(PS7-A12) Minority Stress and Physical Health Within the Transgender Community: The Impact of Posttraumatic Growth and Resiliency

Prior studies have consistently demonstrated that transgender and non-binary (TNB) individuals experience more mental and physical health difficulties than their cisgender peers (Downing et al., 2018; Hanna et al., 2019). The dominant theory used to explain these health disparities is the minority stress theory (Brooks, 1981; Meyer, 2003), which posits that distal stressors (or incidents related to one’s stigmatized status) are essential to understanding the health of minoritized communities. The theory also articulates that those external and objectively stressful incidents are then internalized, which is termed proximal stress. Although prior literature has demonstrated that both distal and proximal stress are associated with more difficulties in TNB individuals, an emerging literature is considering the influence of more general psychological processes (Hatzenbuehler, 2009) and positive psychology factors, including posttraumatic growth (PTG) and resiliency. Therefore, the purpose of the present study was to examine a serial mediation model whereby distal stress was hypothesized to be associated with physical health in TNB individuals serially via proximal stress and PTG. Resiliency was also examined as a potential moderator.

Prolific was used to recruit 266 TNB participants (mean age = 25.82, SD = 7.47; 83.1% White). Participants completed a 15 minute online survey of distal stress, proximal stress, PTG, resiliency, and physical health. They were compensated for their participation with $3.25. A serial mediation model was tested with the Process macro and demonstrated a significant indirect effect whereby greater distal stress was associated with worse physical health serially via greater proximal stress and lower PTG (ab = -0.03, 95% CI [-0.07, -0.01]; 17.0% of variance in physical health accounted for). In terms of resiliency as a moderator, moderated mediation was not supported; however, resiliency did moderate the direct association between distal stress and PTG (b = 0.16, p < .01), such that distal stress was negatively associated with PTG at low levels of resiliency and was not significantly related at moderate or high levels of resiliency.

Overall, the results were consistent with the hypothesis that greater distal stress would be associated with worse physical health via greater proximal stress and lower PTG. The hypothesis regarding resiliency as a moderator was also partially supported because the results revealed that greater distal stress was associated with lower PTG only at low levels of resiliency. In sum, the findings highlight several mechanisms that, if replicated in future research, could inform interventions for fostering greater well-being and promoting better mental and physical health in minoritized communities. Specifically, interventions that enhance hope (Feldman & Dreher, 2012) and self-compassion (Neff & McGehee, 2010) may be particularly promising avenues to support TNB individuals. This line of research should be of high priority for scholars given that TNB individuals face many barriers to seeking care because of systemic inequalities within the mental and physical health fields.