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Health disparities between genderqueer, transgender, and cisgender individuals: An extension of minority stress theory
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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“Both transgender and gender diverse individuals experience pressures attributed to their existence outside cultural gender norms that are heavily based on strict adherence to binary gender roles [6].”
From A Phenomenological Investigation into Cyberbullying as Experienced by People Identifying as Transgender or Gender Diverse (2022) · cites this paper as [6]
In the citing paper
“non-binary gender diverse people may experience even greater levels of gender-based discrimination and negative mental health outcomes than binary transgender individuals”
From A Phenomenological Investigation into Cyberbullying as Experienced by People Identifying as Transgender or Gender Diverse (2022) · cites this paper as [6]
In the citing paper
“they experience depression, anxiety, and suicidality at higher rates than cisgender lesbian, gay, bisexual (LGB), and queer individuals [6,7,8,15].”
From A Phenomenological Investigation into Cyberbullying as Experienced by People Identifying as Transgender or Gender Diverse (2022) · cites this paper as [6]
In the citing paper
“Even within the LGBTQIA+ spectrum, TGD individuals are disproportionately impacted by mental illness”
From A Phenomenological Investigation into Cyberbullying as Experienced by People Identifying as Transgender or Gender Diverse (2022) · cites this paper as [6]
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Srivastava, A., Hall, W. J., Miller, A. B., et al. (2026) · Sex Roles · doi:10.1007/s11199-026-01680-z
“These differences underscore the need to disaggregate TGNB populations in both research and clinical care (Klinger et al., 2024; Lefevor et al., 2019; Srivastava et al., 2021a).”
Turner, K., Galliher, R. V., & Berke, R. (2026) · Psychology and Sexuality · doi:10.1080/19419899.2026.2714185
O’Rourke, T., Zach, L., Haider, K., Klinger, D., Nater, U. M., van Alebeek, H., Pieh, C., & Probst, T. (2026) · Journal of Health Psychology · doi:10.1177/13591053261477479
Metadata
- Authors
- Lefevor, G. T., Boyd-Rogers, C. C., Sprague, B. M., & Janis, R. A.
- Venue
- Journal of Counseling Psychology
- Published
- 2019-07
- Volume
- 66
- Issue
- 4
- Pages
- 385-395
- ISSN
- 0022-0167 (ISSN-L)
- 1939-2168
- 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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