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An integrated framework for conceptualizing and measuring gender dysphoria: Development and psychometric evaluation
M Paz Galupo1, Louis Lindley2, Zakary A Clements3
1Brown School of Social Work, Washington University in St. Louis.
Abstract:
The current article presents an integrated community-informed framework from which to conceptualize the complexity of gender dysphoria and the social context in which it is navigated. Our multidimensional model of gender dysphoria uses a systems-based approach to consider aspects of gender dysphoria that are experienced across individual, interpersonal, structural, and cultural levels. It is from this broad framework that we developed and conducted a psychometric evaluation of the Multidimensional Gender Dysphoria Measure (MGDM). Measure items were developed around five hypothesized subscales with input from content experts and refined through cognitive interviews. The initial 83 items were administered to 599 transgender and nonbinary participants (53.76% people of color) who endorsed diverse gender identities (i.e., 41.1% nonbinary, 24.5% women, and 34.4% men). Exploratory factor analysis revealed a five-factor structure that was upheld during confirmatory factor analysis, representing (a) body gender dysphoria, (b) social gender dysphoria, (c) variability of gender dysphoria, (d) gender dysphoria relief, and (e) internalized gender normativity. The final 25-item scale was found to be invariant across gender, race, and assigned sex, allowing the MGDM to be used to make meaningful within-group comparisons that are not confounded by measurement error. Overall, the MGDM evidenced partial convergent, discriminant, and incremental predictive validity. The MGDM allows for a multidimensional conceptualization of gender dysphoria that is inclusive of both body and social components. Conceptually grounded in both gender normativity and gender minority stress theory, the MGDM can guide further research in these important areas of transgender and nonbinary health. (PsycInfo Database Record (c) 2026 APA, all rights reserved).
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