Table 1.

Scale Descriptions for Minority Stress Theory Constructs

Scale	No. of items	Response options (score)	Scale range	Sample items	Alpha
Distal minority stressors
Gender-related discrimination14	5	Never (0); yes, before age 18 (1); yes, after age 18 (1); yes, in the past year (1)	0–5	“I have had difficulty finding housing or staying in housing because of my gender or gender expression”	0.72
				“I have experienced difficulty getting identity documents that match my gender”
Gender-related victimization14	5	Never (0); yes, before age 18 (1); yes, after age 18 (1); yes, in the past year (1)	0–5	“I have been verbally harassed or teased because of my gender or gender expression (For example, being called ‘it’)”	0.77
				I have been pushed, shoved, hit, or had something thrown at me because of my gender or gender expression”
Gender-related rejection14	6	Never (0); yes, before age 18 (1); yes, after age 18 (1); yes, in the past year (1)	0–6	“I have had difficulty finding a partner or have had a relationship end because of my gender or gender expression”	0.73
				“I have been rejected by or made to feel unwelcome by a religious community because of my gender or gender expression”
Gender nonaffirmation14	6	Strongly disagree (0) to strongly agree (4)	0–24	“I have difficulty being perceived as my gender”	0.87
				“I have to be ‘hypermasculine’ or ‘hyperfeminine’ in order for people to accept my gender”
Proximal minority stressors
Internalized trans-related stigma14	8	Strongly disagree (0) to strongly agree (4)	0–32	“I resent my gender identity or expression”	0.90
				“I feel that my gender identity or expression is embarrassing”
Anticipated trans-related stigma14	9	Strongly disagree (0) to strongly agree (4)	0–36	“If I express my gender identity, others wouldn't accept me”	0.95
				“If I express my gender identity, people would think I am mentally ill or ‘crazy’ ”
Resilience factors
Self-affirmation14	7	Strongly disagree (0) to strongly agree (4)	0–28	“My gender identity or expression makes me feel special and unique”	0.88
				“I am proud to be a person whose gender identity is different from my sex assigned at birth”
Social support22	4	None of the time (0) to all of the time (3)	0–12	“How often is someone available to help with daily chores if you are sick?”	0.80
				“How often is someone available to get together with you or relaxation?”
Community connectedness14	5	Strongly disagree (0) to strongly agree (4)	0–20	“I feel connected to other people who share my gender identity”	0.79
				“I feel isolated and separate from other people who share my gender identity” (reverse coded)