TY - JOUR PY - 2024// TI - Structural transphobia is associated with psychological distress and suicidality in a large national sample of transgender adults JO - Social psychiatry and psychiatric epidemiology A1 - Price, Maggi A. A1 - Hollinsaid, Nathan L. A1 - McKetta, Sarah A1 - Mellen, Emily J. A1 - Rakhilin, Marina SP - 285 EP - 294 VL - 59 IS - 2 N2 - PURPOSE: Transgender adults face increasingly discriminatory laws/policies and prejudicial attitudes in many regions of the United States (US), yet research has neither quantified state-level transphobia using indicators of both, nor considered their collective association with transgender adults' psychological wellbeing, hindering the identification of this potential social determinant of transgender mental health inequity. METHODS: We therefore used factor analysis to develop a more comprehensive structural transphobia measure encompassing 29 indicators of transphobic laws/policies and attitudes at the state level, which we linked to individual-level mental health data from a large national sample of 27,279 transgender adults (ages 18-100) residing in 45 US states and the District of Columbia (DC). RESULTS: Controlling for individual- (i.e., demographics), interpersonal- (i.e., perceived discrimination), and state- (i.e., income inequality, religiosity) level covariates, transgender adults from US states with higher (vs. lower) levels of structural transphobia reported more severe past-month psychological distress and were more likely to endorse past-year and lifetime suicidal thoughts, plans, and attempts. CONCLUSION: Findings provide novel evidence that state-level transphobic laws/policies and attitudes collectively shape a range of important mental health outcomes among transgender adults in the US. Multilevel intervention strategies, such as affirming mental health treatments, provider-training interventions, and supportive legislation, are needed to address structural transphobia's multifaceted nature and negative mental health consequences.

Language: en

LA - en SN - 0933-7954 UR - http://dx.doi.org/10.1007/s00127-023-02482-4 ID - ref1 ER -