Louis Lindley

Emerging research suggests that transnormativity plays an important role in the lives and mental health of transgender and/or nonbinary (TNB) people. Transnormativity encompasses the norms and standards by which the legitimacy of TNB peoples’ gender identities and expressions are measured. This study examined the mediating and moderating role of internalized transnormativity in the association between two forms of gender dysphoria (physical and social) and psychological distress. A sample of TNB adults between the ages of 18 and 65 (N = 472; 202 trans women, 108 trans men, and 162 nonbinary individuals) completed an online survey. Mediation and moderation analyses were then conducted to explore the role of internalized transnormativity within the association between: (1) physical gender dysphoria and psychological distress and (2) social gender dysphoria and psychological distress. Internalized transnormativity partially mediated, but did not moderate, the association between physical or social gender dysphoria and psychological distress. For physical gender dysphoria, this mediation followed a typical pattern, where higher levels of physical gender dysphoria predicted more psychological distress through higher internalized transnormativity. In contrast, the mediation involving social gender dysphoria reflected a suppression effect: higher social gender dysphoria was linked to lower internalized transnormativity, which itself was associated with greater psychological distress. This reduction in transnormativity functioned as a protective pathway, dampening the observed relationship between social gender dysphoria and psychological distress. As little quantitative literature on transnormativity exists, the results of this study provide novel insights into the influence transnormativity may exert on the mental health of TNB people.

Background: There is a notable lack of psychotherapeutic services tailored to the needs of Two Spirit, transgender, and nonbinary (2STNB) people of color; research indicates that 2STNB clients who are people of color report a lack of competence and cultural humility on the part of their therapists. Objective: The purpose of this study was to report the feasibility and acceptability of the Healing Through Ongoing Psychological Empowerment (HOPE) teletherapy intervention using deductive content analysis. Methods: We used an open clinical trial design (testing one intervention without a comparison group) to test the feasibility and acceptability of the HOPE intervention. At baseline, 51 clients were enrolled in the open clinical trial, with 49 2STNB clients who are people of color starting and completing the HOPE intervention. Clients were recruited primarily from social media and therapist waitlists. Clients completed up to 15 free face-to-face telehealth psychotherapy sessions that were provided by nine 2STNB therapists who are people of color. Feasibility and acceptability interviews were conducted prior to the intervention, immediately following the intervention, and at 6 months after completing the intervention. Results: The HOPE intervention demonstrated high feasibility and acceptability, specifically regarding data collection, psychometric adequacy, interventionist recruitment or training or retention, delivery of the intervention, acceptability of the intervention to clients, and client engagement with the intervention. Conclusions: These findings propose HOPE as a potentially feasible, culturally specific therapeutic approach for the 2STNB community who are people of color. Future randomized controlled trials comparing HOPE to existing evidence-based treatments are needed.

Cis-heteronormative frameworks have inadequately addressed the complexity of trans masculine, nonbinary, and agender (TMNB) individuals' sexual attitudes, beliefs, behaviors, and experiences, often marginalizing these perspectives. To fully capture the richness of TMNB sexuality, it is essential for researchers to resist the constraints of cis-heteronormativity by employing participatory research methods that center TMNB voices and lived realities. This participatory study engaged directly with TMNB communities to identify their priorities in sex research. The study sample included 298 participants with diverse gender identities, including trans masculine (52.68%), nonbinary (36.91%), and agender (10.40%). Thematic analysis of participant responses revealed 13 key themes: (1) pleasurability of sexual experiences, (2) interpersonal dynamics of sex, (3) complex impacts of gender dysphoria, (4) intersectionality of sexual experiences, (5) gendered dynamics of sexual experiences, (6) negative societal influences, (7) impacts of sexual trauma on sexuality, (8) relationships between healthcare and sexuality, (9) lack of prior sexual experiences, (10) nuances of asexuality, (11) engagement with technology, (12) reflections on universal versus diverse experiences, and (13) communication to researchers about the study. These findings underscore the necessity for research approaches that are intersectional, individualized, and attuned to the diverse realities of TMNB sexual lives.

In response to negative media attention regarding gender affirming medical interventions (GAMI), the current manuscript explores the content of messages trans and nonbinary (TNB) individuals receive regarding the impacts of GAMI on gender dysphoria. Further, TNB individuals’ experiences of the effects of GAMI on gender dysphoria are described. A sample of responses from 105 TNB participants were analyzed utilizing qualitative content analysis. These qualitative results revealed that the messages participants received were split between trans negative and trans affirming aspects. Relatedly, participants’ experiences also reflected a dichotomy between current limitations and positive impacts of GAMI on gender dysphoria. The discussion focuses on how participants’ positive experiences with GAMI, which resulted in decreased gender dysphoria and psychological distress, challenge the current political discourse that attempts to ban GAMI. Clinical implications focus on how to translate the current findings regarding the limitations of GAMI into more fully informed consent processes.