Patterns of Pronoun Affirmation Across Social Contexts and Opportunities for Resilience Among Trans and Nonbinary...

This study examined chosen pronoun affirmation across multiple social contexts (i.e., home, online school, in-person school, work, friends, and extended family) as a predictor of mental health among 319 trans and nonbinary (TNB) youth (ages: 13-22; M_age = 18.6, SD = 2.18). Pronoun affirmation is increasingly restricted, particularly in schools, as part of widespread anti-trans legislation in the U.S. Guided by an integration of resilience, minority stress, and intersectionality frameworks, this study used a person-centered approach (i.e., latent class analysis), identifying three distinct affirmation classes: predominantly friends affirmation (27.3%), non-familial affirmation (55.8%), and comprehensive affirmation (16.9%). Transmasculine youth were more likely to be represented in comprehensive affirmation, while nonbinary youth were less likely to be represented in the comprehensive affirmation class. Compared to youth in the predominantly friends affirmation class, youth in non-familial affirmation and comprehensive affirmation classes reported significantly lower depressive and anxiety symptoms, better future outlook, and lower odds of suicide thoughts. In variable-centered analyses, home affirmation was associated with fewer depressive and anxiety symptoms, online and in-person school affirmation was associated with all outcomes except suicide attempts, friend affirmation was similarly associated with all outcomes except suicide thoughts and attempts, and extended family affirmation was associated with lower depressive and anxiety symptoms and lower odds of suicide thoughts. Findings underscore the importance of pronoun affirmation across institutional, peer, and family contexts and carry direct implications for school policy, family-based interventions, and advocacy amid increasing legislative restrictions on gender-affirming practices.