The DOI matches its Crossref record; 84 of the 85 references it cites were found in a registry or an index.
Minority stressors and psychological distress in transgender individuals.
Abstract
This study tested direct and indirect associations between minority stressors and psychological distress in a large, geographically diverse sample of transgender individuals (N = 1,207). Transgender individuals were recruited for an online, cross-sectional survey using targeted sampling. Structural equation modeling was used to test the hypothesized model, which was based on Hatzenbuehler's (2009) integrative mediation framework. Expectations of rejection, self-stigma, and prejudice events were all associated with psychological distress, and these relationships were partially accounted for by rumination. This model had good fit (Tucker-Lewis Index =.96, Comparative Fit Index =.98, Root Mean Square Error of Approximation =.05, 90% CI [.05,.06]) and explained 54.5% of the variance in psychological distress and 29.3% in rumination. This is the first study to examine a model of minority stress and psychological distress that includes rumination and all four minority stressors from Meyer's (2003) framework in a large sample of transgender individuals. Results indicate a strong relationship between minority stressors and psychological distress among transgender people, and that these relationships are partially explained by rumination. Results need to be considered in relation to the cross-sectional nature of the design and the possible role for additional variables. Future research should investigate these findings using designs that provide tests of causality.
Overview
Integrity signals
Registry
Cites
Statistics
Verification
Claims the paper makes
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
In the citing paper
“Researchers Timmins et al. confirmed the role of ruminative processes as increased in a transgender sample who also experienced greater minority stress (Timmins et al., Citation2017).”
From Proposed Self-as-Context Interventions for Gender Minority Clients (2025) · cites this paper as Timmins et al., 2017
In the citing paper
“however, to our knowledge, all studies to date have used cross-sectional research designs.”
From Psychological Processes Underlying the Impact of Gender-Related Discrimination on Psychological Distress in Transgender and Gender Nonconforming People. (2019) · cites this paper as Timmins et al., 2017
In the citing paper
“These findings also dovetail with TGNC research demonstrating that emotional management strategies emphasizing suppression, avoidance, excessive focus etc. (i.e., avoidant coping and rumination) mediate relations between prejudice events and psychological distress (Timmins et al., 2017; White Hughto et al., 2017).”
From Psychological Processes Underlying the Impact of Gender-Related Discrimination on Psychological Distress in Transgender and Gender Nonconforming People. (2019) · cites this paper as Timmins et al., 2017
In the citing paper
“Timmins et al. (2017) found that depressive rumination mediated the relationship between prejudice events and psychological distress in transgender people.”
From Psychological Processes Underlying the Impact of Gender-Related Discrimination on Psychological Distress in Transgender and Gender Nonconforming People. (2019) · cites this paper as Timmins et al., 2017
Citations
Cites
Hu, L., & Bentler, P. M. (1999) · Structural Equation Modeling A Multidisciplinary Journal · doi:10.1080/10705519909540118 · Cited by 108,788
Statistical Power Analysis for the Behavioral Sciences
Muller, K. E., & Cohen, J. (1989) · Technometrics · doi:10.2307/1270020 · Cited by 99,603
Tabachnick, B. G., & Fidell, L. S. (1983) · Cited by 79,882
The PHQ-9: Validity of a brief depression severity measure
Kroenke, K., Spitzer, R. L., & Williams, J. B. W. (2001) · Journal of General Internal Medicine · doi:10.1046/j.1525-1497.2001.016009606.x · Cited by 44,910
Principles and Practice of Structural Equation Modeling
Tabri, N., & Elliott, C. M. (2012) · Canadian Graduate Journal of Sociology and Criminology · doi:10.15353/cgjsc.v1i1.3787 · Cited by 39,094
Statistical Power Analysis for the Behavioral Sciences (2nd ed.).
Lachenbruch, P. A., & Cohen, J. (1989) · Journal of the American Statistical Association · doi:10.2307/2290095 · Cited by 37,421
A Brief Measure for Assessing Generalized Anxiety Disorder: The GAD-7
Spitzer, R. L., Kroenke, K., Williams, J. B. W., & Löwe, B. (2006) · Archives of Internal Medicine · doi:10.1001/archinte.166.10.1092 · Cited by 31,765
Meyer, I. H. (2003) · Psychological Bulletin · doi:10.1037/0033-2909.129.5.674 · Cited by 14,736
Asymptotic Confidence Intervals for Indirect Effects in Structural Equation Models
Sobel, M. E. (1982) · Sociological Methodology · doi:10.2307/270723 · Cited by 12,810
Using Multivariate Statistics (5th Edition)
Tabachnick, B. G., & Fidell, L. S. (2006) · Allyn & Bacon, Inc. eBooks · Cited by 11,188
SPSS for Windows Step by Step: A Simple Guide and Reference
Mallery, P., & George, D. (1998) · Cited by 10,312
Spitzer, R. L. (1999) · JAMA · doi:10.1001/jama.282.18.1737 · Cited by 9,802
A Rationale and Test for the Number of Factors in Factor Analysis
Horn, J. L. (1965) · Psychometrika · doi:10.1007/bf02289447 · Cited by 8,965
Required sample size to detect the mediated effect
Fritz, M. S., & MacKinnon, D. P. (2007) · Psychological Science · doi:10.1111/j.1467-9280.2007.01882.x · Cited by 4,810
Responses to depression and their effects on the duration of depressive episodes
Nolen-Hoeksema, S. (1991) · Journal of Abnormal Psychology · doi:10.1037/0021-843x.100.4.569 · Cited by 4,529
Löwe, B., Decker, O., Müller, S., Brähler, E., Schellberg, D., Herzog, W., & Herzberg, P. Y. (2008) · Medical Care · doi:10.1097/mlr.0b013e318160d093 · Cited by 4,527
Rumination reconsidered: a psychometric analysis.
Treynor, W., Gonzalez, R., & Nolen-Hoeksema, S. (2003) · Cognitive Therapy and Research · doi:10.1023/a:1023910315561 · Cited by 3,808
Nolen-Hoeksema, S., & Morrow, J. (1991) · Journal of Personality and Social Psychology · doi:10.1037/0022-3514.61.1.115 · Cited by 3,276
Factor Retention Decisions in Exploratory Factor Analysis: a Tutorial on Parallel Analysis
Hayton, J. C., Allen, D. G., & Scarpello, V. (2004) · Organizational Research Methods · doi:10.1177/1094428104263675 · Cited by 3,104
How does sexual minority stigma “get under the skin”? A psychological mediation framework
Hatzenbuehler, M. L. (2009) · Psychological Bulletin · doi:10.1037/a0016441 · Cited by 2,695
Cognition and Depression: Current Status and Future Directions
Gotlib, I. H., & Joormann, J. (2010) · Annual Review of Clinical Psychology · doi:10.1146/annurev.clinpsy.121208.131305 · Cited by 2,420
Reporting practices in confirmatory factor analysis: an overview and some recommendations
Jackson, D. L., Gillaspy, J. A., & Purc-Stephenson, R. (2009) · Psychological Methods · doi:10.1037/a0014694 · Cited by 2,242
Hendricks, M. L., & Testa, R. J. (2012) · Professional Psychology: Research and Practice · doi:10.1037/a0029597 · Cited by 2,134
Stigma, Mental Health, and Resilience in an Online Sample of the US Transgender Population
Bockting, W. O., Miner, M. H., Swinburne Romine, R. E., Hamilton, A., & Coleman, E. (2013) · American Journal of Public Health · doi:10.2105/ajph.2013.301241 · Cited by 1,540
Development of the Gender Minority Stress and Resilience Measure.
Testa, R. J., Habarth, J., Peta, J., Balsam, K., & Bockting, W. (2015) · Psychology of Sexual Orientation and Gender Diversity · doi:10.1037/sgd0000081 · Cited by 1,406
Guidelines for psychological practice with transgender and gender nonconforming people.
(2015) · American Psychologist · doi:10.1037/a0039906 · Cited by 1,395
Validity of the brief patient health questionnaire mood scale (PHQ-9) in the general population
Martin, A., Rief, W., Klaiberg, A., & Braehler, E. (2006) · General Hospital Psychiatry · doi:10.1016/j.genhosppsych.2005.07.003 · Cited by 1,379
The psychological implications of concealing a stigma: A cognitive-affective-behavioral model
Pachankis, J. E. (2007) · Psychological Bulletin · doi:10.1037/0033-2909.133.2.328 · Cited by 1,305
Internalized stigma among sexual minority adults: Insights from a social psychological perspective.
Herek, G. M., Gillis, J. R., & Cogan, J. C. (2009) · Journal of Counseling Psychology · doi:10.1037/a0014672 · Cited by 982
Clements-Nolle, K., Marx, R., & Katz, M. (2006) · Journal of Homosexuality · doi:10.1300/j082v51n03_04 · Cited by 965
Russell, D. W. (2002) · Personality and Social Psychology Bulletin · doi:10.1177/014616702237645 · Cited by 954
Velicer, W. F., Eaton, C. A., & Fava, J. L. (2000) · Springer eBooks · doi:10.1007/978-1-4615-4397-8_3 · Cited by 886
Durably reducing transphobia: A field experiment on door-to-door canvassing
Broockman, D., & Kalla, J. (2016) · Science · doi:10.1126/science.aad9713 · Cited by 798
Non-binary or genderqueer genders
Richards, C., Bouman, W. P., Seal, L., Barker, M. J., Nieder, T. O., & T’Sjoen, G. (2016) · International Review of Psychiatry · doi:10.3109/09540261.2015.1106446 · Cited by 782
Violence against transgender people: A review of United States data
Stotzer, R. L. (2009) · Aggression and Violent Behavior · doi:10.1016/j.avb.2009.01.006 · Cited by 701
How Many Adults Identify as Transgender in the United States
Flores, A. R., Herman, J. L., Gates, G. J., & Brown, T. N. T. (2016) · eScholarship (California Digital Library) · Cited by 688
The impact of minority stress on mental health and substance use among sexual minority women.
Lehavot, K., & Simoni, J. M. (2011) · Journal of Consulting and Clinical Psychology · doi:10.1037/a0022839 · Cited by 652
van Anders, S. M. (2015) · Archives of Sexual Behavior · doi:10.1007/s10508-015-0490-8 · Cited by 651
Pachankis, J. E., Hatzenbuehler, M. L., Rendina, H. J., Safren, S. A., & Parsons, J. T. (2015) · Journal of Consulting and Clinical Psychology · doi:10.1037/ccp0000037 · Cited by 619
Mohr, J. J., & Kendra, M. S. (2011) · Journal of Counseling Psychology · doi:10.1037/a0022858 · Cited by 615
Norton, A. T., & Herek, G. M. (2012) · Sex Roles · doi:10.1007/s11199-011-0110-6 · Cited by 604
Mental health and gender dysphoria: A review of the literature
Dhejne, C., Van Vlerken, R., Heylens, G., & Arcelus, J. (2016) · International Review of Psychiatry · doi:10.3109/09540261.2015.1115753 · Cited by 580
Gender affirmation: a framework for conceptualizing risk behavior among transgender women of color.
Sevelius, J. M. (2013) · Sex Roles · doi:10.1007/s11199-012-0216-5 · Cited by 572
Nadal, K. L. Y., Whitman, C. N., Davis, L. S., Erazo, T., & Davidoff, K. C. (2016) · The Journal of Sex Research · doi:10.1080/00224499.2016.1142495 · Cited by 571
Kline, R. B. (2015) · Basic and Applied Social Psychology · doi:10.1080/01973533.2015.1049349 · Cited by 460
Suicidal ideation in transgender people: Gender minority stress and interpersonal theory factors.
Testa, R. J., Michaels, M. S., Bliss, W., Rogers, M. L., Balsam, K. F., & Joiner, T. (2017) · Journal of Abnormal Psychology · doi:10.1037/abn0000234 · Cited by 455
The association between rumination and negative affect: A review
Kirkegaard Thomsen, D. (2006) · Cognition and Emotion · doi:10.1080/02699930500473533 · Cited by 416
Feinstein, B. A., Goldfried, M. R., & Davila, J. (2012) · Journal of Consulting and Clinical Psychology · doi:10.1037/a0029425 · Cited by 412
Nemoto, T., Bödeker, B., & Iwamoto, M. (2011) · American Journal of Public Health · doi:10.2105/ajph.2010.197285 · Cited by 410
Watkins, E. R., Mullan, E., Wingrove, J., Rimes, K., Steiner, H., Bathurst, N., Eastman, R., & Scott, J. (2011) · British Journal of Psychiatry · doi:10.1192/bjp.bp.110.090282 · Cited by 410
Self-citationA Two-Question Method for Assessing Gender Categories in the Social and Medical Sciences
Tate, C. C., Ledbetter, J. N., & Youssef, C. P. (2012) · The Journal of Sex Research · doi:10.1080/00224499.2012.690110 · Cited by 383
Kuper, L. E., Nussbaum, R. E., & Mustanski, B. S. (2011) · The Journal of Sex Research · doi:10.1080/00224499.2011.596954 · Cited by 361
Explanation of Two Anomalous Results in Statistical Mediation Analysis
Fritz, M. S., Taylor, A. B., & MacKinnon, D. P. (2012) · Multivariate Behavioral Research · doi:10.1080/00273171.2012.640596 · Cited by 358
Pflum, S. R., Testa, R. J., Balsam, K. F., Goldblum, P. B., & Bongar, B. M. (2015) · Psychology of Sexual Orientation and Gender Diversity · doi:10.1037/sgd0000122 · Cited by 335
Gamarel, K. E., Reisner, S. L., Laurenceau, J., Nemoto, T., & Operario, D. (2014) · Journal of Family Psychology · doi:10.1037/a0037171 · Cited by 308
Suicide risk in trans populations: An application of minority stress theory.
Tebbe, E. A., & Moradi, B. (2016) · Journal of Counseling Psychology · doi:10.1037/cou0000152 · Cited by 307
Szymanski, D. M. (2006) · Sex Roles · doi:10.1007/s11199-006-9340-4 · Cited by 291
Internalized Homonegativity: A Systematic Mapping Review of Empirical Research
Berg, R. C., Munthe‐Kaas, H. M., & Ross, M. W. (2015) · Journal of Homosexuality · doi:10.1080/00918369.2015.1083788 · Cited by 254
Breslow, A. S., Brewster, M. E., Velez, B. L., Wong, S., Geiger, E., & Soderstrom, B. (2015) · Psychology of Sexual Orientation and Gender Diversity · doi:10.1037/sgd0000117 · Cited by 249
The relationship between gender-based victimization and suicide attempts in transgender people.
Goldblum, P., Testa, R. J., Pflum, S., Hendricks, M. L., Bradford, J., & Bongar, B. (2012) · Professional Psychology: Research and Practice · doi:10.1037/a0029605 · Cited by 231
Brewster, M. E., Moradi, B., DeBlaere, C., & Velez, B. L. (2013) · Journal of Counseling Psychology · doi:10.1037/a0033224 · Cited by 224
Bias in the Workplace: Consistent Evidence of Sexual Orientation and Gender Identity Discrimination
Badgett, M. V. L., Sears, B., Lau, H., & Ho, D. (2007) · bepress Legal Repository · Cited by 212
Measuring National Well-being: Life in the UK, 2012
Thomas, J., & Randall, C. (2012) · Cited by 187
Multivariate Exploratory Data Analysis: A Perspective on Exploratory Factor Analysis.
MacCallum, R. C., & Yates, A. (1989) · Journal of the American Statistical Association · doi:10.2307/2289967 · Cited by 181
Testing the tenets of minority stress theory in workplace contexts.
Velez, B. L., Moradi, B., & Brewster, M. E. (2013) · Journal of Counseling Psychology · doi:10.1037/a0033346 · Cited by 180
Szymanski, D. M. (2009) · Journal of Counseling Psychology · doi:10.1037/0022-0167.56.1.142 · Cited by 179
‘The other kind of coming out’
Zimman, L. (2009) · Gender and Language · doi:10.1558/genl.v3i1.53 · Cited by 166
New Paradigms for Research on Heterosexual and Sexual-Minority Development
Diamond, L. M. (2003) · Journal of Clinical Child & Adolescent Psychology · doi:10.1207/s15374424jccp3204_1 · Cited by 163
Perceived discrimination and depression among low-income Latina male-to-female transgender women
Bazargan, M., & Galván, F. H. (2012) · BMC Public Health · doi:10.1186/1471-2458-12-663 · Cited by 159
Developmental and Contextual Factors and Mental Health Among Lesbian, Gay, and Bisexual Youths.
D’Augelli, A. R. (2006) · American Psychological Association eBooks · doi:10.1037/11261-002 · Cited by 145
Emotional, behavioral, and cognitive reactions to microaggressions: Transgender perspectives.
Nadal, K. L. Y., Davidoff, K. C., Davis, L. S., & Wong, Y. (2014) · Psychology of Sexual Orientation and Gender Diversity · doi:10.1037/sgd0000011 · Cited by 132
Hatzenbuehler, M. L., Dovidio, J. F., Nolen–Hoeksema, S., & Phills, C. E. (2009) · Journal of Experimental Social Psychology · doi:10.1016/j.jesp.2009.08.005 · Cited by 131
Internalized stigma within sexual and gender minorities: Change strategies and clinical implications
Puckett, J. A., & Levitt, H. M. (2015) · Journal of LGBT Issues in Counseling · doi:10.1080/15538605.2015.1112336 · Cited by 112
Szymanski, D. M., Dunn, T. L., & Ikizler, A. S. (2014) · Psychology of Sexual Orientation and Gender Diversity · doi:10.1037/sgd0000066 · Cited by 106
A brief telephone interview to identify lesbian and bisexual women in random digit dialing sampling
Meyer, I. H., Rossano, L., Ellis, J., & Bradford, J. (2002) · The Journal of Sex Research · doi:10.1080/00224490209552133 · Cited by 103
Liao, K. Y., Kashubeck‐West, S., Weng, C., & Deitz, C. (2015) · Journal of Counseling Psychology · doi:10.1037/cou0000064 · Cited by 103
Szymanski, D. M., & Ikizler, A. S. (2012) · Psychology of Men & Masculinity · doi:10.1037/a0027787 · Cited by 102
Transforming the paradigm of transgender health: a field in transition
Bockting, W. O. (2009) · Sexual & Relationship Therapy · doi:10.1080/14681990903037660 · Cited by 101
Measuring the Subjective Well-Being of Nations: National Accounts of Time Use and Well-Being
Cutler, D. (n.d.) · RePEc: Research Papers in Economics · Cited by 78
The Gender Identity Reflection and Rumination Scale: Development and Psychometric Evaluation
Bauerband, L. A., & Galupo, M. P. (2014) · Journal of Counseling & Development · doi:10.1002/j.1556-6676.2014.00151.x · Cited by 67
Puckett, J. A., Newcomb, M. E., Garofalo, R., & Mustanski, B. S. (2016) · Sexuality Research and Social Policy · doi:10.1007/s13178-016-0239-8 · Cited by 54
Selective sexual orientation-related differences in object location memory.
Hassan, B., & Rahman, Q. (2007) · Behavioral Neuroscience · doi:10.1037/0735-7044.121.3.625 · Cited by 40
Self-citationStrain, J. D., & Shuff, I. M. (2010) · International Journal of Transgenderism · doi:10.1080/15532739.2010.544231 · Cited by 35
Hakeem, A., Črnčec, R., Asghari-Fard, M., Harte, F., & Eapen, V. (2016) · International Journal of Transgenderism · doi:10.1080/15532739.2016.1217812 · Cited by 29
Flagged first, then by citations
1 of the 85 references couldn’t be matched to a known paper.
Cited by
Sorted by citations
Associations between microaggression and adjustment outcomes: A meta-analytic and narrative review.
Lui, P. P., & Quezada, L. (2018) · Psychological Bulletin · doi:10.1037/bul0000172 · Cited by 253
Scandurra, C., Bochicchio, V., Amodeo, A. L., Esposito, C., Valerio, P., Maldonato, M. N., Bacchini, D., & Vitelli, R. (2018) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph15030508 · Cited by 158
“Summarizing, actual scientific literature reports evidence that both group-specific processes [5,31,33] and general psychological processes [32] mediate the relationship between external stressors and negative mental health outcomes, and that group-level coping mechanisms [5] buffer the effect of stressors on mental h…”
BackgroundMinority Stressors, Rumination, and Psychological Distress in Lesbian, Gay, and Bisexual Individuals
Timmins, L., Rimes, K. A., & Rahman, Q. (2019) · Archives of Sexual Behavior · doi:10.1007/s10508-019-01502-2 · Cited by 141
Self-citationGalupo, M. P., Pulice-Farrow, L., & Lindley, L. M. (2019) · Stigma and Health · doi:10.1037/sah0000189 · Cited by 135
Anzani, A., Lindley, L. M., Tognasso, G., Galupo, M. P., & Prunas, A. (2021) · Archives of Sexual Behavior · doi:10.1007/s10508-021-01935-8 · Cited by 114
Metadata
- Authors
- Timmins, L., Rimes, K. A., & Rahman, Q.
- Affiliations
- King's College London (GB)
- Venue
- Psychology of Sexual Orientation and Gender Diversity
- Published
- 2017-09
- Volume
- 4
- Issue
- 3
- Pages
- 328-340
- ISSN
- 2329-0382 (ISSN-L)
- 2329-0390
- OpenAlex
- W2737774863
- Cited by
- 131
- References
- 85
- Citations by year
- 2026: 8 · 2025: 21 · 2024: 13 · 2023: 11 · 2022: 19 · 2021: 20 · 2020: 22 · 2019: 9 · 2018: 8
- FWCI
- 15.31
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Psychology of Sexual Orientation and Gender Diversity (publishedVersion)
- Cronfa (Swansea University) (acceptedVersion)
- Research Portal (King's College London) (submittedVersion)
- Topics
- Social Sciences › Psychology › Social Psychology › LGBTQ Health, Identity, and Policy
- Social Sciences › Sociology and Political Science › Racial and Ethnic Identity Research
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
- Keywords
- minority stress, transgender people, psychological distress, rumination, self-stigma
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review