Associate Professor University of Mary Washington Fredericksburg, Virginia
More than half of transgender and non-binary individuals (TNB) who experience sexual assault perceive that they were victimized because of their gender identity or expression. Though minority stress theory (Brooks, 1981; Meyer, 2003) postulates that mental and physical health disparities in minoritized communities stem from experiencing discrimination, rejection and violence related to stigmatized status, few prior studies on the TNB community have specifically evaluated the mental health impact of perceiving that their gender identity or expression was a contributing factor in their victimization. This study also considered whether proximal stressors, or internalized minority stress, served as parallel mediators in any observed association. Prolific was used to recruit 141 TNB participants (mean age = 25.99, SD = 7.15; 82.3% White), all of whom had experienced at least one sexual assault since the age of 14 years old. Participants completed an online survey of proximal stressors (i.e., internalized transphobia, non-disclosure of identity, negative expectations about the future), whether or not they perceived that their sexual victimization was because of their gender identity or expression (i.e., gender-based sexual assault), and depression, anxiety, and PTSD symptoms. Parallel mediation models were tested with Process and demonstrated (1) significant indirect effects whereby gender-based sexual assault was associated with greater depression symptoms via greater internalized transphobia (ab = 0.13, 95% CI [0.01, 0.29]) and negative expectations about the future (ab = 0.19, 95% CI [0.04, 0.36]); (2) a significant indirect effect whereby gender-based sexual assault was associated with greater anxiety symptoms via greater internalized transphobia (ab = 0.17, 95% CI [0.04, 0.36]); and (3) a significant indirect effect whereby gender-based based sexual assault was associated with greater PTSD symptoms via greater negative expectations about the future (ab = 0.30, 95% CI [0.13, 0.48]). Therefore, gender-based sexual assault was associated with greater depression, anxiety and PTSD symptoms, and that heightened risk was partially due to internalized minority stress. These findings may inform assessment decisions when working with minoritized sexual assault survivors, including individuals who identify as TNB. The results also highlight that an understanding of minority stress theory may help providers more effectively deliver trauma-focused cognitive behavioral therapies when working with minoritized populations.
