Publications
Dr. Jae Puckett and the Trans-ilience Research Team have contributed numerous publications related to transgender and gender diverse individuals' experiences with stress and resilience. Many of these projects are ongoing, so check back here to see what new publications the team has coming out.
DuBois, L. Z., SturtzSreetharan, C, MacFife, B., Puckett, J. A., Jagielski, A. Dunn, T., Anderson, T., Hope, D. A., Mocarski, R., Juster, R.P. (2022). Trans and gender diverse people’s experience wearing face masks during the COVID-19 Pandemic: Preliminary findings from data across 4 States in the U.S. Sexuality Research and Social Policy. https://doi.org/10.1007/s13178-022-00781-0
Abstract: Introduction: Social isolation and reduced access to public life in response to SARS-CoV-2 (COVID-19) challenges health and well-being for many. Marginalized communities, including transgender and gender diverse (TGD) people, have been dis-proportionally impacted. Experiences of TGD people should be centered in pandemic-related research to better inform policy. Methods: A diverse sample of TGD people (N = 158) were recruited from Michigan, Nebraska, Oregon, and Tennessee to participate in the Trans Resilience and Health Study. Participants ranged from 19 to 70 years old (M = 33.06; SD = 12.88) with 27.2% identifying as trans men/men, 26% identifying as trans women/women, and remaining identifying with terms like genderqueer and nonbinary. Thirty percent identified as people of color. Participants completed a monthly COVID-19-related questionnaire April 2020–March 2021 including open-ended questions to learn what contributed to resilience during this time. Thematic analyses of responses enabled identification of salient themes. Results: Analyses revealed pandemic-related changes in social experiences of marginalization and mask-wearing. Twenty-six participants mentioned face masks as contributing to resilience while also elaborating the influence of masks on experiences of misgendering. Participants identifying as trans women reported decreased misgendering while trans men and nonbinary participants reported increased misgendering. Conclusions and Policy Implications: Mask-wearing helps reduce transmission of COVID-19. For some trans women, masks also reduce the threat of misgendering and possibly other forms of enacted stigma. However, increased risk for misgendering, as noted by trans men in our study, should be considered and increased supports should be provided
Abstract: Introduction: Social isolation and reduced access to public life in response to SARS-CoV-2 (COVID-19) challenges health and well-being for many. Marginalized communities, including transgender and gender diverse (TGD) people, have been dis-proportionally impacted. Experiences of TGD people should be centered in pandemic-related research to better inform policy. Methods: A diverse sample of TGD people (N = 158) were recruited from Michigan, Nebraska, Oregon, and Tennessee to participate in the Trans Resilience and Health Study. Participants ranged from 19 to 70 years old (M = 33.06; SD = 12.88) with 27.2% identifying as trans men/men, 26% identifying as trans women/women, and remaining identifying with terms like genderqueer and nonbinary. Thirty percent identified as people of color. Participants completed a monthly COVID-19-related questionnaire April 2020–March 2021 including open-ended questions to learn what contributed to resilience during this time. Thematic analyses of responses enabled identification of salient themes. Results: Analyses revealed pandemic-related changes in social experiences of marginalization and mask-wearing. Twenty-six participants mentioned face masks as contributing to resilience while also elaborating the influence of masks on experiences of misgendering. Participants identifying as trans women reported decreased misgendering while trans men and nonbinary participants reported increased misgendering. Conclusions and Policy Implications: Mask-wearing helps reduce transmission of COVID-19. For some trans women, masks also reduce the threat of misgendering and possibly other forms of enacted stigma. However, increased risk for misgendering, as noted by trans men in our study, should be considered and increased supports should be provided.
Puckett, J. A., Giffel, R., Brown, F., Gallik, C., Kimball, D., Chu, H., Mustanski, B., & Newcomb, M. E. (2022). Suggestions for improving healthcare for transgender and gender diverse people in the United States. International Journal of Transgender Health. Advance online publication. https://doi.org/10.1080/26895269.2022.2150736
Abstract: Introduction: Social isolation and reduced access to public life in response to SARS-CoV-2 (COVID-19) challenges health and well-being for many. Marginalized communities, including transgender and gender diverse (TGD) people, have been dis-proportionally impacted. Experiences of TGD people should be centered in pandemic-related research to better inform policy. Methods: A diverse sample of TGD people (N = 158) were recruited from Michigan, Nebraska, Oregon, and Tennessee to participate in the Trans Resilience and Health Study. Participants ranged from 19 to 70 years old (M = 33.06; SD = 12.88) with 27.2% identifying as trans men/men, 26% identifying as trans women/women, and remaining identifying with terms like genderqueer and nonbinary. Thirty percent identified as people of color. Participants completed a monthly COVID-19-related questionnaire April 2020–March 2021 including open-ended questions to learn what contributed to resilience during this time. Thematic analyses of responses enabled identification of salient themes. Results: Analyses revealed pandemic-related changes in social experiences of marginalization and mask-wearing. Twenty-six participants mentioned face masks as contributing to resilience while also elaborating the influence of masks on experiences of misgendering. Participants identifying as trans women reported decreased misgendering while trans men and nonbinary participants reported increased misgendering. Conclusions and Policy Implications: Mask-wearing helps reduce transmission of COVID-19. For some trans women, masks also reduce the threat of misgendering and possibly other forms of enacted stigma. However, increased risk for misgendering, as noted by trans men in our study, should be considered and increased supports should be provided
Abstract: Introduction: Transgender and gender diverse (TGD) individuals face disproportionate barriers to accessing affirming healthcare, ranging from individual practitioners’ biases to financial constraints and societal-level cisnormativity. Method: This study identified suggestions for improving healthcare from 420 TGD individuals in the United States. Participants responded to an open-ended question about their suggestions for improving healthcare for TGD people. These responses were then coded using thematic analysis, resulting in 22 specific codes under 6 themes. Results: Results indicated a need for eliminating cisnormativity, taking a holistic approach with clients, adjusting conceptual frameworks for care, eliminating accessibility barriers, promoting affirmative interactions with TGD clients, and providing TGD-affirmative training for providers. Notably, these suggestions spanned from the broader, cultural level regarding general understandings of TGD people and gender to micro-level interactions. Conclusions: This study provides important tools for improving TGD care via a reduction of barriers and an increase in competency and affirmation.
Puckett, J. A., Domínguez, S., & Matsuno, E. (2022). Measures of resilience: Do they reflect the experiences of transgender individuals? Transgender Health. Advance online publication. https://doi-org.proxy1.cl.msu.edu/10.1089/trgh.2022.0015
Abstract: Introduction: Social isolation and reduced access to public life in response to SARS-CoV-2 (COVID-19) challenges health and well-being for many. Marginalized communities, including transgender and gender diverse (TGD) people, have been dis-proportionally impacted. Experiences of TGD people should be centered in pandemic-related research to better inform policy. Methods: A diverse sample of TGD people (N = 158) were recruited from Michigan, Nebraska, Oregon, and Tennessee to participate in the Trans Resilience and Health Study. Participants ranged from 19 to 70 years old (M = 33.06; SD = 12.88) with 27.2% identifying as trans men/men, 26% identifying as trans women/women, and remaining identifying with terms like genderqueer and nonbinary. Thirty percent identified as people of color. Participants completed a monthly COVID-19-related questionnaire April 2020–March 2021 including open-ended questions to learn what contributed to resilience during this time. Thematic analyses of responses enabled identification of salient themes. Results: Analyses revealed pandemic-related changes in social experiences of marginalization and mask-wearing. Twenty-six participants mentioned face masks as contributing to resilience while also elaborating the influence of masks on experiences of misgendering. Participants identifying as trans women reported decreased misgendering while trans men and nonbinary participants reported increased misgendering. Conclusions and Policy Implications: Mask-wearing helps reduce transmission of COVID-19. For some trans women, masks also reduce the threat of misgendering and possibly other forms of enacted stigma. However, increased risk for misgendering, as noted by trans men in our study, should be considered and increased supports should be provided
Abstract: Resilience is often viewed as the ability to bounce back from challenges. This conceptualization tends to be individualistic and can be less fitting for marginalized communities. Research with transgender and gender-diverse (TGD) individuals has shown that resilience can manifest in various ways, such as developing pride in one’s identity, connection to a TGD community, or advocating against oppression. Given these conflicting views, we sought to (1) describe common themes in TGD people’s experience of resilience by pooling information from qualitative research; and (2) evaluate how well quantitative measures of resilience reflected the ways that TGD people define resilience in qualitative research. We reviewed articles published from January 2010 to January 2020. Our search for research on resilience in TGD samples revealed 33 quantitative articles and 17 qualitative articles. We developed a codebook from the qualitative articles by retrieving information about themes from these past studies (e.g., developing motivation and agency, pride or positive self-image). We also reviewed the quantitative studies and retrieved the measures used to assess resilience, followed by coding these scales to understand whether the themes from the qualitative data were reflected in the quantitative measures of resilience. Overall, themes related to social support were common across the measures. However, other themes were not reflected in any measures, such as self-definition of gender, hope, and self-advocacy. Our research demonstrates the discrepancy between qualitative research on TGD resilience and quantitative measurement of resilience. Measure development that more fully reflects TGD people’s experiences is key to advancing this research.
Puckett, J. A., Huit, T. Z., Hope, D. A., Mocarski, R., Lash, B., Walker, T., Holt, N., Ralston, A. L., Miles, M., Capannola, A., Tipton, C., Juster, R. P., & DuBois, L. Z. (2022). Transgender and gender diverse people’s experiences of minority stress, mental health, and resilience in relation to sociopolitical contexts. Transgender Health. Advance online publication. https://doi-org.proxy1.cl.msu.edu/10.1089/trgh.2022.0047
Abstract: Introduction: Social isolation and reduced access to public life in response to SARS-CoV-2 (COVID-19) challenges health and well-being for many. Marginalized communities, including transgender and gender diverse (TGD) people, have been dis-proportionally impacted. Experiences of TGD people should be centered in pandemic-related research to better inform policy. Methods: A diverse sample of TGD people (N = 158) were recruited from Michigan, Nebraska, Oregon, and Tennessee to participate in the Trans Resilience and Health Study. Participants ranged from 19 to 70 years old (M = 33.06; SD = 12.88) with 27.2% identifying as trans men/men, 26% identifying as trans women/women, and remaining identifying with terms like genderqueer and nonbinary. Thirty percent identified as people of color. Participants completed a monthly COVID-19-related questionnaire April 2020–March 2021 including open-ended questions to learn what contributed to resilience during this time. Thematic analyses of responses enabled identification of salient themes. Results: Analyses revealed pandemic-related changes in social experiences of marginalization and mask-wearing. Twenty-six participants mentioned face masks as contributing to resilience while also elaborating the influence of masks on experiences of misgendering. Participants identifying as trans women reported decreased misgendering while trans men and nonbinary participants reported increased misgendering. Conclusions and Policy Implications: Mask-wearing helps reduce transmission of COVID-19. For some trans women, masks also reduce the threat of misgendering and possibly other forms of enacted stigma. However, increased risk for misgendering, as noted by trans men in our study, should be considered and increased supports should be provided
Abstract Purpose: The sociopolitical context in which transgender and gender-diverse (TGD) people live has significant effects on mental health. We examined whether perceptions of context (TGD people’s perceptions of how TGD people were viewed) differed across four United States (U.S.) states and associations with mental health and identity pride, the mediational effects of minority stressors, and potential buffering effects of resilience. Methods: TGD individuals in Oregon, Michigan, Nebraska, and Tennessee (n=158; ages 19–70, mean=33.06) completed questionnaires assessing their perceptions of how TGD people were viewed in their local area and in the U.S., as well as scales assessing minority stressors, pride, resilience, and mental health. Data were collected during Fall 2019 to Spring 2020. Results: Oregon participants viewed perceptions in their state the most positively, with no state-level differences in terms of broader U.S. perceptions. Tennessee participants experienced more expectations of rejection; however, there were no differences across the states in other minority stress variables, identity pride, resilience, ormental health. Participants who viewed their area as having more negative views of TGD people reported higher levels of discrimination, expectations of negative events, internalized stigma, and anxiety, as well as less pride. The effects of perceptions of local context on mental health were partially explained by enacted stigma and internalized stigma. Resilience did not buffer the effects of perceptions of the local context on mental health or pride. Conclusion: Context is important to shaping exposure to minority stressors and mental health, potentially through increasing enacted and internalized stigma.
Puckett, J. A., Holt, N. R., Lash, B., Huit, T. Z., Ralston, A. L., Hope, D. A., Mocarski, R., & DuBois, L. Z. (2022). Transgender and gender diverse adults’ self-reported mental health diagnoses, engagement in mental health services, and perceptions of therapists. Psychotherapy Research. Advance online publication. https://doi.org/10.1080/10503307.2022.2091961
Abstract: Introduction: Social isolation and reduced access to public life in response to SARS-CoV-2 (COVID-19) challenges health and well-being for many. Marginalized communities, including transgender and gender diverse (TGD) people, have been dis-proportionally impacted. Experiences of TGD people should be centered in pandemic-related research to better inform policy. Methods: A diverse sample of TGD people (N = 158) were recruited from Michigan, Nebraska, Oregon, and Tennessee to participate in the Trans Resilience and Health Study. Participants ranged from 19 to 70 years old (M = 33.06; SD = 12.88) with 27.2% identifying as trans men/men, 26% identifying as trans women/women, and remaining identifying with terms like genderqueer and nonbinary. Thirty percent identified as people of color. Participants completed a monthly COVID-19-related questionnaire April 2020–March 2021 including open-ended questions to learn what contributed to resilience during this time. Thematic analyses of responses enabled identification of salient themes. Results: Analyses revealed pandemic-related changes in social experiences of marginalization and mask-wearing. Twenty-six participants mentioned face masks as contributing to resilience while also elaborating the influence of masks on experiences of misgendering. Participants identifying as trans women reported decreased misgendering while trans men and nonbinary participants reported increased misgendering. Conclusions and Policy Implications: Mask-wearing helps reduce transmission of COVID-19. For some trans women, masks also reduce the threat of misgendering and possibly other forms of enacted stigma. However, increased risk for misgendering, as noted by trans men in our study, should be considered and increased supports should be provided
Abstract: Objective: Transgender and gender diverse (TGD) people face various challenges when seeking therapy. Given this, we wanted to understand more about TGD people’s perceptions of providers and how these compare to researcher ratings of providers on metrics of affirming practice. Method: The sample included 158 TGD adults (Mage= 33.06); 57.6% were in therapy. Participants completed measures about mental health, resilience, and therapy. We systematically coded provider websites and intake forms. Results: Participants in therapy were older, had higher depression, and lower resilience than participants not in therapy. Non-binary/genderqueer participants rated providers as less knowledgeable compared to trans feminine participants. Overall, participants appeared satisfied (71.4% extremely satisfied) and viewed providers as at least moderately knowledgeable (89.1%). Provider coding revealed variation across the markers ofaffirmation; 66.04% identified a TGD-specialty and only 26.42% shared provider pronouns. Higher frequency ofinclusivity (via coding) was related to higher ratings of provider knowledge and more of a focus on gender, however, there was not a significant association with satisfaction. Conclusions: Providers who engaged in more affirming practiceswere more knowledgeable compared to those who engaged in fewer affirming practices. This may influence the content of therapy and whether clients feel comfortable discussing gender.
Puckett, J. A., Hanson, C., Dunn, T., Kuehn, K., & DuBois, L. Z. (2022). An examination of predictors of prejudice against transgender individuals. Journal of Homosexuality. Advance online publication. https://doi-org.proxy1.cl.msu.edu/10.1080/00918369.2022.2131130
Abstract: Introduction: Social isolation and reduced access to public life in response to SARS-CoV-2 (COVID-19) challenges health and well-being for many. Marginalized communities, including transgender and gender diverse (TGD) people, have been dis-proportionally impacted. Experiences of TGD people should be centered in pandemic-related research to better inform policy. Methods: A diverse sample of TGD people (N = 158) were recruited from Michigan, Nebraska, Oregon, and Tennessee to participate in the Trans Resilience and Health Study. Participants ranged from 19 to 70 years old (M = 33.06; SD = 12.88) with 27.2% identifying as trans men/men, 26% identifying as trans women/women, and remaining identifying with terms like genderqueer and nonbinary. Thirty percent identified as people of color. Participants completed a monthly COVID-19-related questionnaire April 2020–March 2021 including open-ended questions to learn what contributed to resilience during this time. Thematic analyses of responses enabled identification of salient themes. Results: Analyses revealed pandemic-related changes in social experiences of marginalization and mask-wearing. Twenty-six participants mentioned face masks as contributing to resilience while also elaborating the influence of masks on experiences of misgendering. Participants identifying as trans women reported decreased misgendering while trans men and nonbinary participants reported increased misgendering. Conclusions and Policy Implications: Mask-wearing helps reduce transmission of COVID-19. For some trans women, masks also reduce the threat of misgendering and possibly other forms of enacted stigma. However, increased risk for misgendering, as noted by trans men in our study, should be considered and increased supports should be provided
Abstract: We examined associations between prejudice toward transgen-der people, aggression proneness, history of family violence, contact and closeness with transgender people, and education about issues that impact transgender individuals. We also examined the moderating effects of contact, education, and closeness on the relations between aggression and history of family violence with prejudice. There were 360 participants (M age = 31.34, SD = 12.47, range 18–75) who completed the survey online. Participants were recruited through social media, web-sites, and MTurk. Higher levels of aggression proneness were related to higher levels of prejudice. Higher levels of education about issues that impact transgender people and prior contact with a transgender person were associated with less prejudice. In a multiple regression analysis, the strongest predictor of prejudice was education about transgender people and topics. Moderation analyses revealed that prior contact may buffer the effects of aggression proneness on prejudiced beliefs.
Puckett, J. A., Price, S. F., Mocarski, R., Mustanski, B., & Newcomb, M. E. (2022). Transgender and gender diverse individuals’ daily experiences of rumination. American Journal of Orthopsychiatry, 9, 540-551. http://dx.doi.org/10.1037/ort0000636
Abstract: Introduction: Social isolation and reduced access to public life in response to SARS-CoV-2 (COVID-19) challenges health and well-being for many. Marginalized communities, including transgender and gender diverse (TGD) people, have been dis-proportionally impacted. Experiences of TGD people should be centered in pandemic-related research to better inform policy. Methods: A diverse sample of TGD people (N = 158) were recruited from Michigan, Nebraska, Oregon, and Tennessee to participate in the Trans Resilience and Health Study. Participants ranged from 19 to 70 years old (M = 33.06; SD = 12.88) with 27.2% identifying as trans men/men, 26% identifying as trans women/women, and remaining identifying with terms like genderqueer and nonbinary. Thirty percent identified as people of color. Participants completed a monthly COVID-19-related questionnaire April 2020–March 2021 including open-ended questions to learn what contributed to resilience during this time. Thematic analyses of responses enabled identification of salient themes. Results: Analyses revealed pandemic-related changes in social experiences of marginalization and mask-wearing. Twenty-six participants mentioned face masks as contributing to resilience while also elaborating the influence of masks on experiences of misgendering. Participants identifying as trans women reported decreased misgendering while trans men and nonbinary participants reported increased misgendering. Conclusions and Policy Implications: Mask-wearing helps reduce transmission of COVID-19. For some trans women, masks also reduce the threat of misgendering and possibly other forms of enacted stigma. However, increased risk for misgendering, as noted by trans men in our study, should be considered and increased supports should be provided
Abstract: Transgender and gender diverse (TGD) people face a myriad of daily stressors because of thehegemonic gender norms embedded within U.S. society. Due to these minority stressors, TGD people report elevated anxiety, depression, stress, and suicidality, among other health issues. One mechanism through which stigma may lead to these negative mental health outcomes is through increased rumination. In this intensive daily diary study with 181 TGD individuals (ages 16–40), we gathered qualitative data on their ruminative thoughts over the course of 56 days. There were a total of 2,431 responses across participants, with individuals providing arange of 1–53 responses (M=15 responses). Using an experiential framework and an inductive approach to thematic analysis, we generated the following themes: (a) interpersonal relationships as a site of struggle, (b) fear and worry in response to contextual factors, (c) the weight of basic needs and safety, (d) gender as experienced through self and others, (e) intersections ofhealth and rumination, and (f) the occasional reprieve. Using a deductive approach, we also placed these data within the context of Bronfenbrenner’s Person–Process–Context–Time model to provide a conceptual model for future research in this area. These ruminative experiences revealed significant adversities and challenges weighing on participants’ minds that spanned many areas of life. These findings also highlight the nuanced nature of rumination for TGD individuals and areas that may be overlooked in current assessments of this construct.
Puckett, J. A., Tornello, S., Mustanski, B., & Newcomb, M. E. (2022). Gender variations, generational effects, and mental health of transgender people in relation to timing and status of gender identity milestones. Psychology of Sexual Orientation and Gender Diversity, 9, 165-178. http://dx.doi.org/10.1037/sgd0000391
Abstract: Introduction: Social isolation and reduced access to public life in response to SARS-CoV-2 (COVID-19) challenges health and well-being for many. Marginalized communities, including transgender and gender diverse (TGD) people, have been dis-proportionally impacted. Experiences of TGD people should be centered in pandemic-related research to better inform policy. Methods: A diverse sample of TGD people (N = 158) were recruited from Michigan, Nebraska, Oregon, and Tennessee to participate in the Trans Resilience and Health Study. Participants ranged from 19 to 70 years old (M = 33.06; SD = 12.88) with 27.2% identifying as trans men/men, 26% identifying as trans women/women, and remaining identifying with terms like genderqueer and nonbinary. Thirty percent identified as people of color. Participants completed a monthly COVID-19-related questionnaire April 2020–March 2021 including open-ended questions to learn what contributed to resilience during this time. Thematic analyses of responses enabled identification of salient themes. Results: Analyses revealed pandemic-related changes in social experiences of marginalization and mask-wearing. Twenty-six participants mentioned face masks as contributing to resilience while also elaborating the influence of masks on experiences of misgendering. Participants identifying as trans women reported decreased misgendering while trans men and nonbinary participants reported increased misgendering. Conclusions and Policy Implications: Mask-wearing helps reduce transmission of COVID-19. For some trans women, masks also reduce the threat of misgendering and possibly other forms of enacted stigma. However, increased risk for misgendering, as noted by trans men in our study, should be considered and increased supports should be provided
Abstract: Transgender and gender diverse (TGD) people commonly report the following gender identity milestones: feeling different about their gender than expectations for their sex assigned at birth, identifying as TGD, living in their affirmed gender, and, for some, accessing gender-affirming medical care. We explored the average ages of reaching these milestones and variations across gender groups and generational cohorts. We also examined how gender groups, generational cohorts, and endorsement of reaching each of the milestones related to minority stress variables and mental health. This online study included 695 TGD individuals ages 16–73. Boomersand Generation X groups were more likely to identify as trans women compared with the younger generational cohorts, who were more varied in their identities. Trans women had later ages of starting to live in their affirmed gender and receiving gender affirming medical care compared with other gender groups. The Boomerscohort reported later ages for the milestones compared with other generational cohorts. And, finally, younger generational cohorts had higher levels of internalized stigma, anxiety, and depression, compared with the older cohorts. Gender congruence emerged as a consistent predictor of mental health in the full sample and within each generational cohort. There are important generational differences across identity milestones, minority stress, and mental health that need exploration in future longitudinal research. In addition, beyond the effects of milestone timing, reporting feelings of congruence with one’s gender identity is an important consideration for mental health.
Puckett, J. A., Aboussouan, A. B., Ralston, A. L., Mustanski, B., & Newcomb, M. E. (2021). Systems of cissexism and the daily production of stress for transgender and gender diverse people. International Journal of Transgender Health. Advanced online publication. https://doi.org/10.1080/26895269.2021.1937437
Abstract: Introduction: Social isolation and reduced access to public life in response to SARS-CoV-2 (COVID-19) challenges health and well-being for many. Marginalized communities, including transgender and gender diverse (TGD) people, have been dis-proportionally impacted. Experiences of TGD people should be centered in pandemic-related research to better inform policy. Methods: A diverse sample of TGD people (N = 158) were recruited from Michigan, Nebraska, Oregon, and Tennessee to participate in the Trans Resilience and Health Study. Participants ranged from 19 to 70 years old (M = 33.06; SD = 12.88) with 27.2% identifying as trans men/men, 26% identifying as trans women/women, and remaining identifying with terms like genderqueer and nonbinary. Thirty percent identified as people of color. Participants completed a monthly COVID-19-related questionnaire April 2020–March 2021 including open-ended questions to learn what contributed to resilience during this time. Thematic analyses of responses enabled identification of salient themes. Results: Analyses revealed pandemic-related changes in social experiences of marginalization and mask-wearing. Twenty-six participants mentioned face masks as contributing to resilience while also elaborating the influence of masks on experiences of misgendering. Participants identifying as trans women reported decreased misgendering while trans men and nonbinary participants reported increased misgendering. Conclusions and Policy Implications: Mask-wearing helps reduce transmission of COVID-19. For some trans women, masks also reduce the threat of misgendering and possibly other forms of enacted stigma. However, increased risk for misgendering, as noted by trans men in our study, should be considered and increased supports should be provided
Abstract: Background: Transgender and gender diverse (TGD) people encounter a range of minority stressors (e.g., harassment, victimization, misgendering) that impact many areas of life. Much of the empirical literature on gender minority stress has utilized frameworks that were developed with a focus on sexual orientation and were often limited to cisgender sexual minorities (lesbian, gay, bisexual, and other non-heterosexual individuals), leaving questions about how well existing models fit the experiences of TGD people. Aims: To expand understandings of gender minority stress, we conducted a daily diary study where participants detailed the types of stressors they encountered on a daily basis for 56 days. Methods: There were 181 TGD participants recruited into the study (M age = 25.6 years; SD= 5.6), with 167 retained in the daily surveys from which these analyses were conducted. Results: The written responses revealed a variety of stressors, some of which are novel to the literature. Many participants reported instances of non-affirmation, such as misgendering, as well as vicarious stress when learning of oppressive experiences impacting other TGD people and seeing negative media portrayals of the lives of TGD individuals. Participants also reported bodily vigilance when being on alert for how others were perceiving their gender. Other stressors included rejection, political oppression, physical violence, uneasiness from others, and the enforcement of gender binarism. Discussion: These findings highlight gaps in the existing understandings of marginalization for TGD people that must be addressed to ensure that frameworks include and center the experiences of gender minorities.
Rutledge, J., Anderson-Carpenter, K., & Puckett, J. A. (2021). HIV testing and associated characteristics among Black cisgender and transgender women in the United States. Journal of Healthcare, Science and the Humanities, XI, 137-150.
Abstract: Introduction: Social isolation and reduced access to public life in response to SARS-CoV-2 (COVID-19) challenges health and well-being for many. Marginalized communities, including transgender and gender diverse (TGD) people, have been dis-proportionally impacted. Experiences of TGD people should be centered in pandemic-related research to better inform policy. Methods: A diverse sample of TGD people (N = 158) were recruited from Michigan, Nebraska, Oregon, and Tennessee to participate in the Trans Resilience and Health Study. Participants ranged from 19 to 70 years old (M = 33.06; SD = 12.88) with 27.2% identifying as trans men/men, 26% identifying as trans women/women, and remaining identifying with terms like genderqueer and nonbinary. Thirty percent identified as people of color. Participants completed a monthly COVID-19-related questionnaire April 2020–March 2021 including open-ended questions to learn what contributed to resilience during this time. Thematic analyses of responses enabled identification of salient themes. Results: Analyses revealed pandemic-related changes in social experiences of marginalization and mask-wearing. Twenty-six participants mentioned face masks as contributing to resilience while also elaborating the influence of masks on experiences of misgendering. Participants identifying as trans women reported decreased misgendering while trans men and nonbinary participants reported increased misgendering. Conclusions and Policy Implications: Mask-wearing helps reduce transmission of COVID-19. For some trans women, masks also reduce the threat of misgendering and possibly other forms of enacted stigma. However, increased risk for misgendering, as noted by trans men in our study, should be considered and increased supports should be provided
Abstract: Background: In the United States, Black cisgender and transgender women are disproportionately affected by HIV. HIV testing is one of the primary modes of HIV prevention, but a large majority of the HIV testing literature focuses on individual level risk behaviors. Furthermore, there is little known about HIV testing among Black transgender women. This study aims to contribute to the existing literature by (1) examining the HIV testing behaviors of Black transgender women (2) using socioecological theory to assess what sociodemographic factors are associated with HIV testing among Black cisgender and transgender women. Methods: This study uses secondary data from the 2014-2017 modules of the Behavioral Risk Factor Surveillance System. Analyses included multiple hierarchical regression. Results: There are no major differences in HIV testing between Black cisgender and transgender women. A number of sociodemographic characteristics have been shown to predict HIV testing among Black cisgender women, but only employment status and age were significant predictors of HIV testing among Black transgender women. A moderation analyses suggested that gender identity significantly moderates the association between employment status and HIV testing such that the relationship between employment status and receiving an HIV test differs by gender identity. Discussion: The findings of this study highlight nuances that are useful for improving HIV testing as a mode of HIV prevention. Overall, the findings contribute to our understanding of HIV testing practices among Black cisgender and transgender women. Available via ProQuest: https://www.proquest.com/docview/2435201042?pq-origsite=gscholar&fromopenview=true
Kurth, A. E., Puckett, J. A., & Anderson-Carpenter, K. D. (2021). Legislation restricting access to public restrooms and changing facilities for transgender individuals in Texas (US): A qualitative analysis of testimony. International Journal of Transgender Health, 22, 440-453. https://doi.org/10.1080/26895269.2021.1905580
Abstract: Introduction: Social isolation and reduced access to public life in response to SARS-CoV-2 (COVID-19) challenges health and well-being for many. Marginalized communities, including transgender and gender diverse (TGD) people, have been dis-proportionally impacted. Experiences of TGD people should be centered in pandemic-related research to better inform policy. Methods: A diverse sample of TGD people (N = 158) were recruited from Michigan, Nebraska, Oregon, and Tennessee to participate in the Trans Resilience and Health Study. Participants ranged from 19 to 70 years old (M = 33.06; SD = 12.88) with 27.2% identifying as trans men/men, 26% identifying as trans women/women, and remaining identifying with terms like genderqueer and nonbinary. Thirty percent identified as people of color. Participants completed a monthly COVID-19-related questionnaire April 2020–March 2021 including open-ended questions to learn what contributed to resilience during this time. Thematic analyses of responses enabled identification of salient themes. Results: Analyses revealed pandemic-related changes in social experiences of marginalization and mask-wearing. Twenty-six participants mentioned face masks as contributing to resilience while also elaborating the influence of masks on experiences of misgendering. Participants identifying as trans women reported decreased misgendering while trans men and nonbinary participants reported increased misgendering. Conclusions and Policy Implications: Mask-wearing helps reduce transmission of COVID-19. For some trans women, masks also reduce the threat of misgendering and possibly other forms of enacted stigma. However, increased risk for misgendering, as noted by trans men in our study, should be considered and increased supports should be provided
Abstract: Background: An alarming amount of legislation in the United States has sought to restrict the rights of transgender people, often targeting access to public spaces or restrooms. One example of this legislation is the Texas Privacy Act (Senate Bill 6; 2017), which detailed “regulations and policies for entering or using a bathroom or changing facility” (Texas Legislature Online). Aims: The hearing for SB 6 included over 18 hours of public testimony, which we analyzed to better understand arguments for and against this bill. Methods: We conducted a thematic analysis of this public testimony. Results: Supporters of SB 6 frequently framed their arguments in terms of safety and security, economic impact, and privacy and dignity. Those opposing SB 6 focused on discrimination, safety and security, and the effects of transgender people being forced into the wrong facilities. Discussion: These findings can aid in understanding education that may help to combat viewpoints that lead to passing such legislation and contributes to understanding how legal policies shape views of gender.
Price, S. F., Puckett, J. A., & Mocarski, R. (2021). Impact of the 2016 presidential elections on transgender and gender diverse people. Sexuality Research and Social Policy, 18, 1094-1103. https://doi.org/10.1007/s13178-020-00513-2
Abstract: Introduction: Social isolation and reduced access to public life in response to SARS-CoV-2 (COVID-19) challenges health and well-being for many. Marginalized communities, including transgender and gender diverse (TGD) people, have been dis-proportionally impacted. Experiences of TGD people should be centered in pandemic-related research to better inform policy. Methods: A diverse sample of TGD people (N = 158) were recruited from Michigan, Nebraska, Oregon, and Tennessee to participate in the Trans Resilience and Health Study. Participants ranged from 19 to 70 years old (M = 33.06; SD = 12.88) with 27.2% identifying as trans men/men, 26% identifying as trans women/women, and remaining identifying with terms like genderqueer and nonbinary. Thirty percent identified as people of color. Participants completed a monthly COVID-19-related questionnaire April 2020–March 2021 including open-ended questions to learn what contributed to resilience during this time. Thematic analyses of responses enabled identification of salient themes. Results: Analyses revealed pandemic-related changes in social experiences of marginalization and mask-wearing. Twenty-six participants mentioned face masks as contributing to resilience while also elaborating the influence of masks on experiences of misgendering. Participants identifying as trans women reported decreased misgendering while trans men and nonbinary participants reported increased misgendering. Conclusions and Policy Implications: Mask-wearing helps reduce transmission of COVID-19. For some trans women, masks also reduce the threat of misgendering and possibly other forms of enacted stigma. However, increased risk for misgendering, as noted by trans men in our study, should be considered and increased supports should be provided
Abstract: Introduction: With Trump’s presidency came a rise in the oppression of transgender and gender diverse (TGD) people, as the nation witnessed a removal of protections for TGD people. Methods: We examined the daily experiences of 181 TGD individuals (ages 16–40,Mage = 25.6) through their reflections about daily stressors over the course of 8 weeks (data collected fall 2015–summer 2017), some of which reflected shifts during theelection period. Results: During the 2016 presidential election, participants reported a rise in marginalization stress and the subsequent impact on safety, mental health, and well-being. There were three emergent themes: External Rejection and Stigma from Dominant Culture; Supporting the TGD Community; and Fear for the Self and Development of Proximal Stressors. Conclusions: In line with marginalization stress theory, participants vocalized the progression from exterior stigmatization to proximal stressors and their heightened sense of vigilance and fear of the dominant culture. Policy Implications: Based on the results of this study, policy makers and TGD advocates must work to ensure that political rhetoric and action do not serve to further marginalize and erase TGD communities.
Puckett, J. A., Glozier, W. K., Kimball, D., & Giffel, R. (2021; invited submission). A systematic review of sexuality measurement in transgender and gender diverse populations. Psychology of Sexual Orientation & Gender Diversity, 8, 276-291. https://doi.org/10.1037/sgd0000523
Abstract: Introduction: Social isolation and reduced access to public life in response to SARS-CoV-2 (COVID-19) challenges health and well-being for many. Marginalized communities, including transgender and gender diverse (TGD) people, have been dis-proportionally impacted. Experiences of TGD people should be centered in pandemic-related research to better inform policy. Methods: A diverse sample of TGD people (N = 158) were recruited from Michigan, Nebraska, Oregon, and Tennessee to participate in the Trans Resilience and Health Study. Participants ranged from 19 to 70 years old (M = 33.06; SD = 12.88) with 27.2% identifying as trans men/men, 26% identifying as trans women/women, and remaining identifying with terms like genderqueer and nonbinary. Thirty percent identified as people of color. Participants completed a monthly COVID-19-related questionnaire April 2020–March 2021 including open-ended questions to learn what contributed to resilience during this time. Thematic analyses of responses enabled identification of salient themes. Results: Analyses revealed pandemic-related changes in social experiences of marginalization and mask-wearing. Twenty-six participants mentioned face masks as contributing to resilience while also elaborating the influence of masks on experiences of misgendering. Participants identifying as trans women reported decreased misgendering while trans men and nonbinary participants reported increased misgendering. Conclusions and Policy Implications: Mask-wearing helps reduce transmission of COVID-19. For some trans women, masks also reduce the threat of misgendering and possibly other forms of enacted stigma. However, increased risk for misgendering, as noted by trans men in our study, should be considered and increased supports should be provided
Abstract: Research related to the lives of transgender and gender diverse (TGD) people has grown substantially in recent years. One area of such growth has been research on TGD people’s sexuality. Sexuality can include sexual behaviors, sexual attraction, and sexual identity, among other domains. Historically, sexuality of TGD people was often policed by providers with expectations of heterosexuality or the conflation of sexuality and gender experiences. This resulted in a lag in understanding the lived experiences of TGD people in relation to sexuality. In this review, we examine research that has been conducted over the past 5 years with any measurement of sexuality with TGD participants. The initial search revealed 11,891 articles. After removing duplicates, there were 6,538 articles in the abstract review stage, with 1,669 retained for full text review and 179 retained for extraction. Most studies included majority white samples, and about half were conducted solely in theUnited States. Most studies measured a single dimension of sexuality, specifically sexual identity, whereas only 2.2% asked about all three dimensions of identity, behavior, and attraction. Of those that inquired about sexual identity, most samples were majority sexual minorities. Many studies had issues related to inclusivity, such as the language used in response options or questions. These findings are placed within the context of the revised 2021 guidelines for practice with sexual minorities and emphasize the importance of diversifying our field’s understandings and assessments of sexuality for TGD people.
Puckett, J. A., & Matsuno, E. (2021). Research on evidence based practice with transgender adults: A commentary on “A Systematic Review of Recommendations for Behavioral Health Services for Transgender and Gender Diverse Adults.” Clinical Psychology: Science and Practice, 28, 202-205. https://doi.org/10.1037/cps0000018
Abstract: Introduction: Social isolation and reduced access to public life in response to SARS-CoV-2 (COVID-19) challenges health and well-being for many. Marginalized communities, including transgender and gender diverse (TGD) people, have been dis-proportionally impacted. Experiences of TGD people should be centered in pandemic-related research to better inform policy. Methods: A diverse sample of TGD people (N = 158) were recruited from Michigan, Nebraska, Oregon, and Tennessee to participate in the Trans Resilience and Health Study. Participants ranged from 19 to 70 years old (M = 33.06; SD = 12.88) with 27.2% identifying as trans men/men, 26% identifying as trans women/women, and remaining identifying with terms like genderqueer and nonbinary. Thirty percent identified as people of color. Participants completed a monthly COVID-19-related questionnaire April 2020–March 2021 including open-ended questions to learn what contributed to resilience during this time. Thematic analyses of responses enabled identification of salient themes. Results: Analyses revealed pandemic-related changes in social experiences of marginalization and mask-wearing. Twenty-six participants mentioned face masks as contributing to resilience while also elaborating the influence of masks on experiences of misgendering. Participants identifying as trans women reported decreased misgendering while trans men and nonbinary participants reported increased misgendering. Conclusions and Policy Implications: Mask-wearing helps reduce transmission of COVID-19. For some trans women, masks also reduce the threat of misgendering and possibly other forms of enacted stigma. However, increased risk for misgendering, as noted by trans men in our study, should be considered and increased supports should be provided
No abstract available
Kurth, A. E., Puckett, J. A., & Anderson-Carpenter, K. D. (2021). A qualitative analysis of the Texas Privacy Act (Senate Bill 6). International Journal of Transgender Health, 22, 440-453. https://doi.org/10.1080/26895269.2021.1905580
Abstract: Introduction: Social isolation and reduced access to public life in response to SARS-CoV-2 (COVID-19) challenges health and well-being for many. Marginalized communities, including transgender and gender diverse (TGD) people, have been dis-proportionally impacted. Experiences of TGD people should be centered in pandemic-related research to better inform policy. Methods: A diverse sample of TGD people (N = 158) were recruited from Michigan, Nebraska, Oregon, and Tennessee to participate in the Trans Resilience and Health Study. Participants ranged from 19 to 70 years old (M = 33.06; SD = 12.88) with 27.2% identifying as trans men/men, 26% identifying as trans women/women, and remaining identifying with terms like genderqueer and nonbinary. Thirty percent identified as people of color. Participants completed a monthly COVID-19-related questionnaire April 2020–March 2021 including open-ended questions to learn what contributed to resilience during this time. Thematic analyses of responses enabled identification of salient themes. Results: Analyses revealed pandemic-related changes in social experiences of marginalization and mask-wearing. Twenty-six participants mentioned face masks as contributing to resilience while also elaborating the influence of masks on experiences of misgendering. Participants identifying as trans women reported decreased misgendering while trans men and nonbinary participants reported increased misgendering. Conclusions and Policy Implications: Mask-wearing helps reduce transmission of COVID-19. For some trans women, masks also reduce the threat of misgendering and possibly other forms of enacted stigma. However, increased risk for misgendering, as noted by trans men in our study, should be considered and increased supports should be provided
Abstract: An alarming amount of legislation in the United States has sought to restrict the rights of transgender people, often targeting access to public spaces or restrooms. One example of this legislation is the Texas Privacy Act (Senate Bill 6; 2017), which details "regulations and policies for entering or using a bathroom or changing facility" (Texas Legislature Online). The hearing for SB 6 saw over 18 hours of public testimony. The testimony was transcribed and a thematic analysis was conducted to better understand arguments for and against this bill. Overall, 13.49% of 64 of individuals testified in support of SB 6 and 86.51% testified against it. In contrast, 65% of senators supported the bill and 35% opposed it. Supporters of SB 6 frequently framed their arguments in terms of safety and security, economic impact, and privacy and dignity. Those opposing SB 6 focused more on discrimination, safety and security, and the effects of transgender people being forced in the wrong facilities. Interestingly, not a single mental health provider testified in support of the bill. Information from this analysis can be used to determine what kind of education could help to combat viewpoints that lead to passing such legislation.
Puckett, J. A. (2021). Mental health. In A. E. Goldberg & G. Beemyn (Eds.), The SAGE Encyclopedia of Trans Studies (Vol. 2, pp. 521-528).
Abstract: Introduction: Social isolation and reduced access to public life in response to SARS-CoV-2 (COVID-19) challenges health and well-being for many. Marginalized communities, including transgender and gender diverse (TGD) people, have been dis-proportionally impacted. Experiences of TGD people should be centered in pandemic-related research to better inform policy. Methods: A diverse sample of TGD people (N = 158) were recruited from Michigan, Nebraska, Oregon, and Tennessee to participate in the Trans Resilience and Health Study. Participants ranged from 19 to 70 years old (M = 33.06; SD = 12.88) with 27.2% identifying as trans men/men, 26% identifying as trans women/women, and remaining identifying with terms like genderqueer and nonbinary. Thirty percent identified as people of color. Participants completed a monthly COVID-19-related questionnaire April 2020–March 2021 including open-ended questions to learn what contributed to resilience during this time. Thematic analyses of responses enabled identification of salient themes. Results: Analyses revealed pandemic-related changes in social experiences of marginalization and mask-wearing. Twenty-six participants mentioned face masks as contributing to resilience while also elaborating the influence of masks on experiences of misgendering. Participants identifying as trans women reported decreased misgendering while trans men and nonbinary participants reported increased misgendering. Conclusions and Policy Implications: Mask-wearing helps reduce transmission of COVID-19. For some trans women, masks also reduce the threat of misgendering and possibly other forms of enacted stigma. However, increased risk for misgendering, as noted by trans men in our study, should be considered and increased supports should be provided
Many trans individuals report notable elevations in mental health concerns as a result of the social rejection and oppression that they are exposed to in their immediate and broader communities. Mental health disparities exist across a number of areas, such as depression, anxiety, and suicidality, as well as other forms of psychological distress. Drivers of these mental health disparities include exposure to adverse life events, minority stressors, gender dysphoria, and other contextual factors. Trans individuals who are supported in their identities experience benefits to their mental health and a reduction in health disparities. This entry outlines what is currently known about the mental health disparities reported by trans individuals and the factors that are driving these negative mental health outcomes. This is followed by an overview of several factors that may be associated with improvements in mental health, such as gender affirmation and coping. The entry concludes with an overview of research related to mental health services for trans individuals.
Puckett, J. A. (2021). Gender minority stress. In A. E. Goldberg & G. Beemyn (Eds.), The SAGE Encyclopedia of Trans Studies (Vol. 1, pp. 315-319).
Abstract: Introduction: Social isolation and reduced access to public life in response to SARS-CoV-2 (COVID-19) challenges health and well-being for many. Marginalized communities, including transgender and gender diverse (TGD) people, have been dis-proportionally impacted. Experiences of TGD people should be centered in pandemic-related research to better inform policy. Methods: A diverse sample of TGD people (N = 158) were recruited from Michigan, Nebraska, Oregon, and Tennessee to participate in the Trans Resilience and Health Study. Participants ranged from 19 to 70 years old (M = 33.06; SD = 12.88) with 27.2% identifying as trans men/men, 26% identifying as trans women/women, and remaining identifying with terms like genderqueer and nonbinary. Thirty percent identified as people of color. Participants completed a monthly COVID-19-related questionnaire April 2020–March 2021 including open-ended questions to learn what contributed to resilience during this time. Thematic analyses of responses enabled identification of salient themes. Results: Analyses revealed pandemic-related changes in social experiences of marginalization and mask-wearing. Twenty-six participants mentioned face masks as contributing to resilience while also elaborating the influence of masks on experiences of misgendering. Participants identifying as trans women reported decreased misgendering while trans men and nonbinary participants reported increased misgendering. Conclusions and Policy Implications: Mask-wearing helps reduce transmission of COVID-19. For some trans women, masks also reduce the threat of misgendering and possibly other forms of enacted stigma. However, increased risk for misgendering, as noted by trans men in our study, should be considered and increased supports should be provided
Minority stress broadly refers to the unique stressors that minority groups experience, above and beyond the general types of stressors that anyone may endure. For instance, work may be stressful for many reasons—including navigating relationships with coworkers, job performance and advancement concerns, or other reasons. When someone holds a minority status, there are likely additional stressors that may arise, such as concerns about microaggressions or mistreatment from coworkers or one’s boss, concerns about company policies and whether there are inclusive nondiscrimination protections, or other stressors. Even the stressors that are general in nature may take on additional nuance when experienced as the member of a minority. As such, the general stressors could also be influenced by biases toward minorities, such as interpersonal relationships not only being affected by individual personality differences but also slight or overt displays of stigma. When applied to trans individuals, these unique stressors are termed gender minority stress.
Feinstein, B. A., & Puckett, J. A. (2020). Introduction to the special issue: Psychologists’ role in advocacy to support the health of marginalized populations. the Behavior Therapist, 43, 234-235.
Abstract: Introduction: Social isolation and reduced access to public life in response to SARS-CoV-2 (COVID-19) challenges health and well-being for many. Marginalized communities, including transgender and gender diverse (TGD) people, have been dis-proportionally impacted. Experiences of TGD people should be centered in pandemic-related research to better inform policy. Methods: A diverse sample of TGD people (N = 158) were recruited from Michigan, Nebraska, Oregon, and Tennessee to participate in the Trans Resilience and Health Study. Participants ranged from 19 to 70 years old (M = 33.06; SD = 12.88) with 27.2% identifying as trans men/men, 26% identifying as trans women/women, and remaining identifying with terms like genderqueer and nonbinary. Thirty percent identified as people of color. Participants completed a monthly COVID-19-related questionnaire April 2020–March 2021 including open-ended questions to learn what contributed to resilience during this time. Thematic analyses of responses enabled identification of salient themes. Results: Analyses revealed pandemic-related changes in social experiences of marginalization and mask-wearing. Twenty-six participants mentioned face masks as contributing to resilience while also elaborating the influence of masks on experiences of misgendering. Participants identifying as trans women reported decreased misgendering while trans men and nonbinary participants reported increased misgendering. Conclusions and Policy Implications: Mask-wearing helps reduce transmission of COVID-19. For some trans women, masks also reduce the threat of misgendering and possibly other forms of enacted stigma. However, increased risk for misgendering, as noted by trans men in our study, should be considered and increased supports should be provided
No abstract available
Puckett, J. A., Brown, N., Dunn, T., Mustanski, B., & Newcomb, M. E. (2020). Perspectives from transgender and gender diverse people on how to ask about gender. LGBT Health, 7, 305-311. http://doi.org/10.1089/lgbt.2019.0295
Abstract: Introduction: Social isolation and reduced access to public life in response to SARS-CoV-2 (COVID-19) challenges health and well-being for many. Marginalized communities, including transgender and gender diverse (TGD) people, have been dis-proportionally impacted. Experiences of TGD people should be centered in pandemic-related research to better inform policy. Methods: A diverse sample of TGD people (N = 158) were recruited from Michigan, Nebraska, Oregon, and Tennessee to participate in the Trans Resilience and Health Study. Participants ranged from 19 to 70 years old (M = 33.06; SD = 12.88) with 27.2% identifying as trans men/men, 26% identifying as trans women/women, and remaining identifying with terms like genderqueer and nonbinary. Thirty percent identified as people of color. Participants completed a monthly COVID-19-related questionnaire April 2020–March 2021 including open-ended questions to learn what contributed to resilience during this time. Thematic analyses of responses enabled identification of salient themes. Results: Analyses revealed pandemic-related changes in social experiences of marginalization and mask-wearing. Twenty-six participants mentioned face masks as contributing to resilience while also elaborating the influence of masks on experiences of misgendering. Participants identifying as trans women reported decreased misgendering while trans men and nonbinary participants reported increased misgendering. Conclusions and Policy Implications: Mask-wearing helps reduce transmission of COVID-19. For some trans women, masks also reduce the threat of misgendering and possibly other forms of enacted stigma. However, increased risk for misgendering, as noted by trans men in our study, should be considered and increased supports should be provided
Abstract: Purpose: When inquiring about the gender of research participants, most studies use self-generated questions about gender or questions prepared by researchers that have been evaluated for comprehension by transgender and gender diverse (TGD) and cisgender individuals. However, many gaps still exist in this area, including identifying how TGD people would like to see their gender represented in questions about gender identity. To address this issue, we explored the perspectives of TGD people regarding the construction of questions about gender. Methods: In this online study of 695 TGD people (Mage=25.52), participants provided written suggestions for how to ask about gender and these responses were analyzed thematically. Data were collected between fall 2015 and summer 2017. Results: Three broad categories of responses emerged: (1) specific identities to include in response options; (2)specific questions to ask about gender; and (3) qualifiers/nuanced considerations. Conclusion:Participants provided a variety of suggestions for how to ask about gender and future research is needed to explore the implementation of these suggestions. Recommendations are provided for options that researchers can explore for how to ask about gender. These findings highlight the ways that TGD people would like their gender to be asked about, which is necessary information to ensure that questions about gender reflect TGD people’s identities accurately.
Puckett, J. A., Maroney, M. R., Wadsworth, L. P., Mustanski, M., & Newcomb, M. E. (2020). Coping with discrimination: The insidious effects of gender minority stigma on depression and anxiety in transgender individuals. Journal of Clinical Psychology, 76, 176-194. https://doi.org/10.1002/jclp.22865
Abstract: Introduction: Social isolation and reduced access to public life in response to SARS-CoV-2 (COVID-19) challenges health and well-being for many. Marginalized communities, including transgender and gender diverse (TGD) people, have been dis-proportionally impacted. Experiences of TGD people should be centered in pandemic-related research to better inform policy. Methods: A diverse sample of TGD people (N = 158) were recruited from Michigan, Nebraska, Oregon, and Tennessee to participate in the Trans Resilience and Health Study. Participants ranged from 19 to 70 years old (M = 33.06; SD = 12.88) with 27.2% identifying as trans men/men, 26% identifying as trans women/women, and remaining identifying with terms like genderqueer and nonbinary. Thirty percent identified as people of color. Participants completed a monthly COVID-19-related questionnaire April 2020–March 2021 including open-ended questions to learn what contributed to resilience during this time. Thematic analyses of responses enabled identification of salient themes. Results: Analyses revealed pandemic-related changes in social experiences of marginalization and mask-wearing. Twenty-six participants mentioned face masks as contributing to resilience while also elaborating the influence of masks on experiences of misgendering. Participants identifying as trans women reported decreased misgendering while trans men and nonbinary participants reported increased misgendering. Conclusions and Policy Implications: Mask-wearing helps reduce transmission of COVID-19. For some trans women, masks also reduce the threat of misgendering and possibly other forms of enacted stigma. However, increased risk for misgendering, as noted by trans men in our study, should be considered and increased supports should be provided
Abstract: Lesbian, gay, bisexual, and queer (LGBQ) individuals experience various minority stressors that accountfor increased mental health issues in comparison to heterosexuals, including experiences of prejudice (victimization and discrimination), expectations of encountering prejudice, internalized heterosexism, and identity concealment. Even so, some individuals may be more likely to encounter select minority stressors (e.g., prejudice) as a product of having a nontraditional gender expression. This study examined the role of gender expression in relation to these minority stressors and mental health in a sample of 383 sexual minority cisgender women and men (Mage39.3). Results revealed significant correlations between gender nonconformity and greater experiences and expectations of prejudice, as well as less identity concealment, greater psychological distress, and greater social anxiety. Two multiple mediation analyses were conducted to determine whether these minority stressors accounted for the association between gender nonconformity and mental health indices. Gender nonconformity and the minority stressors accounted for a significant amount of variance in psychological distress, F(10, 363)10.94, R2.23, as well as social anxiety, F(10, 363)9.32, R2.20. With all minority stress predictors included in the model, expectations of prejudice was the only significant mediator of the associations between gender nonconformity and mental health, for both psychological distress and social anxiety (B0.08, SE0.05, 95% confidence interval (CI) [0.01–0.20]; B0.03, SE0.02, 95% CI [0.004–0.06], respectively). This study highlights the importance of considering gender expression in the conceptualization of LGBQ minority stress.
Puckett, J. A., DuBois, L. Z., McNeill, J. N., & Hanson, C. L. (2020). The association between social dominance orientation, critical consciousness, and gender minority stigma. Journal of Homosexuality, 67, 1081-1096. https://doi.org/10.1080/00918369.2019.1603493
Abstract: Introduction: Social isolation and reduced access to public life in response to SARS-CoV-2 (COVID-19) challenges health and well-being for many. Marginalized communities, including transgender and gender diverse (TGD) people, have been dis-proportionally impacted. Experiences of TGD people should be centered in pandemic-related research to better inform policy. Methods: A diverse sample of TGD people (N = 158) were recruited from Michigan, Nebraska, Oregon, and Tennessee to participate in the Trans Resilience and Health Study. Participants ranged from 19 to 70 years old (M = 33.06; SD = 12.88) with 27.2% identifying as trans men/men, 26% identifying as trans women/women, and remaining identifying with terms like genderqueer and nonbinary. Thirty percent identified as people of color. Participants completed a monthly COVID-19-related questionnaire April 2020–March 2021 including open-ended questions to learn what contributed to resilience during this time. Thematic analyses of responses enabled identification of salient themes. Results: Analyses revealed pandemic-related changes in social experiences of marginalization and mask-wearing. Twenty-six participants mentioned face masks as contributing to resilience while also elaborating the influence of masks on experiences of misgendering. Participants identifying as trans women reported decreased misgendering while trans men and nonbinary participants reported increased misgendering. Conclusions and Policy Implications: Mask-wearing helps reduce transmission of COVID-19. For some trans women, masks also reduce the threat of misgendering and possibly other forms of enacted stigma. However, increased risk for misgendering, as noted by trans men in our study, should be considered and increased supports should be provided
Abstract: Transgender people are exposed to great amounts of discrimi-nation and violence, but research has yet to fully understand what drives stigma towards this community. In this study, we hypothesized that social dominance orientation would be associated with greater gender minority stigma (i.e., stigmatizing views of transgender people), with this association mediated by higher levels of trait aggression and lower levels of critical consciousness. Data were collected online from 254 cisgender individuals (158 women, 96 men; Mage=30.81 years). Social dominance orientation was associated with higher levels of gender minority stigma. Trait aggression was not a significant mediator of this association. However, there was a significant indirect effect via lowered critical consciousness (B= 0.10, SE = 0.04, 95% CI: 0.02, 0.17). Approaches that increase awareness about social hierarchies and systems of privilege will likely prove fruitful in facilitating social changein attitudes towards transgender people.
Puckett, J. A., Matsuno, E., Dyar, C., Mustanski, B., & Newcomb, M. E. (2019). Mental health and resilience in transgender individuals: What type of support makes a difference? Journal of Family Psychology, 33, 954-964. http://dx.doi.org/10.1037/fam0000561
Abstract: Introduction: Social isolation and reduced access to public life in response to SARS-CoV-2 (COVID-19) challenges health and well-being for many. Marginalized communities, including transgender and gender diverse (TGD) people, have been dis-proportionally impacted. Experiences of TGD people should be centered in pandemic-related research to better inform policy. Methods: A diverse sample of TGD people (N = 158) were recruited from Michigan, Nebraska, Oregon, and Tennessee to participate in the Trans Resilience and Health Study. Participants ranged from 19 to 70 years old (M = 33.06; SD = 12.88) with 27.2% identifying as trans men/men, 26% identifying as trans women/women, and remaining identifying with terms like genderqueer and nonbinary. Thirty percent identified as people of color. Participants completed a monthly COVID-19-related questionnaire April 2020–March 2021 including open-ended questions to learn what contributed to resilience during this time. Thematic analyses of responses enabled identification of salient themes. Results: Analyses revealed pandemic-related changes in social experiences of marginalization and mask-wearing. Twenty-six participants mentioned face masks as contributing to resilience while also elaborating the influence of masks on experiences of misgendering. Participants identifying as trans women reported decreased misgendering while trans men and nonbinary participants reported increased misgendering. Conclusions and Policy Implications: Mask-wearing helps reduce transmission of COVID-19. For some trans women, masks also reduce the threat of misgendering and possibly other forms of enacted stigma. However, increased risk for misgendering, as noted by trans men in our study, should be considered and increased supports should be provided
Abstract: Research has generally shown the benefits of social support, such as the buffering effects on life stressors, yet there has been little empirical investigation of different types of support resources for transgender individuals. We examined family support, support from friends, and connectedness to a transgender community and how these forms of support come together to influence mental health and resilience. The sample included 695 transgender participants (mean age = 25.52 years, SD = 9.68, range = 16-73; 75.7% White) who completed an online survey. Greater than half of participants reported moderate to severe levels of anxious and depressive symptoms. Family social support had the strongest correlations with symptoms of anxiety and depression (r = -.31 and -.37, respectively, p
Puckett, J. A. (2019; invited submission). An ecological approach to therapy with gender minorities: Special issue commentary. Cognitive and Behavioral Practice, 26, 254-269. https://doi.org/10.1016/j.cbpra.2019.08.002
Abstract: Introduction: Social isolation and reduced access to public life in response to SARS-CoV-2 (COVID-19) challenges health and well-being for many. Marginalized communities, including transgender and gender diverse (TGD) people, have been dis-proportionally impacted. Experiences of TGD people should be centered in pandemic-related research to better inform policy. Methods: A diverse sample of TGD people (N = 158) were recruited from Michigan, Nebraska, Oregon, and Tennessee to participate in the Trans Resilience and Health Study. Participants ranged from 19 to 70 years old (M = 33.06; SD = 12.88) with 27.2% identifying as trans men/men, 26% identifying as trans women/women, and remaining identifying with terms like genderqueer and nonbinary. Thirty percent identified as people of color. Participants completed a monthly COVID-19-related questionnaire April 2020–March 2021 including open-ended questions to learn what contributed to resilience during this time. Thematic analyses of responses enabled identification of salient themes. Results: Analyses revealed pandemic-related changes in social experiences of marginalization and mask-wearing. Twenty-six participants mentioned face masks as contributing to resilience while also elaborating the influence of masks on experiences of misgendering. Participants identifying as trans women reported decreased misgendering while trans men and nonbinary participants reported increased misgendering. Conclusions and Policy Implications: Mask-wearing helps reduce transmission of COVID-19. For some trans women, masks also reduce the threat of misgendering and possibly other forms of enacted stigma. However, increased risk for misgendering, as noted by trans men in our study, should be considered and increased supports should be provided
This special series includes four articles that review important considerations for clinical work with gender minorities, including youth and young adults, individuals who are nonbinary, transgender individuals in inpatient or residential care, and transgender individuals recovering from trauma. These articles provide important insights and concrete suggestions for how to enact affirming practice, spanning across macro, mezzo, and micro levels. Ultimately, a multilevel approach to working with transgender and gender diverse individuals is essential to addressing health disparities in this population, as the work of an affirming provider goes beyond the therapy hour and the therapy office or treatment unit. In this commentary, I review the major themes from these contributions, provide a perspective on how they fit within the existing literature, and provide an overview of pressing future directions in gender minority research.
Puckett, J. A., Cleary, P., Rossman, K., Mustanski, B., & Newcomb. M. (2018). Barriers to gender-affirming care for transgender and gender nonconforming individuals. Sexuality Research and Social Policy, 15, 48-59. https://doi.org/10.1007/s13178-017-0295-8
Abstract: Introduction: Social isolation and reduced access to public life in response to SARS-CoV-2 (COVID-19) challenges health and well-being for many. Marginalized communities, including transgender and gender diverse (TGD) people, have been dis-proportionally impacted. Experiences of TGD people should be centered in pandemic-related research to better inform policy. Methods: A diverse sample of TGD people (N = 158) were recruited from Michigan, Nebraska, Oregon, and Tennessee to participate in the Trans Resilience and Health Study. Participants ranged from 19 to 70 years old (M = 33.06; SD = 12.88) with 27.2% identifying as trans men/men, 26% identifying as trans women/women, and remaining identifying with terms like genderqueer and nonbinary. Thirty percent identified as people of color. Participants completed a monthly COVID-19-related questionnaire April 2020–March 2021 including open-ended questions to learn what contributed to resilience during this time. Thematic analyses of responses enabled identification of salient themes. Results: Analyses revealed pandemic-related changes in social experiences of marginalization and mask-wearing. Twenty-six participants mentioned face masks as contributing to resilience while also elaborating the influence of masks on experiences of misgendering. Participants identifying as trans women reported decreased misgendering while trans men and nonbinary participants reported increased misgendering. Conclusions and Policy Implications: Mask-wearing helps reduce transmission of COVID-19. For some trans women, masks also reduce the threat of misgendering and possibly other forms of enacted stigma. However, increased risk for misgendering, as noted by trans men in our study, should be considered and increased supports should be provided
Abstract: Gender-affirming care, including hormone therapy, "top" (e.g., chest reconstruction surgery) and "bottom" (e.g., vaginoplasty, phalloplasty, metoidioplasty, etc.) surgeries, and puberty blockers, is an efficacious treatment of gender dysphoria for transgender and gender nonconforming (TGNC) individuals. However, many TGNC people encounter significant barriers in accessing gender-affirming care, which we detail via results from on online study. Participants included 256 TGNC individuals (78.9% White, ages 16–73,Mage= 28.4). Among participants, 61.3% were receiving hormone therapy, 22.7% had undergone top surgery, and 5.5% had undergone bottom surgery. Open-ended responses (n= 201) were thematically analyzed and common barriers included finances and insurance issues, a lack of service availability, and fears or worries. Participants reported various systemic issues and incidents of bias within medical and mental health fields, as well as a lack of medical provider awareness and education. Other themes were interpersonal barriers (e.g., fears of rejection); age and need of parental consent for minors; other medical issues; and a lack of information about how to acquire care. These findings can be utilized to educate professionals in medical and mental health fields about barriers their TGNC patients may encounter in receiving affirming care and suggest a num-ber of ways to improve access to these services.
Puckett, J. A., Barr, S. M., Wadsworth, L. P., & Thai, J. (2018). Considerations for clinical work and research with transgender and gender diverse individuals. the Behavior Therapist, 41, 253-262.
Abstract: Introduction: Social isolation and reduced access to public life in response to SARS-CoV-2 (COVID-19) challenges health and well-being for many. Marginalized communities, including transgender and gender diverse (TGD) people, have been dis-proportionally impacted. Experiences of TGD people should be centered in pandemic-related research to better inform policy. Methods: A diverse sample of TGD people (N = 158) were recruited from Michigan, Nebraska, Oregon, and Tennessee to participate in the Trans Resilience and Health Study. Participants ranged from 19 to 70 years old (M = 33.06; SD = 12.88) with 27.2% identifying as trans men/men, 26% identifying as trans women/women, and remaining identifying with terms like genderqueer and nonbinary. Thirty percent identified as people of color. Participants completed a monthly COVID-19-related questionnaire April 2020–March 2021 including open-ended questions to learn what contributed to resilience during this time. Thematic analyses of responses enabled identification of salient themes. Results: Analyses revealed pandemic-related changes in social experiences of marginalization and mask-wearing. Twenty-six participants mentioned face masks as contributing to resilience while also elaborating the influence of masks on experiences of misgendering. Participants identifying as trans women reported decreased misgendering while trans men and nonbinary participants reported increased misgendering. Conclusions and Policy Implications: Mask-wearing helps reduce transmission of COVID-19. For some trans women, masks also reduce the threat of misgendering and possibly other forms of enacted stigma. However, increased risk for misgendering, as noted by trans men in our study, should be considered and increased supports should be provided
The aim of the present article is to provide psychologists, other mental health professionals, and individuals in training with a selection of clinical and research recommendations for working with people who are transgender (or trans) and gender diverse. Within clinical work, there are many considerations for how to create an affirming atmosphere and engage in culturally competent care with trans and gender diverse clients. It is important to remember that it is simply not possible in the current sociopolitical climate for a trans or gender diverse person to avoid exposure to anti-trans stigma and for trans people of color to avoid this in combination with exposure to racism, xenophobia, and White supremacy. The author hopes that this article opens up conversations about how to engage in affirming clinical work and research with trans and gender diverse communities and that it encourages you to think critically about practices in your organization, graduate program, or research lab.
Puckett, J. A., Mereish, E. H., Levitt, H. M., Horne, S. G., & Hayes-Skelton, S. A. (2018). Internalized heterosexism and psychological distress: The moderating effects of decentering. Stigma & Health, 3, 9-15. https://doi.org/10.1037/sah0000065
Abstract: Introduction: Social isolation and reduced access to public life in response to SARS-CoV-2 (COVID-19) challenges health and well-being for many. Marginalized communities, including transgender and gender diverse (TGD) people, have been dis-proportionally impacted. Experiences of TGD people should be centered in pandemic-related research to better inform policy. Methods: A diverse sample of TGD people (N = 158) were recruited from Michigan, Nebraska, Oregon, and Tennessee to participate in the Trans Resilience and Health Study. Participants ranged from 19 to 70 years old (M = 33.06; SD = 12.88) with 27.2% identifying as trans men/men, 26% identifying as trans women/women, and remaining identifying with terms like genderqueer and nonbinary. Thirty percent identified as people of color. Participants completed a monthly COVID-19-related questionnaire April 2020–March 2021 including open-ended questions to learn what contributed to resilience during this time. Thematic analyses of responses enabled identification of salient themes. Results: Analyses revealed pandemic-related changes in social experiences of marginalization and mask-wearing. Twenty-six participants mentioned face masks as contributing to resilience while also elaborating the influence of masks on experiences of misgendering. Participants identifying as trans women reported decreased misgendering while trans men and nonbinary participants reported increased misgendering. Conclusions and Policy Implications: Mask-wearing helps reduce transmission of COVID-19. For some trans women, masks also reduce the threat of misgendering and possibly other forms of enacted stigma. However, increased risk for misgendering, as noted by trans men in our study, should be considered and increased supports should be provided
Abstract: Internalized heterosexism (IH) refers to the internalization of stigma, stereotypes, and negative views of sexual minorities into one’s self concept as a product of social bias. Although substantial research has documented the negative impact of IH on mental health, there is a dearth of research examining variables buffering this association. One cognitive strategy that may help protect individuals against the negative effects of IH on health is decentering, or the ability to view thoughts and feelings as events rather than as truths about oneself. In this online study of 436 sexual minority participants (80% White, age range18–80, mean age39.31), we examined the moderating effects of decentering on the association between IH and psychological distress. Results revealed that there was a significant association between greater IH and psychological distress (B2.43,p.05). Also, higher levels of decentering were related to lower reported psychological distress (B0.31,p.001). In addition, decentering significantly moderated the association between IH and psychological distress (B0.35,p.05). For individuals who reported higher than average levels of decentering, there was not a significant association between IH and psychological distress. However, for individuals who reported average and low levels of decentering, greater IH was associated with greater psychological distress. These results suggest that decentering significantly buffered the association between IH and psychological distress, highlighting a promising avenue for future research to explore in developing empirically supported interventions to cope and manage internalized stigma.