Development and validation of novel measures of gender minority stress for transgender and nonbinary people

Transgender and nonbinary (TNB) people experience various minority stressors, such as discrimination, which have significant effects on mental health. Even so, most of the existing literature about TNB people's experiences of minority stress has utilized models that were developed for cisgender sexual minorities, resulting in a need for measure development.

We drew on data from recent research describing unique forms of gender minority stress and developed eight new measures assessing TNB vigilance, gender strain, misgendering, foreshortened TNB futures, vicarious gender minority stress frequency, vicarious gender minority stress response, transitioning identity stress, and body/gender policing. We used an iterative process where we developed items from in-depth qualitative data, conducted cognitive interviews (N = 30), gathered feedback from a community advisory board, and integrated suggestions from a panel of researchers with expertise in TNB health. To validate the newly developed minority stress measures, data were then gathered (N = 854) via an online survey and from a panel company, with a split sample for the exploratory and confirmatory factor analyses. All data were collected in the U.S.

Results provided evidence of content, structural, convergent, discriminant, criterion, and incremental validity for all scales. Measurement invariance analyses showed that the measures are valid for use with TNB people diverse in gender and racial/ethnic identities.

These newly developed scales provide the means to measure novel forms of minority stress that TNB people have described in past research, but which are not captured by existing cisgender focused models and measures of minority stress.