Table 3.
Gender-Related Stress and Resilience Levels, Overall and Stratified by Testing Behaviors in the Past Year, Reported by 186 Transgender Youth, United States, June 2017 to June 2018
| Tested for HIV in the past year | Tested for other STIs in the past year | ||||||
|---|---|---|---|---|---|---|---|
| Scale | Overall Mean, median | Yes Mean, median | No Mean, median | pa | Yes Mean, median | No Mean, median | pb |
| Gender-related discriminationc | 2.5, 2 (N=174) | 2.3, 2 (n=25) | 2.5, 2 (n=149) | 0.68 | 2.3, 2 (n=38) | 2.5, 2 (n=136) | 0.57 |
| Gender-related rejectiond | 3.6, 4 (N=172) | 3.7, 4 (n=23) | 3.6, 4 (n=149) | 0.73 | 3.8, 5 (n=36) | 3.6, 4 (n=136) | 0.44 |
| Nonaffirmation of gender identitye | 16.8, 19 (N=174) | 17.9, 19 (n=25) | 16.6, 18 (n=149) | 0.35 | 16.9, 18.5 (n=38) | 16.7, 19 (n=136) | 0.59 |
| Internalized transphobiaf | 14.4, 14 (N=170) | 13.0, 11 (n=25) | 14.7, 14 (n=145) | 0.37 | 15.3, 16 (n=37) | 14.2, 14 (n=133) | 0.44 |
| Anticipated stigmag | 16.4, 14 (N=173) | 14.7, 12 (n=25) | 16.7, 14.5 (n=148) | 0.49 | 16.6, 2.5 (n=38) | 16.4, 15 (n=135) | 0.94 |
| Community connectednessh | 7.5, 7 (N=172) | 7.1, 7 (n=25) | 7.5, 7 (n=147) | 0.64 | 6.9, 7 (n=38) | 7.6, 8 (n=134) | 0.63 |
Kruskal–Wallis tests to assess differences in gender-related stress and resilience levels across categories of testing for HIV in the past year.
Kruskal–Wallis tests to assess differences in gender-related stress and resilience levels across categories of testing for other STIs in the past year.
5-Item scale potentially ranging from 0 to 5, with progressively increasing values indicating greater levels of experienced gender-related discrimination. Items scored 0 for never and 1 for yes: (i) had difficulty getting medical or mental health treatment, (ii) had difficulty finding a bathroom to use when out in public, (iii) had difficulty getting identity documents that match their gender identity, (iv) had difficulty finding housing or staying in housing, and (v) had difficulty finding employment or keeping employment, or had been denied a promotion.
6-Item scale potentially ranging from 0 to 6, with progressively increasing values indicating greater levels of experienced gender-related rejection. Items scored 0 for never and 1 for yes: (i) had difficulty finding a partner, or had a relationship end, (ii) had been rejected by or made to feel unwelcome by a religious community, (iii) had been rejected by or made to feel unwelcome in their ethnic/racial community, (iv) had been rejected by or distanced from friends, (v) had been rejected at school or work, and (vi) had been rejected by or distanced from family.
6-Item scale potentially ranging from 0 to 24, with progressively increasing values indicating greater levels of experienced non-affirmation of gender identity. Items scored 0 for strongly disagree to 4 for strongly agree: (i) have to repeatedly explain their gender identity to people or correct the pronouns people use, (ii) have difficulty being perceived as their gender, (iii) have to work hard for people to see their gender accurately, (iv) have to be “hypermasculine” or “hyperfeminine” for people to accept their gender, (v) think that people do not respect their gender identity because of their appearance or body, and (vi) think that people do not understand them because they do not see their gender as they do.
8-Item scale potentially ranging from 0 to 32, with progressively increasing values indicating greater levels of internalized transphobia. Items scored 0 for strongly disagree to 4 for strongly agree: (i) resent their gender identity or expression, (ii) feel like a freak because of their gender identity or expression, (iii) feel depressed when they think of their gender identity or expression, (iv) feel unhappy when they think of their gender identity or expression, (v) feel like an outcast because of their gender identity or expression, (vi) often ask themselves why can't their gender identity or expression just be normal, (vii) feel that their gender identity or expression is embarrassing, and (viii) envy people who do not have a gender identity or expression like theirs.
9-Item scale potentially ranging from 0 to 36, with progressively increasing values indicating greater levels of anticipated stigma. Items scored 0 for strongly disagree to 4 for strongly agree: If they disclosed their assigned sex at birth (i) others would not accept them, (ii) employers would not hire them, (iii) people would think they are mentally ill or “crazy,” (iv) people would think they are disgusting or sinful, (v) most people would think less of them, (vi) most people would look down on them, (vii) they could be a victim of crime or violence, (viii) they could be arrested or harassed by police, and (ix) they could be denied good medical care.
5-Item scale potentially ranging from 0 to 20, with progressively increasing values indicating greater levels of community connectedness. Items scored 0 for strongly disagree to 4 for strongly agree: (i) feel part of a community of people who share their gender identity, (ii) feel connected to other people who share their gender identity, (iii) feel like they belong when interacting with members of the community that shares their gender identity, (iv) are not like other people who share their gender identity (reverse-scored), and (v) feel isolated and separate from other people who share their gender identity (reverse-scored).