Enhancing Scholarship Focused on Trans People and Issues

Abstract

Scholarship about lesbian, gay, bisexual, and transgender (LGBT) people and issues has been growing. However, trans issues are often overlooked or addressed only nominally in this literature, leading to calls for further focused attention to trans people and issues. In a series of articles, this Major Contribution addresses such calls by (a) providing a content analysis of scholarship about trans people and issues, (b) discussing methodological considerations and strategies for conducting research with trans populations, and (c) presenting an empirical study that addresses how intersecting identities (e.g., ethnicity/race, sexual orientation, socioeconomic status) combine in relation to trans people’s mental health. This article provides a context for the Major Contribution and offers an overview of each of the component articles.

Keywords

transgender content analysis intersectionality research methods

The acronym LGBT, short for lesbian, gay, bisexual, and transgender (hereafter referred to as trans), is often used in psychological literature and other scholarship to capture a variety of identities and experiences associated with having a stigmatized sexual orientation or gender identity. To signal greater inclusiveness, the acronym has been expanded over the years to add B for bisexual, T for transgender, and more recently, Q for queer and questioning, and I for intersex (Moradi, Mohr, Worthington, & Fassinger, 2009; Parent, DeBlaere, & Moradi, 2013). Although the acronym has evolved, there are concerns that its expansion often reflects only nominal inclusion of some subpopulations, including trans people. Indeed, counseling psychologists have cautioned that the inclusion of T in the acronym must be accompanied by a substantive expansion of knowledge about trans people and issues (e.g., Fassinger & Arseneau, 2007; Moradi & DeBlaere, 2010; Moradi, DeBlaere, & Huang, 2010; Moradi et al., 2009). In a series of articles, this Major Contribution addresses this call by (a) providing a content analysis of scholarship about trans people and issues, (b) discussing methodological considerations for conducting research with trans populations, and (c) presenting an empirical study that addresses how intersecting identities (e.g., ethnicity/race, sexual orientation, socioeconomic status [SES]) relate to trans people’s mental health. Intersectionality, conceptualized here as attention to how privilege and oppression across multiple sociodemographic statuses or identities combine to shape people’s lives (e.g., Cole, 2009), is a theme attended to across the articles: It is coded among the content analysis topics, is addressed as a consideration in the methodology article, and is a focus of analysis in the empirical study.

Definitions and Context

The labels trans and the associated term cisgender reflect a continuing evolution of terminology. Specifically, cisgender is a term used to describe people whose gender identity and expression correspond with their assigned sex at birth, whereas trans has evolved as an umbrella term used to capture a variety of gender identities and expressions for people whose gender identity or expression is different from their assigned sex at birth (e.g., transgender, transsexual, male-to-female, female-to-male, genderqueer, gender nonconforming; for example, see Tebbe & Budge, 2016 [this issue]; Wernick, Kulick, & Inglehart, 2014). We use trans, rather than trans*, throughout this special issue. Trans*, used at times as an umbrella term, where the asterisk represents the variety of identities that may follow the trans stem (e.g., “transsexual,” “transgender,” etc.), is a term that has been used predominantly within academic circles; it is not one that was developed by trans communities themselves (Enke, 2012). Although we acknowledge that the articles in this Major Contribution are situated within an academic publication, our hope throughout this work is to align ourselves with trans communities—one small step of which is to use trans rather than the more academically derived trans*.

Conceptualizations of trans identities are grounded in definitions of sex, gender, gender identity, and gender expression. Sex refers to biological and anatomical characteristics, typically used to assign people at birth to categories of female, male, or intersex. Gender is the social meaning or package of expectations that a culture assigns to each sex. Gender identity is a person’s sense of self as a female/woman, male/man, or a person with a nonbinary or other gender identity (e.g., genderqueer). Gender expression involves ways of communicating gender within a cultural context, for example, through clothing, appearance, and behavior (Coleman et al., 2011). Sex, gender, gender identity, and gender expression are separate from, but foundational to, conceptualizations of sexual orientation which itself is multidimensional (e.g., behavioral, emotional, relational, self-identification dimensions) and captures the sex(es) or gender(s) of people to whom one is attracted (American Psychological Association [APA], 2012). Readers interested in learning about more specific terms and labels commonly related to trans identities can find online sources, such as www.transequality.org, where the most up-to-date terms and definitions can be readily found.

Understanding of the concepts of gender identity and expression, and trans identities and experiences, has increased in recent years. This is in part because the voices of trans people have been gaining visibility in public discourse and popular culture. For example, the public transition of Chaz Bono, the celebrity author, activist, and son of Sonny and Cher, received notable media coverage (Bono & Fitzpatrick, 2011). In 2012, Kylar Broadus, founder of the Trans People of Color Coalition, became the first trans person to testify before Congress (Towsend, 2012). In February 2014, Janet Mock, journalist and activist, published her memoir describing her identity process, criticizing the concepts of “realness” and gender (Mock, 2014). In May 2014, Laverne Cox, actress and activist, became the first trans person to be featured on the cover of TIME magazine and to be nominated for an Emmy (Machlitt, 2014). Finally, Caitlyn Jenner introduced herself to the world through her Vanity Fair cover, “Call me Caitlyn” (Bissinger, 2015), breaking records on Twitter for numbers of followers, and making her arguably the most famous transgender person to date (Tanzer, 2015). Many of these voices also explicitly address the intersections of gender identity and expression with class, ethnicity, race, and other sociodemographic dimensions of privilege and oppression.

Along with such milestones, trans civil rights advocacy and a number of legal precedents have paved the way for nondiscrimination protections for trans people. These include the lifting of requirements to document surgical interventions to update gender markers on documents issued by federal government agencies (e.g., State Department, Social Security Administration, Veteran’s Administration), as well as extensions of Titles VII and IX of the Civil Rights Act to trans people in federal employment and educational settings (Molloy, 2014). It is important to note, however, that 32 states do not yet include trans people in nondiscrimination legislation, and people in these states may be terminated from jobs in the private sector merely for being trans (Transgender Law Center, 2014).

Despite some progress, trans people continue to experience discrimination at extremely high rates (e.g., Clements-Nolle, Marx, & Katz, 2006; Grant et al., 2011). For example, in a study with trans people in the San Francisco Bay Area, 59% of participants reported experiencing rape, 36% reported physical victimization (e.g., being abused or beaten), 83% reported verbal discrimination (e.g., verbal abuse or harassment), and 62% reported other forms of discrimination (e.g., being fired, evicted or denied housing, denied access to health care services) based on their gender identity (Clements-Nolle et al., 2006). Similar patterns emerged in a national survey of 6,450 trans respondents in which rates of exposure to harassment ranged from 19% to 61% across educational, housing, employment, and health care settings. Trans people’s experiences of discrimination and violence have been associated with adverse mental health outcomes, including psychological distress, substance use, and suicide (e.g., Bockting, Miner, Romine, Hamilton, & Coleman, 2013; Clements-Nolle et al., 2006; Goldblum et al., 2012; Nemoto, Bödecker, & Iwamoto, 2011; Nuttbrock et al., 2010; Testa et al., 2012; Xavier, Bobbin, Singer, & Budd, 2005).

In the context of growing public attention to trans people and issues, some advancements in trans civil rights, and continued high rates of discrimination and violence against trans people, counseling psychologists can play a critical role in producing scholarship, delivering health care, and engaging in advocacy to meet the needs of trans people. Indeed, Guidelines for Psychological Practice With Transgender and Gender Nonconforming People (APA, 2015) were adopted by the APA Council of Representatives at the Annual Convention of the APA in August, 2015. We hope to promote and support ongoing engagement of counseling psychologists with trans communities with this Major Contribution.

Specific Goals of the Major Contribution

This Major Contribution has three primary goals, addressed with three articles. The first goal is to elucidate the current state of empirical and nonempirical psychosocial literature on trans people and issues and to identify needed directions for advancement. We conceptualize psychosocial broadly to include topics related to intrapersonal and/or social variables (e.g., identities, health, relationships, work). This goal is addressed in the article, “A Content Analysis of Literature on Trans People and Issues: 2002-2012” (Moradi et al., 2016 [this issue]). Most prior content analyses of scholarship on LGBT issues and populations do not focus specifically on trans people or issues (e.g., Huang et al., 2010; Phillips, Ingram, Smith, & Mindes, 2003; Singh & Shelton, 2011). A few content analyses included some attention to trans people or issues, and findings from these analyses underscore the relatively limited trans focus in the literature (e.g., Blumer, Green, Knowles, & Williams, 2012; Boehmer, 2002). Building on such prior analyses, the present content analysis provides an empirical analysis of the content of literature published between 2002 and 2012, on psychosocial topics about trans people and issues. Specifically, this analysis codifies topics, methodologies, and subgroups (e.g., trans men, trans women, genderqueer people) that are represented in the literature, as well as topics, methodologies, and subgroups that are underrepresented. As such, findings from this study can provide a map of the current landscape of psychosocial knowledge about trans people and issues for scholars, practitioners, and advocates to draw from, and these findings will delineate areas that need further attention and development.

The article, “Research With Trans Communities: Applying a Process-Oriented Approach to Methodological Considerations and Research Recommendations,” provides readers with tools to critically consider decisions related to conducting research with trans populations (Tebbe & Budge, 2016). Based on findings from the content analysis, we provide methodological considerations in the context of the current state of trans research. In this article, we begin by outlining historical and contemporary contexts that shaped our thinking and approach to writing. Pulling from a number of scholarly social justice frameworks (Fischer & DeBord, 2012; Goodman et al., 2004; Namaste, 2009), we articulate our own critical framework for research with trans populations. We discuss considerations for participant recruitment and sampling strategies, including effective use of language in recruitment materials, selection of research venues, and strategies for recruiting diverse trans samples. We also discuss considerations related to research methods and design, including issues related to measurement. We finish by discussing dissemination of study results. Overall, this article raises a number of important issues to reflect upon in research with trans populations, and it also provides readers with tools for adapting their decision making in a variety of situations.

The third and final goal of this Major Contribution is to present an empirical study that addresses a relatively understudied topic in trans scholarship in ways that exemplify some of the recommendations from the other articles in the Major Contribution. The article, “The Intersection of Race, Sexual Orientation, Socioeconomic Status, Trans Identity, and Mental Health Outcomes,” presents the results of a study with 442 trans individuals residing across the United States (Budge, Thai, Tebbe, & Howard, 2016 [this issue]). The aim of this study is to determine how intersecting sociodemographic identity markers (e.g., trans identity, race/ethnicity, SES, education, and sexual orientation) predict mental health concerns. This study provides readers with a broader understanding of the multiple identity statuses that trans people hold and how these identities may combine in association with psychological distress. As such, findings from this study can inform future research and also guide clinical practice that attends to the experiences and identities of trans people.

Summary

This set of Major Contribution articles addresses calls for more focused and substantive attention to trans people’s experiences. Specifically, the content analysis elucidates the current state of psychosocial literature about trans people and issues and identifies needed methodological and topic advancements. The methodological article offers tools for reflecting upon and making decisions throughout the process of conducting research with trans populations. The empirical study provides data regarding how intersecting sociodemographic statuses relate to trans people’s mental health concerns.

Collectively, these articles can contribute to expanding the breadth of counseling psychologists’ competencies in research, practice, and social justice advocacy with trans people in several ways. The content analysis and methodological article can guide further research and training that inform clinical practice and advocacy with trans populations. Specifically, these articles can orient readers to the topics and methodologies reflected in the literature, help them to critically examine their research questions and processes, and guide them to consider options and approaches that will enhance their work and address the needs of trans populations. The empirical article provides data that can inform clinical practice and training directly. Specifically, findings yield important implications to assist therapists in focusing on trans clients holistically, while also being able to attend to stress that may result from multiple minority statuses. We hope that this Major Contribution encourages counseling psychologists to engage in producing scholarship, delivering health care, and engaging in advocacy that gives substantive attention to, and meets the needs of, trans people.

Footnotes

Declaration of Conflicting Interests

The authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Funding

The authors received no financial support for the research, authorship, and/or publication of this article.

Author Biographies

Elliot A. Tebbe is an assistant professor of counseling psychology in the Department of Educational Psychology at the University of Nebraska–Lincoln. His research focuses primarily on identity and sociocultural factors related to health and well-being in marginalized groups. Much of his research to date has centered on issues related to sexual minority and trans and gender nonconforming populations.

Bonnie Moradi is a professor of psychology and director of the Center for Women’s Studies and Gender Research at the University of Florida. She has received a number of honors, including the Distinguished Scientific Contribution Award from the APA Society for the Psychological Study of LGBT Issues (2015), the Florence Denmark Distinguished Mentoring Award from the Association for Women in Psychology (2012), and the Leadership Award for Scholarship from the APA Committee on Women in Psychology (2010). Her research focuses on experiences of prejudice, discrimination, and objectification, as well as collective identity.

Stephanie L. Budge is a visiting assistant professor in counseling psychology at the University of Wisconsin–Madison. Her research interests include trans individuals’ emotional and coping processes, as well as positive psychological experiences and resilience. She has practiced pscyhology with LGBTQ clients since 2006 and also trains therapists on the use of affirmative psychotherapy with LGBTQ clients.

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