analysis; writing \u0026ndash; review and editing\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eLE: conceptualization; formal analysis; writing \u0026ndash; review and editing\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eFunding\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eNo funding was received.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eEthical Approval\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThis study was previously approved by the Ethics Committee of the Universidad Loyola Andaluc\u0026iacute;a.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eCompeting Interests\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eNo competing potential or actual, financial, or other interests exist.\u0026nbsp;\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\n \u003cli\u003eCampbell M, Hinton JDX, Anderson JR. 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Impacts of strong parental support for trans youth: A report prepared for Children\u0026apos;s Aid Society of Toronto and Delisle Youth Services. Ontario: Trans Pulse; 2012; pp. 1-5. Available from: https://transpulseproject.ca/wp-content/uploads/2012/10/Impacts-of-Strong-Parental-Support-for-Trans-Youth-vFINAL.pdf [Last accessed: December 14, 2023]\u003c/li\u003e\n \u003cli\u003eHealy KZ. Internalized Transphobia, Minority Stress, and Collective Self-Esteem. Diss. The Ohio State University, 2011.\u003c/li\u003e\n \u003cli\u003eTesta RJ, Habarth J, Peta J, et al. Development of the gender minority stress and resilience measure. Psychol Sex Orientat Gend Divers 2015;2(1):65\u0026ndash;77. https://doi.org/10.1037/sgd0000081\u003c/li\u003e\n \u003cli\u003eSingh AA, Hays DG, Watson LS. Strength in the face of adversity: Resilience strategies of transgender individuals. J Couns Dev 2011;89(1):20\u0026ndash;27. https://doi.org/10.1002/j.1556-6678.2011.tb00057.x\u003c/li\u003e\n \u003cli\u003eFrost DM, Meyer IH. Measuring community connectedness among diverse sexual minority populations. J Sex Res 2012;49(1):36\u0026ndash;49. https://doi.org/10.1080/00224499.2011.565427\u003c/li\u003e\n \u003cli\u003eOwen-Smith AA, Gerth J, Sineath RC, et al. Association between gender confirmation treatments and perceived gender congruence, body image satisfaction, and mental health in a cohort of transgender individuals. J Sex Med 2018;15(4):591\u0026ndash;600. https://doi.org/10.1016/j.jsxm.2018.01.017\u003c/li\u003e\n \u003cli\u003evan de Grift TC, Cohen-Kettenis PT, Steensma TD, et al. Body satisfaction and physical appearance in gender dysphoria. Arch Sex Behav 2016;45(3):575\u0026ndash;585. https://doi.org/10.1007/s10508-015-0614-1\u003c/li\u003e\n\u003c/ol\u003e"},{"header":"Tables","content":"\u003cp\u003e\u003cstrong\u003eTable 1\u0026nbsp;\u003c/strong\u003e\u003cem\u003eSociodemographic characteristics of the sample.\u0026nbsp;\u003c/em\u003e\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\" width=\"120%\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 443px;\"\u003e\n \u003cp\u003eVariables\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 64px;\"\u003e\n \u003cp\u003e\u003cem\u003en\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 59px;\"\u003e\n \u003cp\u003e%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 443px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eSex assigned at birth\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003eFemale\u003c/p\u003e\n \u003cp\u003eMale\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 64px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e165\u003c/p\u003e\n \u003cp\u003e62\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 59px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e70.05\u003c/p\u003e\n \u003cp\u003e29.95\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 443px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eOccupation\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003eEmployment\u003c/p\u003e\n \u003cp\u003eUnavailable\u003c/p\u003e\n \u003cp\u003eUnemployment\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 64px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e79\u003c/p\u003e\n \u003cp\u003e97\u003c/p\u003e\n \u003cp\u003e31\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 59px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e38.16\u003c/p\u003e\n \u003cp\u003e46.86\u003c/p\u003e\n \u003cp\u003e14.98\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 443px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eStudies\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003eNo qualification\u003c/p\u003e\n \u003cp\u003ePrimary\u003c/p\u003e\n \u003cp\u003eLower secondary\u003c/p\u003e\n \u003cp\u003eUpper secondary\u003c/p\u003e\n \u003cp\u003eUniversity\u003c/p\u003e\n \u003cp\u003ePost-secondary non-tertiary education\u003c/p\u003e\n \u003cp\u003eShort-cycle tertiary education\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 64px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e6\u003c/p\u003e\n \u003cp\u003e8\u003c/p\u003e\n \u003cp\u003e32\u003c/p\u003e\n \u003cp\u003e38\u003c/p\u003e\n \u003cp\u003e71\u003c/p\u003e\n \u003cp\u003e21\u003c/p\u003e\n \u003cp\u003e31\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 59px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e2.90\u003c/p\u003e\n \u003cp\u003e3.86\u003c/p\u003e\n \u003cp\u003e15.45\u003c/p\u003e\n \u003cp\u003e18.35\u003c/p\u003e\n \u003cp\u003e34.30\u003c/p\u003e\n \u003cp\u003e10.14\u003c/p\u003e\n \u003cp\u003e15.00\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 443px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eSocioeconomic level\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003eHigh\u003c/p\u003e\n \u003cp\u003eMedium\u003c/p\u003e\n \u003cp\u003eLow\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 64px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e9\u003c/p\u003e\n \u003cp\u003e126\u003c/p\u003e\n \u003cp\u003e72\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 59px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e4.35\u003c/p\u003e\n \u003cp\u003e60.87\u003c/p\u003e\n \u003cp\u003e34.78\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 443px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eTransitioning\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 64px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e183\u003c/p\u003e\n \u003cp\u003e24\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 59px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e88.41\u003c/p\u003e\n \u003cp\u003e11.59\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 443px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eInitiation of the transition\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003eChildhood\u003c/p\u003e\n \u003cp\u003eAdolescence\u003c/p\u003e\n \u003cp\u003eAdulthood\u003c/p\u003e\n \u003cp\u003eNo reported\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 64px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e5\u003c/p\u003e\n \u003cp\u003e92\u003c/p\u003e\n \u003cp\u003e86\u003c/p\u003e\n \u003cp\u003e24\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 59px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e2.42\u003c/p\u003e\n \u003cp\u003e44.44\u003c/p\u003e\n \u003cp\u003e41.55\u003c/p\u003e\n \u003cp\u003e11.59\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 443px;\"\u003e\n \u003cp\u003e\u003cstrong\u003ePreviously psychology therapy\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 64px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e144\u003c/p\u003e\n \u003cp\u003e63\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 59px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e69.57\u003c/p\u003e\n \u003cp\u003e30.43\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 443px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eSexual orientation\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003eExclusively heterosexual\u003c/p\u003e\n \u003cp\u003ePredominantly heterosexual, only incidentally homosexual\u003c/p\u003e\n \u003cp\u003ePredominantly heterosexual, but more than incidentally homosexual\u003c/p\u003e\n \u003cp\u003eBisexual, equally heterosexual and homosexual\u003c/p\u003e\n \u003cp\u003ePredominantly homosexual, but more than incidentally heterosexual\u003c/p\u003e\n \u003cp\u003ePredominantly homosexual, only incidentally heterosexual\u003c/p\u003e\n \u003cp\u003eExclusively homosexual\u003c/p\u003e\n \u003cp\u003eAsexual\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 64px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e69\u003c/p\u003e\n \u003cp\u003e27\u003c/p\u003e\n \u003cp\u003e6\u003c/p\u003e\n \u003cp\u003e60\u003c/p\u003e\n \u003cp\u003e14\u003c/p\u003e\n \u003cp\u003e8\u003c/p\u003e\n \u003cp\u003e20\u003c/p\u003e\n \u003cp\u003e3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 59px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e33.33\u003c/p\u003e\n \u003cp\u003e13.05\u003c/p\u003e\n \u003cp\u003e2.90\u003c/p\u003e\n \u003cp\u003e28.99\u003c/p\u003e\n \u003cp\u003e6.76\u003c/p\u003e\n \u003cp\u003e3.86\u003c/p\u003e\n \u003cp\u003e9.66\u003c/p\u003e\n \u003cp\u003e1.45\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eTable 2\u0026nbsp;\u003c/strong\u003e\u003cem\u003eDescriptive statistics analysis of the Spanish 15-item version of the Transgender Identity Survey.\u003c/em\u003e\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\" width=\"120%\" class=\"fr-table-selection-hover\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 10px;\"\u003e\n \u003cp\u003eOriginal version\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 10px;\"\u003e\n \u003cp\u003eSpanish version\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 7px;\"\u003e\n \u003cp\u003e\u003cem\u003eM\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e\u003cem\u003eSD\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 10px;\"\u003e\n \u003cp\u003e\u003cem\u003eMin\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 11px;\"\u003e\n \u003cp\u003e\u003cem\u003eMax\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 12px;\"\u003e\n \u003cp\u003e\u003cem\u003eSkewness\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 12px;\"\u003e\n \u003cp\u003e\u003cem\u003eKurtosis\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e\u003cem\u003erit\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e\u003cem\u003e\u0026alpha;-i\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 10px;\"\u003e\n \u003cp\u003eTIS 1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 10px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 7px;\"\u003e\n \u003cp\u003e3.91\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e1.88\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 10px;\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 11px;\"\u003e\n \u003cp\u003e7\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 12px;\"\u003e\n \u003cp\u003e-.06\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 12px;\"\u003e\n \u003cp\u003e-.94\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e.14\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e.88\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 10px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eTIS 2\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 10px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e1\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 7px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e4.78\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e1.83\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 10px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e1\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 11px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e7\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 12px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e-.42\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 12px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e-.94\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e.54\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e.87\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 10px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eTIS 3\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 10px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e2\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 7px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e4.22\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e2.08\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 10px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e1\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 11px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e7\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 12px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e.09\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 12px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e-1.39\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e.61\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e.86\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 10px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eTIS 4\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 10px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e3\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 7px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e4.75\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e1.91\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 10px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e1\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 11px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e7\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 12px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e-.23\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 12px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e-1.26\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e.62\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e.86\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 10px;\"\u003e\n \u003cp\u003eTIS 5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 10px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 7px;\"\u003e\n \u003cp\u003e5.16\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e1.74\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 10px;\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 11px;\"\u003e\n \u003cp\u003e7\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 12px;\"\u003e\n \u003cp\u003e-.64\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 12px;\"\u003e\n \u003cp\u003e-.64\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e.37\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e.87\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 10px;\"\u003e\n \u003cp\u003eTIS 6\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 10px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 7px;\"\u003e\n \u003cp\u003e5.45\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e1.78\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 10px;\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 11px;\"\u003e\n \u003cp\u003e7\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 12px;\"\u003e\n \u003cp\u003e-1.00\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 12px;\"\u003e\n \u003cp\u003e-.20\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e.52\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e.87\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 10px;\"\u003e\n \u003cp\u003eTIS 7\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 10px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 7px;\"\u003e\n \u003cp\u003e3.25\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e1.70\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 10px;\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 11px;\"\u003e\n \u003cp\u003e7\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 12px;\"\u003e\n \u003cp\u003e.20\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 12px;\"\u003e\n \u003cp\u003e-.60\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e.34\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e.87\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 10px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eTIS 8\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 10px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e4\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 7px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e5.36\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e1.74\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 10px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e1\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 11px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e7\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 12px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e-.74\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 12px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e-.73\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e.74\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e.86\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 10px;\"\u003e\n \u003cp\u003eTIS 9\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 10px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 7px;\"\u003e\n \u003cp\u003e4.72\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e1.84\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 10px;\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 11px;\"\u003e\n \u003cp\u003e7\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 12px;\"\u003e\n \u003cp\u003e-.34\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 12px;\"\u003e\n \u003cp\u003e-.93\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e.42\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e.87\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 10px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eTIS 10\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 10px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e5\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 7px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e5.31\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e1.85\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 10px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e1\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 11px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e7\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 12px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e-.84\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 12px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e-.45\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e.50\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e.87\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 10px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eTIS 11\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 10px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e6\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 7px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e4.67\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e1.87\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 10px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e1\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 11px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e7\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 12px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e-.24\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 12px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e-1.14\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e.52\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e.87\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 10px;\"\u003e\n \u003cp\u003eTIS 12\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 10px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 7px;\"\u003e\n \u003cp\u003e3.86\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e1.89\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 10px;\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 11px;\"\u003e\n \u003cp\u003e7\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 12px;\"\u003e\n \u003cp\u003e-.03\u003c/p\u003e\n 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\u003cp\u003e\u003cstrong\u003e1\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 11px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e7\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 12px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e-.74\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 12px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e-.30\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e.39\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e.87\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 10px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eTIS 14\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 10px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e8\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 7px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e5.51\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e1.65\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 10px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e1\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 11px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e7\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 12px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e-.92\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 12px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e-.21\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e.56\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e.87\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 10px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eTIS 15\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 10px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e9\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 7px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e5.03\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e1.93\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 10px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e1\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 11px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e7\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 12px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e-.48\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 12px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e-1.29\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e.39\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e.87\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 10px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eTIS 16\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 10px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e10\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 7px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e3.70\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e2.14\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 10px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e1\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 11px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e7\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 12px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e.29\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 12px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e-1.31\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e.61\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e.86\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 10px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eTIS 17\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 10px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e11\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 7px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e4.67\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e1.99\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 10px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e1\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 11px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e7\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 12px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e-.31\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 12px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e-1.12\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e.55\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e.87\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 10px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eTIS 18\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 10px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e12\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 7px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e5.59\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e1.80\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 10px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e1\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 11px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e7\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 12px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e-1.05\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 12px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e-.31\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e.66\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e.86\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 10px;\"\u003e\n \u003cp\u003eTIS 19\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 10px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 7px;\"\u003e\n \u003cp\u003e5.61\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e1.51\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 10px;\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 11px;\"\u003e\n \u003cp\u003e7\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 12px;\"\u003e\n \u003cp\u003e-1.06\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 12px;\"\u003e\n \u003cp\u003e.64\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e.38\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e.87\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 10px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eTIS 20\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 10px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e13\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 7px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e4.57\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e2.00\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 10px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e1\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 11px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e7\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 12px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e-.21\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 12px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e-1.26\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e.38\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e.87\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 10px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eTIS 21\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 10px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e14\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 7px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e4.97\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e1.83\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 10px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e1\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 11px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e7\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 12px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e-.41\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 12px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e-1.15\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e.44\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e.87\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 10px;\"\u003e\n \u003cp\u003eTIS 22\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 10px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 7px;\"\u003e\n \u003cp\u003e5.05\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e1.85\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 10px;\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 11px;\"\u003e\n \u003cp\u003e7\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 12px;\"\u003e\n \u003cp\u003e-.70\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 12px;\"\u003e\n \u003cp\u003e-.65\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e.27\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e.87\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 10px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eTIS 23\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 10px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e15\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 7px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e4.74\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e2.00\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 10px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e1\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 11px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e7\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 12px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e-.32\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 12px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e-1.25\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e.59\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e.87\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 10px;\"\u003e\n \u003cp\u003eTIS 24\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 10px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 7px;\"\u003e\n \u003cp\u003e3.95\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e1.85\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 10px;\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 11px;\"\u003e\n \u003cp\u003e7\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 12px;\"\u003e\n \u003cp\u003e.06\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 12px;\"\u003e\n \u003cp\u003e-.82\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e.03\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e.88\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 10px;\"\u003e\n \u003cp\u003eTIS 25\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 10px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 7px;\"\u003e\n \u003cp\u003e4.28\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e1.68\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 10px;\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 11px;\"\u003e\n \u003cp\u003e7\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 12px;\"\u003e\n \u003cp\u003e-.23\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 12px;\"\u003e\n \u003cp\u003e-.65\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e.28\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e.87\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 10px;\"\u003e\n \u003cp\u003eTIS 26\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 10px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 7px;\"\u003e\n \u003cp\u003e5.48\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e1.56\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 10px;\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 11px;\"\u003e\n \u003cp\u003e7\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 12px;\"\u003e\n \u003cp\u003e-.96\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 12px;\"\u003e\n \u003cp\u003e.47\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e.29\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e.87\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e\u003cem\u003eNote.\u0026nbsp;\u003c/em\u003eItems from the 15-item Spanish version are in bold. \u003cem\u003eM\u003c/em\u003e: mean; \u003cem\u003eSD\u003c/em\u003e: Standard deviation;\u003cem\u003e\u0026nbsp;rit\u003c/em\u003e: item-total correlation; \u0026alpha;-i: Cronbach\u0026rsquo;s alpha if item deleted\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eTable 3\u0026nbsp;\u003c/strong\u003e\u003cem\u003eFactor loading of the items from the reduced 15-item Spanish version of the Transgender Identity Survey.\u003c/em\u003e\u003c/p\u003e\n\u003cdiv align=\"\"\u003e\n \u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 321px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eItems\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 274px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eFactor 1\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 321px;\"\u003e\n \u003cp\u003eTIS 1 (2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 274px;\"\u003e\n \u003cp\u003e.57\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 321px;\"\u003e\n \u003cp\u003eTIS 2 (3)\u003c/p\u003e\n \u003cp\u003eTIS 3 (4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 274px;\"\u003e\n \u003cp\u003e.68\u003c/p\u003e\n \u003cp\u003e.70\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 321px;\"\u003e\n \u003cp\u003eTIS 4 (8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 274px;\"\u003e\n \u003cp\u003e.80\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 321px;\"\u003e\n \u003cp\u003eTIS 5(10)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 274px;\"\u003e\n \u003cp\u003e.57\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 321px;\"\u003e\n \u003cp\u003eTIS 6(11)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 274px;\"\u003e\n \u003cp\u003e.62\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 321px;\"\u003e\n \u003cp\u003eTIS 7 (13)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 274px;\"\u003e\n \u003cp\u003e.47\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 321px;\"\u003e\n \u003cp\u003eTIS 8 (14)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 274px;\"\u003e\n \u003cp\u003e.64\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 321px;\"\u003e\n \u003cp\u003eTIS 9 (15)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 274px;\"\u003e\n \u003cp\u003e.48\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 321px;\"\u003e\n \u003cp\u003eTIS 10 (16)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 274px;\"\u003e\n \u003cp\u003e.69\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 321px;\"\u003e\n \u003cp\u003eTIS 11 (17)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 274px;\"\u003e\n \u003cp\u003e.65\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 321px;\"\u003e\n \u003cp\u003eTIS 12 (18)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 274px;\"\u003e\n \u003cp\u003e.71\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 321px;\"\u003e\n \u003cp\u003eTIS 13 (20)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 274px;\"\u003e\n \u003cp\u003e.48\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 321px;\"\u003e\n \u003cp\u003eTIS 14 (21)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 274px;\"\u003e\n \u003cp\u003e.52\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 321px;\"\u003e\n \u003cp\u003eTIS 15 (23)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 274px;\"\u003e\n \u003cp\u003e.67\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n \u003c/table\u003e\n\u003c/div\u003e\n\u003cp\u003e\u003cem\u003eNote\u003c/em\u003e. TIS = Transgender Identity Survey. Numbered items from the original version in brackets.\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eTable 4\u0026nbsp;\u003c/strong\u003e\u003cem\u003eCorrelation between Transgender Identity Survey, self-esteem and body image for the total sample and correlation between Transgender Identity Survey and self-esteem for subsamples based on self-identification of gender identity.\u003c/em\u003e\u003c/p\u003e\n\u003ctable border=\"0\" cellspacing=\"0\" cellpadding=\"0\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 91px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"6\" valign=\"top\" style=\"width: 473px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eTIS\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 91px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 58px;\"\u003e\n \u003cp\u003eTotal\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 94px;\"\u003e\n \u003cp\u003eTransgender man\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003eTrans man\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 92px;\"\u003e\n \u003cp\u003eTransgender woman\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 84px;\"\u003e\n \u003cp\u003eTrans woman\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 60px;\"\u003e\n \u003cp\u003eNon-binary\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 91px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eSelf-esteem\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 58px;\"\u003e\n \u003cp\u003e.47***\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 94px;\"\u003e\n \u003cp\u003e.51***\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e.51***\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 92px;\"\u003e\n \u003cp\u003e.33\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 84px;\"\u003e\n \u003cp\u003e.56*\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 60px;\"\u003e\n \u003cp\u003e.48**\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 91px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eBody image\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 58px;\"\u003e\n \u003cp\u003e.47***\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 94px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 92px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 84px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 60px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e\u003cem\u003eNote. ***p\u0026nbsp;\u003c/em\u003e\u0026lt; .001, \u003cem\u003e**p\u0026nbsp;\u003c/em\u003e\u0026lt; .01, \u003cem\u003e*p\u0026nbsp;\u003c/em\u003e\u0026lt; .05\u003cstrong\u003e\u003cbr\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":false,"highlight":"","institution":"","isAcceptedByJournal":true,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"international-journal-of-impotence-research","isNatureJournal":false,"hasQc":false,"allowDirectSubmit":false,"externalIdentity":"ijir","sideBox":"Learn more about [International Journal of Impotence Research](http://www.nature.com/ijir/)","snPcode":"41443","submissionUrl":"https://mts-ijir.nature.com/cgi-bin/main.plex","title":"International Journal of Impotence Research","twitterHandle":"","acdcEnabled":true,"dfaEnabled":true,"editorialSystem":"ejp","reportingPortfolio":"Nature AJ","inReviewEnabled":true,"inReviewRevisionsEnabled":false},"keywords":"internalized transphobia, TIS, TGNC, gender, identity, validation","lastPublishedDoi":"10.21203/rs.3.rs-7179752/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-7179752/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003eInternalized transphobia (IT) is the rejection that gender non-conforming people (TGNC) feel towards themselves because of the internalization of negative values, prejudices, and/or stereotypes that prevail in society. This study aimed to adapt and validate a Spanish version of the Transgender Identity Survey (TIS) to assess internalized transphobia in Spanish-speaking transgender and gender non-conforming (TGNC) individuals. The sample consisted of 207 TGNC Spanish-speaking adults who completed the TIS, along with measures of self-esteem and body image. Translation, adaptation, and validation analyses of the TIS were carried out. A reduced version of the original scale composed of 15 items in a one-dimension to assess internalized transphobia was obtained through Exploratory Factor Analysis (EFA). Validity evidence based on the internal structure was tested through Confirmatory Factor Analysis (CFA). The scale showed adequate reliability values (α\u0026thinsp;=\u0026thinsp;.890; Ω\u0026thinsp;=\u0026thinsp;.892). Correlations between TIS, self-esteem and body image reported convergent validity evidence. The Spanish version of the TIS provides a useful, reliable, and valid instrument for both research and clinical areas, supporting interventions aimed at reducing internalized stigma and promoting well-being and self-acceptance in the gender-diverse community.\u003c/p\u003e","manuscriptTitle":"Spanish Adaptation of a Measure of Internalized Transphobia: Validation of the Transgender Identity Survey","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2025-07-25 13:20:32","doi":"10.21203/rs.3.rs-7179752/v1","editorialEvents":[{"type":"communityComments","content":0},{"type":"decision","content":"revise","date":"2025-09-16T09:06:29+00:00","index":"","fulltext":""},{"type":"editorInvitedReview","content":"This content is not available.","date":"2025-08-18T10:34:15+00:00","index":2,"fulltext":"This content is not available."},{"type":"reviewerAgreed","content":"This content is not available.","date":"2025-08-17T10:04:15+00:00","index":2,"fulltext":"This content is not available."},{"type":"editorInvitedReview","content":"This content is not available.","date":"2025-08-12T10:27:33+00:00","index":1,"fulltext":"This content is not available."},{"type":"reviewerAgreed","content":"This content is not available.","date":"2025-07-31T10:11:11+00:00","index":1,"fulltext":"This content is not available."},{"type":"reviewersInvited","content":"","date":"2025-07-23T05:38:16+00:00","index":"","fulltext":""},{"type":"checksComplete","content":"","date":"2025-07-22T13:03:27+00:00","index":"","fulltext":""},{"type":"editorAssigned","content":"","date":"2025-07-21T17:02:39+00:00","index":"","fulltext":""},{"type":"submitted","content":"International Journal of Impotence Research","date":"2025-07-21T17:02:39+00:00","index":"","fulltext":""}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"international-journal-of-impotence-research","isNatureJournal":false,"hasQc":false,"allowDirectSubmit":false,"externalIdentity":"ijir","sideBox":"Learn more about [International Journal of Impotence Research](http://www.nature.com/ijir/)","snPcode":"41443","submissionUrl":"https://mts-ijir.nature.com/cgi-bin/main.plex","title":"International Journal of Impotence Research","twitterHandle":"","acdcEnabled":true,"dfaEnabled":true,"editorialSystem":"ejp","reportingPortfolio":"Nature AJ","inReviewEnabled":true,"inReviewRevisionsEnabled":false}}],"origin":"","ownerIdentity":"86328474-1f15-468b-81ff-4408277ac6be","owner":[],"postedDate":"July 25th, 2025","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"published-in-journal","subjectAreas":[{"id":52124958,"name":"Biological sciences/Psychology/Human behaviour"},{"id":52124959,"name":"Health sciences/Health care/Quality of life"}],"tags":[],"updatedAt":"2026-02-12T08:11:27+00:00","versionOfRecord":{"articleIdentity":"rs-7179752","link":"https://doi.org/10.1038/s41443-026-01238-3","journal":{"identity":"international-journal-of-impotence-research","isVorOnly":false,"title":"International Journal of Impotence Research"},"publishedOn":"2026-02-11 05:00:00","publishedOnDateReadable":"February 11th, 2026"},"versionCreatedAt":"2025-07-25 13:20:32","video":"","vorDoi":"10.1038/s41443-026-01238-3","vorDoiUrl":"https://doi.org/10.1038/s41443-026-01238-3","workflowStages":[]},"version":"v1","identity":"rs-7179752","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-7179752","identity":"rs-7179752","version":["v1"]},"buildId":"8U1c8b4HqxoKbykW_rLl7","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}