Cited by 422LGBTQ Health, Identity, and PolicyGender and Feminist StudiesGender Roles and Identity Studies

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Health disparities between genderqueer, transgender, and cisgender individuals: An extension of minority stress theory

Lefevor, G. Tyler, Boyd-Rogers, Caroline C., Sprague, Brianna M., Janis, Rebecca A.·2019·Journal of Counseling Psychology

DOI 10.1037/cou0000339

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Abstract

Interpersonal, social, and structural stressors have been identified as key elements that explain health disparities between transgender and cisgender individuals. However, most of this research has focused on binary transgender individuals or has not differentiated between binary and nonbinary individuals; little research has examined the experiences of minority stress or health of those identifying outside the gender binary. Guided by intersectionality and drawing on a sample of 3,568 college students from the Center for Collegiate Mental Health's 2012-2016 database-of whom 892 identified outside the gender binary-we conducted analyses of demographic and outcome measures administered in participants' 1st counseling appointment, examining differences between cisgender, transgender, and genderqueer individuals. We found that genderqueer individuals were harassed, sexually abused, and subjected to traumatic events at higher rates than were either cisgender or binary transgender individuals, with approximately 50% of genderqueer individuals reporting one of these experiences. We found that genderqueer individuals experienced more anxiety, depression, psychological distress, and eating concerns than did binary transgender and cisgender individuals and more social anxiety than did cisgender individuals. Genderqueer individuals more frequently reported self-harm and suicidality than did any other group, with approximately 2/3 of participants' having contemplated and nearly 50% making a suicide attempt. We extend current theorizing about minority stress (Hendricks & Testa, 2012; Meyer, 2003) to include genderqueer individuals and delineate several structural aspects of genderqueer experiences that may be responsible for these trends, including others' lack of knowledge about genderqueer experiences and pronouns, poor access to legal and medical resources, and systemic discrimination. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

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“As gender minority individuals reportedly experience higher rates of sexual abuse, harassment, and trauma exposure than cisgender individuals (Lefevor et al., 2019), elevated (C)PTSD diagnoses could be expected (Lonnen & Pas-kell, 2024).”
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Parmenter, J. G., & Galliher, R. V. (2022) · The Counseling Psychologist · doi:10.1177/00110000221124274 · Cited by 11
“LGBTQ+ BIPOC, plurisexual, and gender diverse people (e.g., transgender, genderqueer, or nonbinary identities) are at elevated risk for negative mental health outcomes because of experiences of inequity (Jaspal et al., 2019; Lefevor et al., 2019).”
Background
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Singh, A. A., Estevez, R., & Truszczynski, N. (2021) · Springer eBooks · doi:10.1007/978-3-030-74146-4_7 · Cited by 9
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Choo, S., Kim, R., Lee, H., Eom, Y., Yi, H., Kim, R., & Kim, S. (2023) · Social Psychiatry and Psychiatric Epidemiology · doi:10.1007/s00127-023-02554-5 · Cited by 11
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Flourishing in a Binary World: The Creation of Transgender Alternative Narratives
Schwab, J. R., & Stamper, A. J. (2024) · Sex Roles · doi:10.1007/s11199-024-01475-0 · Cited by 9
“And nonbinary, genderqueer, gender fluid, and gender nonconforming people have been found to experience more harassment, abuse, and mental health difficulties than any other gender groups (Lefevor et al., 2019).”
Reducing Ableism and the Social Exclusion of People With Disabilities: Positive Impacts of Openness and Education
Conley, K. T., & Nadler, D. R. (2022) · Psi Chi Journal of Psychological Research · doi:10.24839/2325-7342.jn27.1.21 · Cited by 11
Minority Stress and Psychological Distress Among Asexual Transgender and Gender Nonconforming Individuals
Boot-Haury, J. W. (2023) · Psi Chi Journal of Psychological Research · doi:10.24839/2325-7342.jn28.2.132 · Cited by 8
“Informed by the concepts of intersectionality and minority stress theory, and based on previous sexual and gender minority research (Bockting et al., 2013; Brennan et al., 2017; Hendricks & Testa, 2012; Lefevor et al., 2019; McInroy et al., 2020), each minority stressor (gender expression, proximal [vigilance and isol…”
MethodResult
The identity-related experiences of LGBTQ + students in engineering spaces
Pradell, L. R., Parmenter, J. G., Galliher, R. V., et al. (2024) · International Journal of Qualitative Studies in Education · doi:10.1080/09518398.2024.2318271 · Cited by 6
“Our findings are in line with previous research extending MST to genderqueer and transgender people (Hendricks & Testa, 2012; Lefevor et al., 2019), showing that TGQ people continue to face harassment and marginalization across contexts.”
Mapping Multilevel Contributions to the Sexual Victimization of Trans Women and Trans Feminine People: A Qualitative Intersectional Stigma Analysis
Berke, D. S., Hotchkiss, M. E., Smith, A. M., & Gilbert, C. (2024) · Journal of Child Sexual Abuse · doi:10.1080/10538712.2024.2414996 · Cited by 7
“…the epidemiology of risk for sexual victimization exposure and its attendant health consequences, which is not evenly distributed, but instead coalesces around experiences of intersecting marginalization (Dinno, 2017; Graham, 2014; Lefevor et al., 2019; Singh & McKleroy, 2011; Wirtz et al., 2020).”
Traditional and individual care pathways in gender-affirming healthcare for transgender and gender-diverse individuals - results from the ENIGI follow-up study
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“This includes mental health counseling (e.g., to cope with minority stress) [2], hormone therapy, gender-af ﬁ rming surgery (e.g., genital reconstructive surgeries), and additional interventions (e.g., hair removal, speech therapy [3], in the following: transition-related interventions [4]).”
Grade-level differences of peer and dating victimization among transgender, gender expansive, female, and male adolescents
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“This theory suggests that differences in rates of victimization may be fueled by systemic inequities (Hendricks & Testa, 2012; Lefevor et al., 2019).”
Background
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Background
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Self-citation
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“…health factors shared by the TNB population (e.g., freedom to express gender), other variables often differ across groups (e.g., discrimination, resilience, and health outcomes experienced by binary vs. nonbinary trans people), 51,52 which presents a limitation when pooling these populations.”
Background
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Background
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Working with gender‐expansive clients in psychotherapy
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Background
Sexual Orientation and Gender Identity Reporting in Highly Cited Current Alcohol Research
Connolly, D. J., Coduri-Fulford, S., Tugulu, C., Yalew, M., Moss, E., & Yang, J. (2023) · LGBT Health · doi:10.1089/lgbt.2023.0085 · Cited by 6
“3 10 Despite the high acceptability, among both the general population and LGBTQ+ communities, of sexual orientation and gender identity (SOGI) data collection, 11 SOGI is rarely recorded in electronic health records, health data systems and large epidemiological surveys, 12 resulting in a paucity…”
Background

Authors: Lefevor, G. T., Boyd-Rogers, C. C., Sprague, B. M., & Janis, R. A.
ORCID: Lefevor, G. Tyler
Boyd-Rogers, Caroline C.
Janis, Rebecca A.
Venue: Journal of Counseling Psychology
Publisher: American Psychological Association (APA)
Published: 2019-07
Volume: 66
Issue: 4
Pages: 385-395
ISSN: 0022-0167 (ISSN-L)
1939-2168
DOI: 10.1037/cou0000339
OpenAlex: W2922712531
Cited by: 422
References: 0
Citations by year: 2026: 57 · 2025: 66 · 2024: 78 · 2023: 83 · 2022: 59 · 2021: 49 · 2020: 22 · 2019: 7
FWCI: 42.73
Type: journal article
Language: en
Open access: closed
Locations: Journal of Counseling Psychology (publishedVersion)
PubMed (publishedVersion)
Digital Commons - USU (Utah State University) (submittedVersion)
Topics: Social Sciences › Psychology › Social Psychology › LGBTQ Health, Identity, and Policy
Social Sciences › Gender Studies › Gender and Feminist Studies
Social Sciences › Gender Studies › Gender Roles and Identity Studies
Keywords: transgender people, cisgender individuals, minority stress, health disparities, non-binary gender identity, university students, sexual abuse, harassment, psychological distress, anxiety, depression, eating concerns, social anxiety, self-harm, suicidality, intersectionality, institutional discrimination
MeSH terms: Adult, Anxiety, Depression, Female, Gender Identity, Health Status, Humans, Male, Minority Groups, Sex Offenses, Stress, Psychological, Transsexualism, Sexual Harassment, Transgender Persons

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Health disparities between genderqueer, transgender, and cisgender individuals: An extension of minority stress theory

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