The Gender Minority Stress and Resilience Measure: Psychometric Validity of an Adolescent Extension

Abstract

Objective: Minority stress contributes to several physical and psychological problems in sexual and gender minorities but is largely understudied in transgender/gender-nonconforming (TGNC) individuals, particularly TGNC adolescents. The availability of psychometrically sound measures of adolescent minority stress can help improve assessment and treatment planning in this area. This original research study examined whether an existing measure of TGNC-related minority stress and resilience among adults could retain construct and psychometric validity when administered to TGNC adolescents. Method: Respondents were 258 TGNC adolescents, aged 12 to 17.99 years (M = 15.1, SD = 1.4), majority White/European American (70.2%) and assigned female at birth (71.7%) seeking care in an interdisciplinary gender-health clinic within a pediatric academic medical center in the Midwestern United States. Respondents completed a battery of clinical measures as standard of care, including the Gender Minority Stress and Resilience (GMSR) measure, measures of anxiety and depressive symptoms, and parental support. Results: Findings indicated that minor adaptation of the existing adult measure resulted in high internal consistency and construct validity across 9 subscales assessing domains of minority stress and resilience in this sample of TGNC adolescents. Conclusions: This study provides evidence of the factor structure, reliability, and validity of an adolescent extension of the GMSR (i.e., GMSR-A). These findings demonstrate the clinical utility of the GMSR-A, a tool that can help increase understanding of minority stress and resilience phenomena experienced by TGNC adolescents.

Implications for Impact Statement

The findings from this research study show that mental health clinicians can adequately assess gender minority stress and resilience among transgender/gender-nonconforming (TGNC) adolescents by using a slightly modified version of an existing measure originally created for TGNC adults.

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References

Adelson

S. L.

American Academy of Child and Adolescent Psychiatry (AACAP) Committee on Quality Issues (CQI) . (2012). Practice parameter on gay, lesbian, or bisexual sexual orientation, gender nonconformity, and gender discordance in children and adolescents. Journal of the American Academy of Child & Adolescent Psychiatry, 51, 957–974. 10.1016/j.jaac.2012.07.004

Brennan

S. L.

Irwin

Drincic

Amoura

N. J.

Randall

Smith-Sallans

(2017). Relationship among gender-related stress, resilience factors, and mental health in a Midwestern U.S. transgender and gender-nonconforming population. International Journal of Transgenderism, 18, 433–445. 10.1080/15532739.2017.1365034

Chen

Hidalgo

M. A.

Leibowitz

Leininger

Simons

L. K.

Finlayson

Garofalo

(2016). Multidisciplinary care for gender-diverse youth: A narrative review and unique model of gender-affirming care. Transgender Health, 1, 117–123.

Dawson

A. E.

Wymbs

B. T.

Gidycz

C. A.

Pride

Figueroa

(2017). Exploring rates of transgender individuals and mental health concerns in an online sample. International Journal of Transgenderism, 18, 295–304. 10.1080/15532739.2017.1314797

de Vries

A. L.

Doreleijers

T. A.

Steensma

T. D.

Cohen-Kettenis

P. T.

(2011). Psychiatric comorbidity in gender dysphoric adolescents. Journal of Child Psychology and Psychiatry, 52, 1195–1202. 10.1111/j.1469-7610.2011.02426.x

Fuller

K. A.

Riggs

D. W.

(2018). Family support and discrimination and their relationship to psychological distress and resilience amongst transgender people. International Journal of Transgenderism, 19, 379–388. 10.1080/15532739.2018.1500966

Gadow

K. D.

Sprafkin

(2016). The Youth’s Inventory-4 screening manual. Stony Brook, NY: Checkmate Plus.

Grant

J. M.

Mottet

L. A.

Tanis

Harrison

Herman

J. L.

Keisling

(2011). Injustice at every turn: A report of the National Transgender Discrimination Survey. Retrieved from http://transequality.org/pPDFs/NTDS_Report.pdf

Grossman

A. H.

D’Augelli

A. R.

(2007). Transgender youth and life-threatening behaviors. Suicide and Life-Threatening Behavior, 37, 527–537. 10.1521/suli.2007.37.5.527

10.

Hatzenbuehler

M. L.

(2009). How does sexual minority stigma “get under the skin”? A psychological mediation framework. Psychological Bulletin, 135, 707–730. 10.1037/a0016441

11.

Hatzenbuehler

M. L.

Pachankis

J. E.

(2016). Stigma and minority stress as social determinants of health among lesbian, gay, bisexual, and transgender youth: Research evidence and clinical implications. Pediatric Clinics, 63, 985–997.

12.

Hidalgo

M. A.

Chen

Garofalo

Forbes

(2017). Perceived parental attitudes of gender expansiveness: Development and preliminary factor structure of a self-report youth questionnaire. Transgender Health, 2, 180–187. 10.1089/trgh.2017.0036

13.

Hidalgo

M. A.

Ehrensaft

Tishelman

A. C.

Clark

L. F.

Garofalo

Rosenthal

S. M.

. . . Olson

(2013). The gender affirmative model: What we know and what we aim to learn. Human Development, 56, 285–290.

14.

Holmbeck

G. N.

Devine

K. A.

(2009). Editorial: An author’s checklist for measure development and validation manuscripts. Journal of Pediatric Psychology, 34, 691–696. 10.1093/jpepsy/jsp046

15.

Human Rights Campaign . (2018). 2018 LGBTQ youth report. Retrieved from https://assets2.hrc.org/files/assets/resources/2018-YouthReport-0514-Final.pdf

16.

Keo-Meier

C. L.

Fitzgerald

K. M.

(2017). Affirmative psychological testing and neurocognitive assessment with transgender adults. Psychiatric Clinics of North America, 40, 51–64. 10.1016/j.psc.2016.10.011

17.

Mays

V. M.

Cochran

S. D.

(2001). Mental health correlates of perceived discrimination among lesbian, gay, and bisexual adults in the United States. American Journal of Public Health, 91, 1869–1876. 10.2105/AJPH.91.11.1869

18.

McDonald

R. P.

(1999). Test theory: A unified treatment. Mahwah, NJ: Erlbaum.

19.

Meyer

I. H.

(1995). Minority stress and mental health in gay men. Journal of Health and Social Behavior, 36, 38–56. 10.2307/2137286

20.

Meyer

I. H.

(2003). Prejudice, social stress, and mental health in lesbian, gay, and bisexual populations: Conceptual issues and research evidence. Psychological Bulletin, 129, 674–697. 10.1037/0033-2909.129.5.674

21.

Meyer

I. H.

(2015). Resilience in the study of minority stress and health of sexual and gender minorities. Psychology of Sexual Orientation and Gender Diversity, 2, 209–213. 10.1037/sgd0000132

22.

Muthén

L. K.

Muthén

B. O.

(1998–2017). Mplus user’s guide. Los Angeles, CA: Author.

23.

Newcomb

M. E.

Mustanski

(2010). Internalized homophobia and internalizing mental health problems: A meta-analytic review. Clinical Psychology Review, 30, 1019–1029. 10.1016/j.cpr.2010.07.003

24.

Reisner

S. L.

Katz-Wise

S. L.

Gordon

A. R.

Corliss

H. L.

Austin

S. B.

(2016). Social epidemiology of depression and anxiety by gender identity. Journal of Adolescent Health, 59, 203–208. 10.1016/j.jadohealth.2016.04.006

25.

Reisner

S. L.

Vetters

Leclerc

Zaslow

Wolfrum

Shumer

Mimiaga

M. J.

(2015). Mental health of transgender youth in care at an adolescent urban community health center: A matched retrospective cohort study. Journal of Adolescent Health, 56, 274–279. 10.1016/j.jadohealth.2014.10.264

26.

Roberts

K. E.

Schwartz

Hart

T. A.

(2011). Social anxiety among lesbian, gay, bisexual, and transgender adolescents and young adults. In Alfano

& Beidel

(Eds.), Social anxiety disorder in adolescents and young adults: Translating developmental science into practice (pp. 161–181). Washington, DC: American Psychological Association. 10.1037/12315-009

27.

Russell

S. T.

Pollitt

A. M.

Grossman

A. H.

(2018). Chosen name use is linked to reduced depressive symptoms, suicidal ideation, and suicidal behavior among transgender youth. Journal of Adolescent Health, 63, 503–505. 10.1016/j.jadohealth.2018.02.003

28.

Schreiber

J. B.

Nora

Stage

F. K.

Barlow

E. A.

King

(2006). Reporting structural equation modeling and confirmatory factor analysis results: A review. The Journal of Educational Research, 99, 323–338. 10.3200/JOER.99.6.323-338

29.

Simons

Schrager

S. M.

Clark

L. F.

Belzer

Olson

(2013). Parental support and mental health among transgender adolescents. Journal of Adolescent Health, 53, 791–793. 10.1016/j.jadohealth.2013.07.019

30.

Stephenson

Metheny

Sharma

Sullivan

Riley

(2017).Providing home-based HIV testing and counseling for transgender youth (Project Moxie): Protocol for a pilot randomized controlled trial. JMIR Research Protocols, 6, e237. 10.2196/resprot.8562

31.

Testa

R. J.

Habarth

Peta

Balsam

Bockting

(2015). Development of the Gender Minority Stress and Resilience Measure. Psychology of Sexual Orientation and Gender Diversity, 2, 65–77. 10.1037/sgd0000081

32.

Traggiai

Stanhope

(2003). Disorders of pubertal development. Best Practice & Research Clinical Obstetrics & Gynaecology, 17, 41–56. 10.1053/ybeog.2003.0360

33.

Valentine

S. E.

Shipherd

J. C.

(2018). A systematic review of social stress and mental health among transgender and gender non-conforming people in the United States. Clinical Psychology Review, 66, 24–38. 10.1016/j.cpr.2018.03.003

34.

Ybarra

M. L.

Mitchell

K. J.

Palmer

N. A.

Reisner

S. L.

(2015). Online social support as a buffer against online and offline peer and sexual victimization among U.S. LGBT and non-LGBT youth. Child Abuse & Neglect, 39, 123–136. 10.1016/j.chiabu.2014.08.006

35.

Zimet

G. D.

Dahlem

N. W.

Zimet

S. G.

Farley

G. K.

(1988). The Multidimensional Scale of Perceived Social Support. Journal of Personality Assessment, 52, 30–41. 10.1207/s15327752jpa5201_2