Minority stressors and protection factors in trans and non-binary individuals

Background: Minority stress theory explores the health impacts of stress on sexual and gender minorities. Its extensions recognize that transgender, non-binary, and gender-nonconforming individuals experience unique stressors beyond those faced by cisgender non-heterosexual people, including both distal and proximal stressors affecting their well-being. Aims: This study investigates factors contributing to high rates of psychological distress in transgender, non-binary, and gender-nonconforming (TGNC) individuals, focusing on minority stressors and sources of resilience. Methods: Using a sample of 250 TGNC (transgender: 20%; nonbinary: 33%; other identities: 9%) and cisgender (38%) individuals, we assessed the effects of distal (Perceived and Anticipated Discrimination) and proximal (Internalized Transphobia) minority stressors, alongside resilience factors (Social Support and Support for Gender/Sexual Identity), on symptoms of common mental disorders (SRQ-20 scores) and internalizing symptoms (IDAS-II scores). Data were analyzed using generalized linear models with moderated mediation. Results: TGNC participants exhibited higher SRQ-20 and IDAS-II scores compared to cisgender participants. Minority stressors mediated the relationship between gender identity and SRQ-20 and IDAS-II scores. While Social Support moderated the relationship between trans identity and both Anticipated Discrimination and Internalized Transphobia, its protective effect varied across gender identities. Support for Gender/Sexual Identity mitigated the impact of Internalized Transphobia in SRQ-20 and IDAS-II scores in TGNC individuals. Conclusion: TGNC individuals face elevated psychological distress due to unique stressors. The study highlights the need for targeted interventions that promote social and identity-based support, emphasizing the role of resilience factors in improving mental health outcomes.