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Social Support, Trans Community Connectedness, and Mental Health Symptoms Among Transgender and Gender Nonconforming Adults

American Psychological Association
Psychology of Sexual Orientation and Gender Diversity
Authors:
Samantha Pflum at University of North Carolina at Chapel Hill
Samantha Pflum
Rylan J. Testa
Rylan J. Testa
Rylan J. Testa
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Kimberly Balsam at Palo Alto University
Kimberly Balsam
Peter Goldblum at Palo Alto University
Peter Goldblum
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Abstract

For those identifying as transgender or gender nonconforming (TGNC), the support of others can be instrumental in mitigating the challenges associated with cross-gender transition and identification. Social support and connectedness to the TGNC community can positively impact psychological well-being, facilitate resilience, and buffer against external stigmatization, prejudice, and discrimination (Frost & Meyer, 2012; Hendricks & Testa, 2012). The present study seeks to improve understanding of relationships among general social support (GSS), trans community connectedness (TCC), depressive symptoms, and anxiety symptoms. The inclusion of 2 forms of social support allows for greater examination of the differential impact of perceived general support (i.e., from both cisgender and TGNC friends and family members) and TGNC-specific social support (i.e., feeling connected to other TGNC people). To honor the diversity within the TGNC community, the impact of social support was examined among TGNC participants differentiated by gender identity, ethnicity, and living environment. As part of the Internet-based Trans Health Survey, standardized measures of depression, generalized anxiety, and social support were administered to 865 TGNC adults. For both trans male spectrum (TMS) and trans female spectrum (TFS) participants, general social support was significantly negatively associated with symptoms of anxiety and depression. However, the negative correlation between trans community connectedness and mental health symptoms was significant only for TFS participants. Variations in perceived TCC among ethnicity and living environment groups--distinguished by gender identity--are also explored. Finally, targets for future minority stress and social support research with the TGNC population are discussed. Language: en
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... This is further augmented by a study reporting many TGD people have endured negative experiences accessing healthcare services , although those who receive affirmative approaches view this as more helpful (Hunt, 2013). Research demonstrates that TCC (Trans Community Connectedness) could be a factor in wellbeing and being more connected to the trans community may mean better overall psychological health (Pflum et al., 2015). ...
... Participant 5 had shared her gender identity with her partner, but she had not been supportive, and she had stopped transition, but within a month they ended the relationship and began to transition again, she had not made her family aware. Having contact with the TGD community was seen as beneficial, participants reported being isolated and lonely when not connected, consistent with the suggestion that TCC is helpful for overall wellbeing (Pflum et al., 2015). ...
The Lived Experience of Autistic Transgender and Gender Diverse (ATGD) People: A Meta- Ethnography
Thesis
Full-text available
  • Dec 2023
Background Warrier et al. (2020) reported that TGD people were 3.03 to 6.36 times as likely to be autistic than cisgender people. At present this co-occurrence is poorly understood although research studies into this phenomenon have begun to emerge with various theories posited, and qualitative studies providing a rich insight into this experience have been published. This literature review sought to explore the lived experience of ATGD people. Methods Databases were searched to find research articles which utilised qualitative methodologies to explore the experience of ATGD people. These were analysed using the meta-ethnographic approach developed by Noblit and Hare (1988). Results Eight studies were identified for review, and analysis resulted in three main themes: 1. Autism acts as a barrier to gender transition; 2. Autism acts as a facilitator to being your authentic self; 3. There is a need for support and adaptations to mitigate external and internal factors. Discussion The synthesis concludes that there are unique challenges to being an ATGD person. Clinicians can support people to access services such as considering the sensory impact of the environment and adapting their communication style. Providing groups where people can 1 meet people with similar experiences can also be a helpful way of supporting people to develop social connections.
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... This is further augmented by a study reporting many TGD people have endured negative experiences accessing healthcare services , although those who receive affirmative approaches view this as more helpful (Hunt, 2013). Research demonstrates that TCC (Trans Community Connectedness) could be a factor in wellbeing and being more connected to the trans community may mean better overall psychological health (Pflum et al., 2015). ...
... Participant 5 had shared her gender identity with her partner, but she had not been supportive, and she had stopped transition, but within a month they ended the relationship and began to transition again, she had not made her family aware. Having contact with the TGD community was seen as beneficial, participants reported being isolated and lonely when not connected, consistent with the suggestion that TCC is helpful for overall wellbeing (Pflum et al., 2015). ...
What is the experience of adults with a diagnosis of gender incongruence at an NHS GIC (Gender Identity Clinic) in England who have sought treatment, but decided to detransition, or retransition during the treatment pathway?
Thesis
Full-text available
  • Dec 2023
Introduction Some people who experience gender incongruence, comprised typically of feelings of gender dysphoria, will refer to a GIC to access medical interventions to align their body with their gender identity (NHS England, 2013). Recent research has noted the phenomenon of people pausing or stopping (detransitioning) their gender identity following a period of transitioning, with studies in the UK suggesting this is prevalent in around 1-6.9% of cases (Hall et al., 2021; Richards & Doyle, 2019). Although some studies have noted detransition, or pausing and/or stopping, may not be wholly attributable to the cessation of feelings of gender incongruence but rather difficulties external to them (Turban et al., 2021), this area is still largely under researched. Methods Participants were recruited from an NHS GIC and were interviewed about their experience of pausing or stopping transition, and in some cases transitioning again. Interviews were transcribed and analysed utilising IPA methodology (Smith et al., 2021). Results Five participants took part in the research study, all had been assigned male at birth. Two participants had stopped gender transition and did not have any intention to transition again, one had paused and wishes to transition again, and two had already begun to transition again. There were four main themes: 1. A sense of difference from childhood; 2. Gender transition is challenging in multiple ways; 3. Conflicts are experienced, and 4. Stopping transition has challenges and benefits. Discussion Gender transition is a varied experience and people experiencing this have multiple needs. Psychological support is viewed as beneficial and helpful in navigating the challenges of transition, and in pausing and stopping transition. GIC’s should consider the dynamic nature of transition in clinical decision making and offer adequate medical and psychological support.
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... That said, there remains a critical need for improving PrEP use among Black TW, as estimates suggest that approximately 88% of Black TW could benefit from PrEP (Cooney et al., 2022) and only 15% of women (inclusive of TW) who could benefit from PrEP have received a PrEP prescription (Centers for Disease Control & Prevention, 2023). Social support and peer networks have been identified as key factors that may support PrEP use among Black TW (Pflum et al., 2015;Wood et al., 2017). Due to transphobia, social exclusion, and oppression, Black TW often find support within Black trans and/or LGBTQ+ communities, with whom they share experiences of adversity and a sense of community and empowerment (Cahill et al., 2013;Lockett et al., 2023;Ramirez-Valles, 2002). ...
... Due to transphobia, social exclusion, and oppression, Black TW often find support within Black trans and/or LGBTQ+ communities, with whom they share experiences of adversity and a sense of community and empowerment (Cahill et al., 2013;Lockett et al., 2023;Ramirez-Valles, 2002). Theories of social support and minority stress (Breslow et al., 2015;Pflum et al., 2015) suggest that social connection and community may buffer against the adverse health outcomes faced by transgender individuals. Indeed, prior research has demonstrated that social support may attenuate the negative effects of minority stressors on marginalized communities and support mental well-being and in some cases, survival, for transgender individuals (Kia et al., 2023). ...
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Black transgender women (TW) have disproportionately low uptake and use of HIV pre-exposure prophylaxis (PrEP), despite high vulnerability to HIV. Community and peer support may be important intervention targets to improve PrEP use among Black TW. We conducted qualitative interviews with 42 Black TW in the midwestern United States to understand Black TW’s experiences with PrEP and explore barriers to PrEP use and the ways peers and Black trans communities may support PrEP use. Using inductive thematic analysis, we identified three primary themes. First, many Black TW see themselves as PrEP advocates and look out for other Black TW. Second, participants described a desire to support the broader Black trans community thrive. Finally, participants described the importance of supporting Black TW involved in sex work, including by supporting the use of PrEP. Data from this study show that, despite numerous health care and structural-level barriers, Black TW play a vital role in supporting PrEP use among other Black TW and supporting their communities. Our results highlight the promise of community-driven interventions among Black TW in supporting PrEP use.
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... During the time they are first coming out, they are also more inclined to find out more about the trans people community as your identity develops trans males on stage. It was hypothesized that transgender community connectedness would be inversely correlated with depressive symptoms and anxiety (Pflum et al. 2015). Many transgender people struggle with homelessness. ...
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Transgender community consists of individuals whose gender identity is different from the sex assigned to them at birth. The present research focuses on assessing the determinants of social inclusion determinants for transgender people and understanding their perspective. The objectives of the research are to identify the challenges, understand the inclusivity of transgenders, examine family support and acceptance, and to examine social inclusion factors which include income, education, employment opportunities and access to housing. Our aim is to create a society which does not discriminate transgender people based on their gender and to rely more on the inclusion of them in our society. Through various research, it is to be said that they face many issues in our country in the form of employment opportunities, housing, health care, education, and more. This study adopts survey design method. Several literature reviews which highlight the vulnerability of transgender people and the challenges they face. Through analysis and interpretation, it is evident that they do not receive adequate support and find it difficult to live as transgender individuals. Due to discrimination, prejudice, and stereotypes they face barriers in accessing housing, transportation, employment, and healthcare. Many of them face rejection from their families and lack secure housing options.
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... This is consistent with findings from past research that indicate that many non-binary young adults seek information from community members through online interactions, as these interactions provide them a space to relate their experiences with each other, seek exposure, and receive other support (Selkie et al., 2020). The current study also suggests that community support is a source of better mental well-being, which is consistent with previous findings that non-binary individuals who feel more connected to their community are more likely to have better psychological well-being (Pflum et al., 2015). Hence, social support itself can be considered a coping mechanism for nonbinary individuals. ...
Minority Stress and Mental Health of Indian Non-binary Individuals
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  • May 2025
This study investigated how Indian non-binary individuals experience minority stress and its impact on mental health, with a focus on the role of social support and coping mechanisms. Semi-structured interviews with eight non-binary participants aged 18–23 from Bengaluru revealed four main themes: societal treatment, self-identity, minority stress and mental health, and social support. Findings indicate that experiences with discrimination, misgendering, gender dysphoria, and identity concealment contribute to negative mental health outcomes. However, social support and effective coping strategies were found to positively influence mental health by affirming identity. These results suggest potential avenues for developing targeted interventions and support systems to improve mental health among non-binary individuals.
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... Minority stress theory posits that in addition to general stressors, SGM individuals also experience distal minority stressors (e.g., prejudice, discrimination, and victimization) and proximal minority stressors (e.g., internalization of stigmatizing messaging, concealment of one's identity, expectations of rejection), the combination of which leads to poorer mental health outcomes and increased risk for suicide attempts compared to their cisgender, heterosexual counterparts. Critically, variables have also been identified that buffer the effects of these stressors on negative mental health outcomes, namely social support (broadly, and specific to other SGM members) and coping skills (Bockting et al. 2013;Detrie and Lease 2007;Hatzenbuehler 2009;Pflum et al. 2015;Russell and Fish 2016). The second theoretical model considered in the creation of the intervention was the interpersonal theory of suicide (IPTS). ...
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Full-text available
  • Apr 2025
  • SUICIDE LIFE-THREAT
Background Patient navigation (PN), paired with the safety planning intervention (SPI), may allay mechanisms that theoretically underlie suicide among sexual and gender minorities (SGM). This paper describes (a) the iterative development of a theory‐informed PN + SPI intervention (QueerCare) to prevent suicide among at‐risk SGM youth and young adults and (b) a case series examining the feasibility and acceptability of study procedures, measures, and QueerCare. Methods Seven initial QueerCare modules and a glossary of terms were drafted. Seven participants completed the case series. Feasibility and acceptability over 3 months were examined by triangulating multi‐method data. Results The study procedures and measures in the at‐risk population were feasible and sensitive, provided that remote safety monitoring and parental consent waivers were in place. QueerCare was feasible, helpful, and appropriate based on satisfaction ratings and four emerging themes: matched identity care, internalized barriers, support, and flexibility valued. Two additional modules and guardian materials were created. Suicidal crisis management protocols were continuously refined. Conclusion QueerCare was developed as a highly flexible modular intervention to meet the needs of SGM youth and young adults and prevent repeat suicide attempts in this population. Findings indicate study procedures, measures, and QueerCare were feasible and acceptable based on triangulated data. Trial Registration This study was registered under ClinicalTrials.gov identifier NCT04757649
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... Data was collected from 865 transgenders including both trans male spectrum and trans female spectrum. The result of study indicated that there is negative association between social support with depression and anxiety symptoms (Pflum et al., 2015). Furthermore, transgender also reported the high level of anger, sadness and hopelessness feelings (Hawkins, 2023). ...
A Comparative Study of Transgender Gurru & Chella: Exploring the Interplay of Anxiety, Social Support, and Anger from Lahore
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The Current study was conducted in aimed to explore intricate association among the anger, social support and anxiety in transgender (Guru & Chellas). To conduct this study (N=150) transgender sampled including 75 Guru and 75 Chellas with the age range of 19 to 70 years (M age =42.13; SD=13.27). The data was collected by using purposive and snowball sampling techniques. The data was collected through Multidimensional Scale of Perceived Social Support (Dahlem & Farley, 1988) Depression Anxiety Stress Scales (Lovibond and Lovibond, 1995) and Anger Expression Scale (Ijaz & Ghafoor, 2016) along with demographic information sheet. The data was analyzed by using Statistical Package for Social Sciences (SPSS, V25). The results of the study indicated that there is intricate negative association(r=-.30**) between anxiety and social support and significant positive association (r=.19*) between anger and anxiety, as well as the social support and anger was significant predictor of anxiety. The t-test analysis showed the results that Guru has high level of social support but have more mental health problems than Chellas. The implication of the study and recommendations for future studies are given below.
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Operationalizing Microaffirmations for Queer and Transgender People of Color
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