2 - (SYM 50) Interoceptive Awareness, in Relation to Multiple Indicators of Distress Among Transgender and Nonbinary People: The Moderating Role of Gender Appearance Congruence and Gender-affirming Interventions

Transgender and non-binary (TNB) people are at higher risk for self-injurious thoughts and behaviors (SITBs) and psychological distress compared to cisgender heterosexual and sexual minority people (Surace et al., 2021). Interoception is the awareness of one’s body and bodily sensations (Mehling et al., 2012) and is thought to be adaptive with respect to psychological functioning. While there is evidence supporting a link between interoceptive difficulties, SITBs, depression, anxiety, and stress, there has been no research investigating this relationship among TNB people, despite embodiment experiences being central to experiences of gender dysphoria or euphoria among TNB people. Thus, we examined the relationship between interoception and SITBs, depression, anxiety, and stress in TNB adults (N=58) with past month SI who completed baseline measures followed by a three-week ecological momentary assessment (EMA) protocol. While interoceptive awareness was not associated with lifetime suicide attempts (SA), past month NSSI, or EMA-reported SI or NSSI, depression, anxiety, and stress were all significantly positively correlated with interoception. We then tested whether transgender appearance congruence and gender-affirming medical care would moderate these associations. There was no evidence of moderation for most indices of psychological distress. However, gender appearance congruence and gender-affirming surgical interventions did moderate the relationship between lifetime SA and interoception. Specifically, lifetime SA was associated with higher interoception only for those with low gender appearance congruence or for those who had not accessed gender-affirming surgical interventions. The positive relationships between interoception and indicators of distress in this sample contradict previous research on interoception in cisgender samples, providing preliminary evidence that interoceptive awareness and related psychological difficulties may not function the same way among TNB people. These findings should be interpreted in light of the limited sample size but offer an important first step in examining the embodiment and sensorial experiences of TNB people related to SITBs and general distress.