Enacted Stigma, Mental Health, and Protective Factors Among Transgender Youth in Canada

Veale, Jaimie F.; Peter, Tracey; Travers, Robb; Saewyc, Elizabeth M.

doi:10.1089/trgh.2017.0031

Cited by 228LGBTQ Health, Identity, and PolicyHate Speech and Cyberbullying DetectionSexuality, Behavior, and Technology

Enacted Stigma, Mental Health, and Protective Factors Among Transgender Youth in Canada

Open access

Veale, Jaimie F., Peter, Tracey, Travers, Robb, Saewyc, Elizabeth M.·2017·Transgender Health

DOI 10.1089/trgh.2017.0031PMC PMC5734137

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Abstract

Purpose: We aimed to assess the Minority Stress Model which proposes that the stress of experiencing stigma leads to adverse mental health outcomes, but social supports (e.g., school and family connectedness) will reduce this negative effect. Methods: We measured stigma-related experiences, social supports, and mental health (self-injury, suicide, depression, and anxiety) among a sample of 923 Canadian transgender 14- to 25-year-old adolescents and young adults using a bilingual online survey. Logistic regression models were conducted to analyze the relationship between these risk and protective factors and dichotomous mental health outcomes among two separate age groups, 14- to 18-year-old and 19- to 25-year-old participants. Results: Experiences of discrimination, harassment, and violence (enacted stigma) were positively related to mental health problems and social support was negatively associated with mental health problems in all models among both age groups. Among 14–18 year olds, we examined school connectedness, family connectedness, and perception of friends caring separately, and family connectedness was always the strongest protective predictor in multivariate models. In all the mental health outcomes we examined, transgender youth reporting low levels of enacted stigma experiences and high levels of protective factors tended to report favorable mental health outcomes. Conversely, the majority of participants reporting high levels of enacted stigma and low levels of protective factors reported adverse mental health outcomes. Conclusion: While these findings are limited by nonprobability sampling procedures and potential additional unmeasured risk and protective factors, the results provide positive evidence for the Minority Stress Model in this population and affirm the need for policies and programs to support schools and families to support transgender youth.

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Crossref · 10.1089/trgh.2017.0031

Cites

33 of 33 references verified0 citation errors · 0 not checkable

Statistics

Nothing to recompute.

Claims the paper makes

5 of 35 cited sources checked · 3 supported · 0 flagged · accuracy not yet measured

Premisecitation
Studies of transgender adults have found that family support is associated with better mental health.
“Studies of transgender adults have also found that family support is associated with better mental health.17”
Quote in the paperNot a substantial claim1 of 1 sources checked
- cites [17] source
  Experimental — accuracy not yet measured
Premisecitation
Around 80% of transgender youth report verbal harassment or bullying at school.
“with around 80% reporting verbal harassment10–12 or bullying at school.13”
Quote in the paperNot a substantial claim1 of 4 sources checked
- cites [10]
  Couldn’t be matched to a paper in Crossref, so it can’t be checked.
- cites [11] source
- cites [12] source
- cites [13] source
  The Results table reports that 82.6% of transgender or gender-nonconforming youth experienced bullying in the past 12 months, which supports “around 80%.” It does not identify those bullying experiences as occurring at school; 75.5% reported in-person bullying, but that measure also does not specify a school setting. (LLM, conf=0.85)
  Experimental — accuracy not yet measured
Findingown data
For 14-18 year olds, the probability of suicide attempts dropped to 7% when family connectedness and friends caring were high and enacted stigma was low.
“The optimal scenario is for transgender youth to have high levels of family connectedness and friends caring, and low levels of enacted stigma exposure—in such cases, the probability of suicide attempts dropped to 7%.”
Quote in the paperSubstantial claim
- The authors state this as an assumption: Missing values on scales were missing at random with respect to mental health, enacted stigma, and protective factors.
Findingown data
For each enacted stigma experience, 14-18 year old participants were 25% more likely to report NSSI in the past year.
“for each enacted stigma experience, participants were 25% more likely to have reported NSSI in the past year”
Quote in the paperSubstantial claim
- The authors state this as an assumption: Missing values on scales were missing at random with respect to mental health, enacted stigma, and protective factors.
Findingown data
A number of enacted stigma experiences were reported by the majority of Canadian transgender youth.
“a number of these enacted stigma experiences were reported by the majority of Canadian transgender youth.”
Quote in the paperNot a substantial claim
- The authors state this as an assumption: Missing values on scales were missing at random with respect to mental health, enacted stigma, and protective factors.

Findingown data
The majority of participants reporting high enacted stigma and low protective factors reported adverse mental health outcomes.
“Conversely, the majority of participants reporting high levels of enacted stigma and low levels of protective factors reported adverse mental health outcomes.”
Quote in the paperSubstantial claim
- The authors state this as an assumption: Missing values on scales were missing at random with respect to mental health, enacted stigma, and protective factors.
Findingown data
Among 14-18 year olds, perception of friends caring predicted suicide attempts in the past year.
“perception of friends caring was also predictive of suicide attempts in the past year”
Quote in the paperNot a substantial claim
- The authors state this as an assumption: Missing values on scales were missing at random with respect to mental health, enacted stigma, and protective factors.
Findingown data
Among 19-25 year old participants, almost three-quarters reported ever seriously considering suicide.
“almost three-quarters reported they had ever seriously considered suicide”
Quote in the paperNot a substantial claim
- The authors state this as an assumption: Missing values on scales were missing at random with respect to mental health, enacted stigma, and protective factors.
Findingown data
Enacted stigma experiences (discrimination, harassment, and violence) are positively associated with mental health problems in all regression models among both age groups of Canadian transgender youth.
“Experiences of discrimination, harassment, and violence (enacted stigma) were positively related to mental health problems and social support was negatively associated with mental health problems in all models among both age groups.”
- Also stated in: § Younger youth (14–18 year olds) · plain
  “The Enacted Stigma Index was a positive predictor of mental health problems in all the regression models.”
- Also stated in: § Older youth (19–25 year olds) · plain
  “The Enacted Stigma Index was a positive predictor of mental health problems in all the regression models, and similarly, Social Support was a negative predictor in all the models.”
Quote in the paperSubstantial claim
- The authors state this as an assumption: Missing values on scales were missing at random with respect to mental health, enacted stigma, and protective factors.
Findingown data
Probability profiling results for 19-25 year olds show greatly varying probabilities depending on the mix of risk and protective factors.
“as with the 14 to 18 year olds, these show greatly varying probabilities depending on the mix of risk and protective factors.”
Quote in the paperNot a substantial claim
- The authors state this as an assumption: Missing values on scales were missing at random with respect to mental health, enacted stigma, and protective factors.
Findingown data
Among 14-18 year old participants, 28% reported extreme despair in the past 30 days.
“45% and 28% reporting extreme stress and despair in the past 30 days, respectively”
Quote in the paperNot a substantial claim
- The authors state this as an assumption: Missing values on scales were missing at random with respect to mental health, enacted stigma, and protective factors.
Findingown data
Among 19-25 year old participants, more than half reported nonsuicidal self-injury in the past year.
“More than half of these participants reported NSSI in the past year”
Quote in the paperNot a substantial claim
- The authors state this as an assumption: Missing values on scales were missing at random with respect to mental health, enacted stigma, and protective factors.
Findingown data
Among 14-18 year old participants, almost three-quarters reported nonsuicidal self-injury in the past year.
“almost three-quarters reporting NSSI in the past year”
- Also stated in: § Discussion · plain
  “three out of four reported NSSI behaviors in the past year”
Quote in the paperSubstantial claim
- The authors state this as an assumption: Missing values on scales were missing at random with respect to mental health, enacted stigma, and protective factors.
Findingown data
For 14-18 year olds, even with low enacted stigma, if parental and social supports are low, the probability of serious suicidal ideation was 38%.
“Even if transgender youth reported low levels of enacted stigma, when levels of parental and social supports are low, their probability of serious suicidal ideation was still at 38%.”
Quote in the paperSubstantial claim
- The authors state this as an assumption: Missing values on scales were missing at random with respect to mental health, enacted stigma, and protective factors.
Findingown data
Among 14-18 year old participants, 45% reported extreme stress in the past 30 days.
“45% and 28% reporting extreme stress and despair in the past 30 days, respectively”
- Also stated in: § Discussion · hedged
  “nearly half experienced extreme stress in the past 30 days”
Quote in the paperNot a substantial claim
- The authors state this as an assumption: Missing values on scales were missing at random with respect to mental health, enacted stigma, and protective factors.
Findingown data
Transgender youth reporting low enacted stigma and high protective factors tended to report favorable mental health outcomes across the examined outcomes.
“In all the mental health outcomes we examined, transgender youth reporting low levels of enacted stigma experiences and high levels of protective factors tended to report favorable mental health outcomes.”
Quote in the paperSubstantial claim
- The authors state this as an assumption: Missing values on scales were missing at random with respect to mental health, enacted stigma, and protective factors.
Findingown data
Among 19-25 year old participants, 71% reported feeling sad or depressed for more than 2 weeks in the past year.
“71% reported having felt sad or depressed for more than 2 weeks in the past year”
Quote in the paperNot a substantial claim
- The authors state this as an assumption: Missing values on scales were missing at random with respect to mental health, enacted stigma, and protective factors.
Findingown data
Among 19-25 year olds, parent connectedness predicted lower odds of serious suicidal thoughts in the final multivariate model.
“Parent connectedness also played a role in the final multivariate model, predicting lower odds of serious suicidal thoughts.”
Quote in the paperNot a substantial claim
- The authors state this as an assumption: Missing values on scales were missing at random with respect to mental health, enacted stigma, and protective factors.
Findingown data
Among 14-18 year olds, school connectedness was a significant protective factor in models for extreme stress and extreme despair.
“School Connectedness was a significant protective factor in the models for extreme stress and extreme despair”
Quote in the paperSubstantial claim
- The authors state this as an assumption: Missing values on scales were missing at random with respect to mental health, enacted stigma, and protective factors.
Findingown data
Social support is negatively associated with mental health problems in all models among both age groups.
“and social support was negatively associated with mental health problems in all models among both age groups.”
- Also stated in: § Older youth (19–25 year olds) · plain
  “Social Support was a negative predictor in all the models.”
Quote in the paperSubstantial claim
- The authors state this as an assumption: Missing values on scales were missing at random with respect to mental health, enacted stigma, and protective factors.
Findingown data
Among 14-18 year olds, family connectedness was always the strongest protective predictor in multivariate models.
“Among 14–18 year olds, we examined school connectedness, family connectedness, and perception of friends caring separately, and family connectedness was always the strongest protective predictor in multivariate models.”
- Also stated in: § Younger youth (14–18 year olds) · hedged
  “Family Connectedness was usually the strongest protective factor in the final models”
Quote in the paperNot a substantial claim
- The authors state this as an assumption: Missing values on scales were missing at random with respect to mental health, enacted stigma, and protective factors.
Findingown data
For 14-18 year olds, the model predicted a 72% probability of ever seriously considering suicide for a transgender youth with high enacted stigma and low protective factors.
“the model predicted that a transgender youth who had experienced high levels of discrimination, harassment, or violence perpetrated against them, who were also low on protective factors, had a 72% probability of reporting this.”
Quote in the paperSubstantial claim
- The authors state this as an assumption: Missing values on scales were missing at random with respect to mental health, enacted stigma, and protective factors.
Findingown data
For 14-18 year olds, the estimated probability of serious suicidal ideation remains close to 50% even when family connectedness and/or friends caring is high.
“This estimate is reduced markedly when family connectedness and/or friends caring was high, but even with these supports, the estimated probability remains at close to 50%.”
Quote in the paperSubstantial claim
- The authors state this as an assumption: Missing values on scales were missing at random with respect to mental health, enacted stigma, and protective factors.
Findingown data
Among 14-18 year old participants, over one-third attempted suicide in the past year.
“over one-third having attempted suicide in the past year”
- Also stated in: § Discussion · plain
  “a third attempted suicide in the last year”
Quote in the paperSubstantial claim
- The authors state this as an assumption: Missing values on scales were missing at random with respect to mental health, enacted stigma, and protective factors.
Premisecitation
In a Virginia study of transgender youth, 45% reported in-school victimization based on their gender.
“Another study of transgender youth in Virginia found 45% had reported in-school victimization based on their gender”
Quote in the paperNot a substantial claim0 of 1 sources checked
- cites [3] source
Interpretationown data
The results provide positive evidence for the Minority Stress Model in this population.
“the results provide positive evidence for the Minority Stress Model in this population”
- Also stated in: § Discussion · plain
  “This is consistent with the minority stress model applied to transgender people”
- Also stated in: § Conclusions · plain
  “These results are in accordance with the minority stress theory”
Quote in the paperSubstantial claim
Premisecitation
Ybarra et al. found that transgender youth who experienced intense bullying were almost five times more likely to report suicidal ideation.
“Ybarra et al.5 found that transgender youth who had experienced intense bullying were almost five times more likely to report suicidal ideation”
Quote in the paperNot a substantial claim0 of 1 sources checked
- cites [5] source
Premisecitation
In that Virginia study, those who experienced in-school victimization had a fourfold greater likelihood of suicidal ideation.
“those who had endured these experiences had a fourfold greater likelihood of suicidal ideation.3”
Quote in the paperNot a substantial claim0 of 1 sources checked
- cites [3] source
Premisecitation
GSAs have been found to have positive effects on all students, not only LGB students.
“GSAs have also been found to have positive effects on all students, not only LGB students, providing evidence for them aiding transgender students as well.31”
Quote in the paperNot a substantial claim0 of 1 sources checked
- cites [31] source
Interpretationown data
Supportive environments (family, friends, schools) appear to reduce negative impacts of enacted stigma on mental health among transgender youth.
“we also found that supportive environments (i.e., family, friends, and schools) appear to reduce these negative impacts.”
- Also stated in: § Conclusions · hedged
  “When youth feel cared about and connected to their families, friends, and schools, the negative impacts of stigma experiences on mental health may be reduced.”
Quote in the paperSubstantial claim
Premisecitation
This topic has received less attention than stigma and risk factors in empirical research on the theory.
“but this topic has received less attention than stigma and risk factors in empirical research on the theory.15”
Quote in the paperSubstantial claim0 of 1 sources checked
- cites [15] source
Interpretationown data
Transgender youth have a greatly reduced likelihood of negative mental health outcomes when strongly connected to family or school, even when experiencing stigma and discrimination elsewhere.
“The importance of protective factors demonstrates that transgender youth have a greatly reduced likelihood of negative mental health outcomes when they reported being strongly connected to their family or their school, even when they experienced stigma and discrimination elsewhere.”
Quote in the paperSubstantial claim
Study design and conductreasoning
The study had relatively fewer trans girls/women and nonbinary assigned male at birth participants.
“This study had relatively fewer trans girls/women and nonbinary assigned male at birth participants.”
Quote in the paperNot a substantial claim
Interpretationown data
When transgender youth have supportive family and school environments, even with high exposure to enacted stigma, the stress is buffered to an extent.
“This study found that when transgender youth have supportive family and school environments, even when they have high exposure to enacted stigma, the stress is buffered to an extent.”
Quote in the paperSubstantial claim
Study design and conductreasoning
Participants who are more resourceful and engaged in the transgender community were likely overrepresented due to recruitment techniques.
“Given the recruitment techniques, participants who are more resourceful and engaged in the transgender community were likely to have been overrepresented.”
Quote in the paperNot a substantial claim

Classified as probably not a substantial claim. 26
May combine two claims. 17

Classified as probably not a substantial claim. May combine two claims.
Premisecitation
Being perceived as transgender may make youth vulnerable to minority stress, which has been proposed as an explanation for high rates of mental health difficulties in this group.
“Being perceived as transgender may make youth vulnerable to minority stress, which has been proposed as an explanation for the high rates of mental health difficulties reported among this group.3–5”
Quote in the paperSubstantial claim1 of 3 sources checked
- cites [3] source
- cites [4] source
  The Discussion reports high rates of psychiatric disorders among young transgender women and proposes that stressors associated with gender transition and affirmation may affect their mental health. It does not specifically say that being perceived as transgender exposes youth to minority stress or identify that as the explanation for the elevated rates. The cited study also concerns young transgender women, rather than transgender youth generally. (LLM, conf=0.83)
  Experimental — accuracy not yet measured
- cites [5] source
May combine two claims.
Premisecitation
In a Los Angeles clinic study, parental support was associated with decreased depressive symptoms and improved life satisfaction among transgender youth.
“A study of transgender youth in a Los Angeles clinic found that parental support was associated with decreased depressive symptoms and improved life satisfaction.16”
Quote in the paperNot a substantial claim1 of 1 sources checked
- cites [16] source
Probably not a substantial claim: may not pass S3 (load-bearing).
Study design and conductcitation
The first five items of the family connectedness scale had high internal consistency reliability.
“One study found high levels of internal consistency reliability for the first five items of this scale.25”
Quote in the paperNot a substantial claim1 of 1 sources checked
- cites [25] source
May combine two claims.
Findingown data
Among 14-18 year olds, all protective factors negatively predicted mental health difficulties, but not all met the 0.5 odds ratio criterion for final multivariate models due to intercorrelation.
“While all the protective factors negatively predicted mental health difficulties, they did not all meet the criterion of a 0.5 odds ratio to be included in the final multivariate models due to these predictors being intercorrelated.”
Quote in the paperNot a substantial claim
- The authors state this as an assumption: Missing values on scales were missing at random with respect to mental health, enacted stigma, and protective factors.
Probably not a substantial claim: may not pass S3 (load-bearing).
Premisecitation
Transgender youth who experienced parental abuse were more likely to have attempted suicide.
“another study found that transgender youth who had experienced parental abuse were more likely to have attempted suicide.14”
Quote in the paperNot a substantial claim0 of 1 sources checked
- cites [14] source
Probably not a substantial claim: may not pass S3 (load-bearing).
Premisecitation
In a US study of 290 high school students, the majority had been physically harassed in the past year due to their gender expression.
“A study of 290 high school students across the United States found that the majority had been physically harassed in the past year due to their gender expression”
Quote in the paperNot a substantial claim0 of 1 sources checked
- cites [10]
  Couldn’t be matched to a paper in Crossref, so it can’t be checked.
May combine two claims.
Premisecitation
Transgender-specific stressors include feeling or being unsafe in public restrooms, lack of access to legal documents or medical care due to differing records of sex and legal name, and nonaffirmation of one's gender by others.
“Stressors that are specific to transgender individuals, which have been identified, include feeling or being unsafe in public restrooms, lack of access to legal documents or medical care due to differing records of sex and legal name, and nonaffirmation of one's gender by others.9”
Quote in the paperSubstantial claim0 of 1 sources checked
- cites [9] source
Classified as probably not a substantial claim.
Premisecitation
Minority stress theory holds that members of minority groups experience stressors related specifically to their group membership.
“Minority stress theory suggests that members of minority groups experience stressors related specifically to their membership with that group.6”
Quote in the paperSubstantial claim0 of 1 sources checked
- cites [6] source
Classified as probably not a substantial claim.
Premisecitation
LGBTQ youth who report more positive and supportive school experiences are more likely to report better mental health.
“studies have shown that lesbian, gay, bisexual, transgender, and queer (LGBTQ) youth who report more positive and supportive school experiences are more likely to also report better mental health.18,19”
Quote in the paperSubstantial claim0 of 2 sources checked
- cites [18] source
- cites [19] source
Probably not a substantial claim: may not pass S3 (load-bearing).
Premisecitation
Minority stress includes not only specific negative events but also overarching societal experiences negotiated in everyday life.
“Experiences of minority stress not only result from specific negative events but also from the overarching experiences in society that the minority individual negotiates in their everyday lives.7”
Quote in the paperNot a substantial claim0 of 1 sources checked
- cites [7] source
Probably not a substantial claim: may not pass S3 (load-bearing).
Premisecitation
In that US study, more than a quarter reported being physically assaulted in the past year due to their gender expression.
“more than a quarter reported being physically assaulted in the past year due to their gender expression.10”
Quote in the paperNot a substantial claim0 of 1 sources checked
- cites [10]
  Couldn’t be matched to a paper in Crossref, so it can’t be checked.
Classified as probably not a substantial claim.
Premisecitation
These minority stressors result from sociocultural sanctions of status, prejudice, and discrimination.
“These stressors are a result of sociocultural sanctions of status, prejudice, and discrimination”
Quote in the paperSubstantial claim0 of 1 sources checked
- cites [6] source
Probably not a substantial claim: may not pass S3 (load-bearing).
Premisecitation
In that US study, almost two-thirds reported feeling unsafe at school due to their gender expression.
“almost two-thirds reporting they feel unsafe at school due to their gender expression”
Quote in the paperNot a substantial claim0 of 1 sources checked
- cites [10]
  Couldn’t be matched to a paper in Crossref, so it can’t be checked.
Classified as probably not a substantial claim.
Premisecitation
Minority stress theory has been applied to transgender people.
“Minority stress theory has been applied to transgender people.8”
Quote in the paperSubstantial claim0 of 1 sources checked
- cites [8] source
Classified as probably not a substantial claim.
Premisecitation
Minority stress theory proposes that these stressors negatively impact psychological well-being and adaptation.
“the theory proposes that they negatively impact psychological well-being and adaptation.”
Quote in the paperSubstantial claim0 of 1 sources checked
- cites [6] source
Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.
Study design and conductown data
An error in survey skip logic reduced data on suicidal attempts for 19-25 year olds, so it was not used in this study.
“While we also collected data on suicidal attempts for 19–25 year olds, we decided to not use it in this study because it was reduced due to an error we made in our survey skip logic.”
Quote in the paperNot a substantial claim
May combine two claims.
Study design and conductreasoning
Other protective factors such as living in felt gender and access to competent healthcare were not included in estimates, and their inclusion may have resulted in lower estimates of poor mental health for youth reporting the best-case scenario.
“other protective factors, such as living in their felt gender and access to competent healthcare, were not included in our estimates, and their inclusion may have resulted in lower estimates of poor mental health for those youth reporting the best-case scenario.”
Quote in the paperNot a substantial claim
Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.
Study design and conductreasoning
Using questions drawn from Canadian population-based surveys ensured that questions were widely used and had undergone thorough validation.
“Using questions drawn from Canadian population-based surveys ensured that questions are widely used and had undergone thorough validation.”
Quote in the paperNot a substantial claim
Probably not a substantial claim: may not pass S3 (load-bearing).
Interpretationcitation
The findings are consistent with previous studies of transgender youth.
“These findings are consistent with previous studies of transgender youth,3,5,14,29”
Quote in the paperNot a substantial claim0 of 4 sources checked
- cites [3] source
- cites [5] source
- cites [14] source
- cites [29] source
Probably not a substantial claim: may not pass S3 (load-bearing).
Study design and conductnone given
The study relied on cross-sectional data when longitudinal data would be preferable to test causal hypotheses.
“This study also relied on cross-sectional data when longitudinal data would be preferable to test these causal hypotheses.”
Quote in the paperNot a substantial claim
Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.
Study design and conductcitation
The School Connectedness Scale has adequate concurrent validity, reliability, and measurement stability across 18 ethnic groups.
“One study reported that this scale has adequate concurrent validity, reliability, and measurement stability across 18 ethnic groups.24”
Quote in the paperNot a substantial claim0 of 1 sources checked
- cites [24] source
Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.
Premisecitation
Meyer recognized individual-level resilience in coping with minority stress as an additional area for potential intervention, but suggested caution because individuals within different groups have different access to this resilience.
“Meyer also recognized individual-level resilience in coping with minority stress as an additional area for potential intervention for enhancing resilience, but he suggested caution with focusing on this because individuals within different groups have different access to this resilience.15”
Quote in the paperNot a substantial claim0 of 1 sources checked
- cites [15] source
Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.
Study design and conductown data
Responses were manually screened for careless responding by examining fastest response times, and no evidence of careless responding was observed.
“Responses were also screened manually for careless responding by examining participants with the fastest response times, and no evidence of careless responding was observed.”
Quote in the paperNot a substantial claim
Probably not a substantial claim: may not pass S3 (load-bearing).
Study design and conductnone given
The study did not examine support received specifically from the transgender community.
“this study did not examine support received specifically from the transgender community.”
Quote in the paperNot a substantial claim
Probably not a substantial claim: may not pass S3 (load-bearing).
Study design and conductown data
Probability profiling results illustrated only outcomes at the 10th and 90th percentiles.
“these probability profiling results illustrated only those outcomes at more extreme ends (10th and 90th percentiles).”
Quote in the paperNot a substantial claim
May combine two claims.
Study design and conductreasoning
The study used nonprobability recruitment, so there is no way to know how representative the sample is of the larger Canadian transgender youth population.
“the sampling frame was based on nonprobability recruitment methods and, as such, there is no way of knowing how representative the sample is from the larger transgender youth population across Canada.”
Quote in the paperSubstantial claim
May combine two claims.
Study design and conductnone given
The Enacted Stigma Index included experiences that might be expected due to anti-transgender stigma, but except for one discrimination question, it did not include questions specifically about anti-transgender stigma.
“the Enacted Stigma Index used in this study included experiences that might be expected due to anti-transgender stigma, but except for one discrimination question, it did not include questions specifically about anti-transgender stigma.”
Quote in the paperNot a substantial claim
Classified as probably not a substantial claim.
Premisecitation
Resilience and protective factors that may reduce minority stress and negative health effects are essential components of the minority stress theory.
“Resilience and protective factors that may reduce minority stress and negative health effects are essential components of the minority stress theory”
Quote in the paperSubstantial claim0 of 1 sources checked
- cites [15] source
Classified as probably not a substantial claim. May combine two claims.
Study design and conductnone given
The study relied on single questions with dichotomized responses for mental health outcomes, though these questions are widely used and validated on large probability surveys.
“This study relied on single questions with responses dichotomized for mental health outcomes, while these questions are widely used and validated on large probability surveys.”
Quote in the paperSubstantial claim
May combine two claims.
Study design and conductcitation
The 12-item Medical Outcomes Study Social Support Survey performed well on confirmatory factor analysis as a single factor or higher-order factor model and had excellent reliability.
“This version of the scale performed well on confirmatory factor analysis as either a single factor or a higher-order factor model, and it had excellent reliability.27”
Quote in the paperNot a substantial claim0 of 1 sources checked
- cites [27] source
Probably not a substantial claim: may not pass S3 (load-bearing), S4 (based). May combine two claims.
Study design and conductnone given
Recruitment methods did not differ between the two age groups, and the two age groups had the same overall pattern of demographics.
“Recruitment methods did not differ between these two age groups and these two age groups had the same overall pattern of demographics.”
Quote in the paperNot a substantial claim
May combine two claims.
Interpretationown data
Negative mental health outcomes are complex, with several co-occurring risk and protective factors.
“Since our results suggest that negative mental health outcomes are complex, with several co-occurring risk and protective factors”
Quote in the paperSubstantial claim
Probably not a substantial claim: may not pass S3 (load-bearing).
Interpretationreasoning
Community-level resilience might have been captured indirectly through school connectedness, family connectedness, and social support variables.
“Community-level resilience might have been captured indirectly through the school connectedness, family connectedness, and social support variables assessed.”
Quote in the paperNot a substantial claim
May combine two claims.
Study design and conductreasoning
The study's methodology allowed gathering a large sample size, giving added confidence about generalizability, though generalizations should be made with caution.
“This study's methodology allowed us to gather a large sample size, giving us added confidence about the generalizability of our findings, even if these generalizations ought to be made with caution.”
Quote in the paperNot a substantial claim
Probably not a substantial claim: may not pass S4 (based).
Interpretationnone given
This was the first study to examine the impact of both risk and protective factors in the probability of developing adverse mental health outcomes for transgender people.
“this was the first study to examine the impact of both risk and protective factors in the probability of developing adverse mental health outcomes for transgender people.”
Quote in the paperNot a substantial claim

35 of 35

The authors state this as an assumption.
Missing values on scales were missing at random with respect to mental health, enacted stigma, and protective factors.
“We had no reason to believe that the missing values differed across different levels of mental health, enacted stigma, or protective factors (i.e., we believe data were missing at random); so we did not attempt to correct for this missingness.”

1 of 1

Self-check

Percentages, sums and reported differences re-computed from the paper’s own numbers.

Each contradiction between two passages listed here was confirmed by an independent check.

Younger participants' suicide outcome switches from attempts to ideation
Major
The methods say the younger group was asked about suicide attempts, not suicidal ideation. The results nevertheless describe its probability model as predicting whether a younger participant had seriously considered suicide.
Younger-youth suicide item described inconsistently
Minor
In the questionnaire section, younger participants are described as being asked about suicide attempts in the past 12 months, but later the results discussion refers to the probability of reporting 'ever seriously considered suicide' for the younger group. These are different outcomes, so the description of what was measured and what was modeled does not match.

2 of 2

Minority Stress and Mental Health in Gay Men
Meyer, I. H. (1995) · Journal of Health and Social Behavior · doi:10.2307/2137286 · Cited by 4,264 · cited 3× · see citing works
“Nonbinary (AMAB) 18 (6) 43 (8) New Brunswick 14 (4) 9 (2) Central/South American 8 (3) 4 (1) 6 years or more 31 (10) 54 (9)”
Background
Protecting Adolescents From Harm: Findings From the National Longitudinal Study on Adolescent Health
Resnick, M. D. (1997) · JAMA · doi:10.1001/jama.1997.03550100049038 · Cited by 2,846 · cited 2× · see citing works
“Boys/men 140 (47) 216 (36) Alberta 41 (13) 73 (12) White only 225 (72) 446 (75) Less than 1 year 1 (0) 6 (1) Girls/women 32 (11) 107 (20) British Columbia 85 (26) 124 (21) Aboriginal 42 (13) 51 (9) 1 to 2 years 2 (1) 6 (1) Nonbinary (AFAB) 110 (37) 173 (32) Manitoba 13 (4) 19 (3) Black 6 (2) 9 (2) 3 to 5 years 5 (2) 1…”
Background
A conceptual framework for clinical work with transgender and gender nonconforming clients: an adaptation of the Minority stress model
Hendricks, M. L., & Testa, R. J. (2012) · Professional Psychology: Research and Practice · doi:10.1037/a0029597 · Cited by 2,134 · cited 2× · see citing works
“2) 43 (7) South Asian 4 (1) 8 (1) English only 252 (79) 442 (74) Ontario 87 (27) 181 (30) East Asian 14 (5) 28 (5) French only 12 (4) 47 (8) Prince Edward Island 1 (0) 3 (1) Multi-racial 9 (3) 20 (3) English and French 24 (8) 42 (7)”
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 · cited 1× · see citing works
“Harassment in the past year for n (%) n (%) Race or culture 32 (17) Sexual orientation 120 (63) Body size/shape/appearance 106 (55) Gender identity 132 (69)”
Background
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 · see citing works
Resilience in the study of minority stress and health of sexual and gender minorities.
Meyer, I. H. (2015) · Psychology of Sexual Orientation and Gender Diversity · doi:10.1037/sgd0000132 · Cited by 1,152 · cited 1× · see citing works
“Physically threatened/injured past year 69 (36) Contact/use of violence services in the past 5 years 178 (52) Threatened with weapon past year 18 (9) Physically hurt by someone in family past year 29 (15) Sexual abuse 74 (35) Forced/attempted unwanted sexual activity in the past year 27 (7) Sexual touch by older or st…”
Background
Transgender Youth and Life‐Threatening Behaviors
Grossman, A. H., & D'Augelli, A. R. (2007) · Suicide and Life-Threatening Behavior · doi:10.1521/suli.2007.37.5.527 · Cited by 672 · see citing works
Parental Support and Mental Health Among Transgender Adolescents
Simons, L., Schrager, S. M., Clark, L. F., Belzer, M., & Olson, J. (2013) · Journal of Adolescent Health · doi:10.1016/j.jadohealth.2013.07.019 · Cited by 553 · see citing works
School support groups, other school factors, and the safety of sexual minority adolescents
Goodenow, C., Szalacha, L., & Westheimer, K. (2006) · Psychology in the Schools · doi:10.1002/pits.20173 · Cited by 553 · cited 1× · see citing works
“Quebec 31 (10) 106 (18) Other English and another language 19 (6) 41 (7)”
Background
The Health and Well-Being of Transgender High School Students: Results From the New Zealand Adolescent Health Survey (Youth'12)
Clark, T. C., Lucassen, M. F. G., Bullen, P., Denny, S. J., Fleming, T. M., Robinson, E. M., & Rossen, F. V. (2014) · Journal of Adolescent Health · doi:10.1016/j.jadohealth.2013.11.008 · Cited by 528 · cited 1× · see citing works
“Cyberbullying Cyberbullying Felt unsafe with internet contact 56 (29) Received threatening messages 155 (45) Been bullied on the internet 64 (33) Received hateful comments 141 (42) Had threatening e-mails sent out Using their identity 18 (5) Other cyberbullying 106 (33) Bullying in the past year Been bullied/taunted/r…”
Background
Gender Minority Social Stress in Adolescence: Disparities in Adolescent Bullying and Substance Use by Gender Identity
Reisner, S. L., Greytak, E. A., Parsons, J. T., & Ybarra, M. L. (2015) · The Journal of Sex Research · doi:10.1080/00224499.2014.886321 · Cited by 513 · cited 1× · see citing works
“Boys/men 140 (47) 216 (36) Alberta 41 (13) 73 (12) White only 225 (72) 446 (75) Less than 1 year 1 (0) 6 (1) Girls/women 32 (11) 107 (20) British Columbia 85 (26) 124 (21) Aboriginal 42 (13) 51 (9) 1 to 2 years 2 (1) 6 (1) Nonbinary (AFAB) 110 (37) 173 (32) Manitoba 13 (4) 19 (3) Black 6 (2) 9 (2) 3 to 5 years 5 (2) 1…”
School Climate for Transgender Youth: A Mixed Method Investigation of Student Experiences and School Responses
McGuire, J. K., Anderson, C. R., Toomey, R. B., & Russell, S. T. (2010) · Journal of Youth and Adolescence · doi:10.1007/s10964-010-9540-7 · Cited by 469 · cited 2× · see citing works
“Boys/men 140 (47) 216 (36) Alberta 41 (13) 73 (12) White only 225 (72) 446 (75) Less than 1 year 1 (0) 6 (1) Girls/women 32 (11) 107 (20) British Columbia 85 (26) 124 (21) Aboriginal 42 (13) 51 (9) 1 to 2 years 2 (1) 6 (1) Nonbinary (AFAB) 110 (37) 173 (32) Manitoba 13 (4) 19 (3) Black 6 (2) 9 (2) 3 to 5 years 5 (2) 1…”
Background
Stressors for Gay Men and Lesbians: Life Stress, Gay-Related Stress, Stigma Consciousness, and Depressive Symptoms
Lewis, R. J., Derlega, V. J., Griffin, J. L., & Krowinski, A. C. (2003) · Journal of Social and Clinical Psychology · doi:10.1521/jscp.22.6.716.22932 · Cited by 468 · cited 3× · see citing works
“2) 43 (7) South Asian 4 (1) 8 (1) English only 252 (79) 442 (74) Ontario 87 (27) 181 (30) East Asian 14 (5) 28 (5) French only 12 (4) 47 (8) Prince Edward Island 1 (0) 3 (1) Multi-racial 9 (3) 20 (3) English and French 24 (8) 42 (7)”
Background
A concurrent validational study of the NCHS General Well-Being schedule.
Fazio, A. F. (1977) · PsycEXTRA Dataset · doi:10.1037/e409022004-001 · Cited by 342 · see citing works
School disconnectedness: identifying adolescents at risk.
Bonny, A. E., Britto, M. T., Klostermann, B. K., Hornung, R. W., & Slap, G. B. (2000) · Pediatrics · doi:10.1542/peds.106.5.1017 · Cited by 309 · see citing works
Sexual harassment among adolescents of different sexual orientations and gender identities
Mitchell, K. J., Ybarra, M. L., & Korchmaros, J. D. (2014) · Child Abuse & Neglect · doi:10.1016/j.chiabu.2013.09.008 · Cited by 250 · see citing works
Non-binary and binary transgender youth: Comparison of mental health, self-harm, suicidality, substance use and victimization experiences
Rimes, K. A., Goodship, N., Ussher, G., Baker, D., & West, E. (2017) · International Journal of Transgenderism · doi:10.1080/15532739.2017.1370627 · Cited by 236 · see citing works
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 · cited 5× · see citing works
“Newfoundland 11 (3) 21 (4) West Asian or Arab 2 (1) 14 (2) Entire life 282 (88) 516 (86)”
Influential
Offsetting risks: High school gay-straight alliances and lesbian, gay, bisexual, and transgender (LGBT) youth.
Heck, N. C., Flentje, A., & Cochran, B. N. (2011) · School Psychology Quarterly · doi:10.1037/a0023226 · Cited by 215 · see citing works
Sex and Gender Diversity Among Transgender Persons in Ontario, Canada: Results From a Respondent-Driven Sampling Survey
Scheim, A. I., & Bauer, G. R. (2014) · The Journal of Sex Research · doi:10.1080/00224499.2014.893553 · Cited by 212 · cited 5× · see citing works
“Northwest Territories 1 (0) 3 (1) Southeast Asian 3 (1) 10 (2) Usual language”
BackgroundInfluential
Offsetting risks: High school gay-straight alliances and lesbian, gay, bisexual, and transgender (LGBT) youth.
Heck, N. C., Flentje, A., & Cochran, B. N. (2013) · Psychology of Sexual Orientation and Gender Diversity · doi:10.1037/2329-0382.1.s.81 · Cited by 196 · see citing works
A Confirmatory Factor Analysis of an Abbreviated Social Support Instrument: The MOS-SSS
Gjesfjeld, C. D., Greeno, C. G., & Kim, K. H. (2008) · Research on Social Work Practice · doi:10.1177/1049731507309830 · Cited by 195 · cited 1× · see citing works
“2) 43 (7) South Asian 4 (1) 8 (1) English only 252 (79) 442 (74) Ontario 87 (27) 181 (30) East Asian 14 (5) 28 (5) French only 12 (4) 47 (8) Prince Edward Island 1 (0) 3 (1) Multi-racial 9 (3) 20 (3) English and French 24 (8) 42 (7)”
Performance of the Composite International Diagnostic Interview Short Form for major depression in community and clinical samples.
Patten, S. B. (1997) · PubMed · Cited by 184 · see citing works
SCHOOL-BASED STRATEGIES TO REDUCE SUICIDAL IDEATION, SUICIDE ATTEMPTS, AND DISCRIMINATION AMONG SEXUAL MINORITY AND HETEROSEXUAL ADOLESCENTS IN WESTERN CANADA
Saewyc, E., Konishi, C., Rose, H., & Homma, Y. (2014) · International Journal of Child, Youth and Family Studies · doi:10.18357/ijcyfs.saewyce.512014 · Cited by 168 · see citing works
Self-citation
Suicidal behavior in "normal" adolescents: Risk and protective factors.
Rubenstein, J. L., Heeren, T., Housman, D. E., Rubin, C., & Stechler, G. (1989) · American Journal of Orthopsychiatry · doi:10.1111/j.1939-0025.1989.tb01635.x · Cited by 159 · cited 1× · see citing works
“Physically hurt or forced sex by a date 37 (24) Physically hurt or forced sex by a date 92 (28) Physically forced into sexual intercourse 49 (21) Physically forced sexual intercourse 103 (25)”
Background
Psychiatric Diagnoses and Comorbidities in a Diverse, Multicity Cohort of Young Transgender Women: Baseline Findings From Project LifeSkills
Reisner, S. L., Biello, K. B., White Hughto, J. M., Kuhns, L., Mayer, K. H., Garofalo, R., & Mimiaga, M. J. (2016) · JAMA Pediatrics · doi:10.1001/jamapediatrics.2016.0067 · Cited by 149 · cited 6× · see citing works
“Newfoundland 11 (3) 21 (4) West Asian or Arab 2 (1) 14 (2) Entire life 282 (88) 516 (86)”
BackgroundInfluential
Psychometric properties of the Add Health School Connectedness Scale for 18 sociocultural groups
Furlong, M. J., O'brennan, L. M., & You, S. (2011) · Psychology in the Schools · doi:10.1002/pits.20609 · Cited by 148 · cited 2× · see citing works
“Physically hurt or forced sex by a date 37 (24) Physically hurt or forced sex by a date 92 (28) Physically forced into sexual intercourse 49 (21) Physically forced sexual intercourse 103 (25)”
Background
A concurrent validational study of the NCHS General Well-Being Schedule.
Fazio, A. F. (1977) · PubMed · Cited by 145 · see citing works
Management of the Transgender Adolescent
Olson, J., Forbes, C., & Belzer, M. E. (2011) · Archives of Pediatrics and Adolescent Medicine · doi:10.1001/archpediatrics.2010.275 · Cited by 134 · cited 4× · see citing works
“Northwest Territories 1 (0) 3 (1) Southeast Asian 3 (1) 10 (2) Usual language”
BackgroundInfluential
Restoring Healthy Developmental Trajectories for Sexually Exploited Young Runaway Girls: Fostering Protective Factors and Reducing Risk Behaviors
Saewyc, E. M., & Edinburgh, L. D. (2010) · Journal of Adolescent Health · doi:10.1016/j.jadohealth.2009.06.010 · Cited by 111 · cited 1× · see citing works
“Physically hurt or forced sex by a date 37 (24) Physically hurt or forced sex by a date 92 (28) Physically forced into sexual intercourse 49 (21) Physically forced sexual intercourse 103 (25)”
BackgroundSelf-citation
The Success of Gay–Straight Alliances in Waterloo Region, Ontario: A Confluence of Political and Social Factors
John, A. S., Travers, R., Munro, L., Liboro, R. M., Schneider, M. S., & Greig, C. L. (2014) · Journal of LGBT Youth · doi:10.1080/19361653.2014.878564 · Cited by 34 · cited 1× · see citing works
“2) 43 (7) South Asian 4 (1) 8 (1) English only 252 (79) 442 (74) Ontario 87 (27) 181 (30) East Asian 14 (5) 28 (5) French only 12 (4) 47 (8) Prince Edward Island 1 (0) 3 (1) Multi-racial 9 (3) 20 (3) English and French 24 (8) 42 (7)”
Self-citation
Enacted Stigma, Problem Substance Use, and Protective Factors among Asian Sexual Minority Youth in British Columbia
Poon, C., Saewyc, E., & Chen, W. (2011) · Canadian Journal of Community Mental Health · doi:10.7870/cjcmh-2011-0016 · Cited by 29 · cited 1× · see citing works
“Boys/men 140 (47) 216 (36) Alberta 41 (13) 73 (12) White only 225 (72) 446 (75) Less than 1 year 1 (0) 6 (1) Girls/women 32 (11) 107 (20) British Columbia 85 (26) 124 (21) Aboriginal 42 (13) 51 (9) 1 to 2 years 2 (1) 6 (1) Nonbinary (AFAB) 110 (37) 173 (32) Manitoba 13 (4) 19 (3) Black 6 (2) 9 (2) 3 to 5 years 5 (2) 1…”
Self-citation
The Relation Between Suicidal Ideation and Bullying Victimization in a National Sample of Transgender and Non-Transgender Adolescents
Ybarra, M. L., Mitchell, K. J., & Kosciw, J. (2014) · Youth Suicide and Bullying · doi:10.1093/med:psych/9780199950706.003.0012 · Cited by 27 · see citing works

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Sorted by citations

Prevalence and correlates of non-suicidal self-injury among lesbian, gay, bisexual, and transgender individuals: A systematic review and meta-analysis
Liu, R. T., Sheehan, A. E., Walsh, R. F. L., Sanzari, C. M., Cheek, S. M., & Valencia, E. M. H. (2019) · Clinical Psychology Review · doi:10.1016/j.cpr.2019.101783 · Cited by 221 · see citing works
Suicidality Disparities Between Transgender and Cisgender Adolescents
Thoma, B. C., Salk, R. H., Choukas-Bradley, S., Goldstein, T. R., Levine, M. D., & Marshal, M. P. (2019) · Pediatrics · doi:10.1542/peds.2019-1183 · Cited by 198 · see citing works
“TGA suicidality is likely predicted by minority stress experiences, including victimization targeting their stigmatized gender identity.(11,13,39,40) In future work, researchers should examine how psychosocial stressors contribute to both the onset of suicidal ideation as well as the transition from suicidal ideation…”
Background
Mental health of transgender and gender diverse youth
Wittlin, N. M., Kuper, L. E., & Olson, K. R. (2023) · Annual Review of Clinical Psychology · doi:10.1146/annurev-clinpsy-072220-020326 · Cited by 199 · see citing works
Suicidality Among Transgender Youth: Elucidating the Role of Interpersonal Risk Factors
Austin, A., Craig, S. L., D'Souza, S. A., & McInroy, L. B. (2020) · Journal of Interpersonal Violence · doi:10.1177/0886260520915554 · Cited by 157 · see citing works
“Empirical research has demonstrated associations between minority stressors and suicidality among transgender youth (Veale et al., 2017) and adults (Testa et al.”
Background
A systematic review and meta-analysis of victimisation and mental health prevalence among LGBTQ+ young people with experiences of self-harm and suicide
Williams, A. J., Jones, C. A., Arcelus, J., Townsend, E., Lazaridou, A., & Michail, M. (2021) · PLoS ONE · doi:10.1371/journal.pone.0245268 · Cited by 198 · see citing works
Risk and Resilience Factors for Mental Health among Transgender and Gender Nonconforming (TGNC) Youth: A Systematic Review
Tankersley, A. P., Grafsky, E. L., Dike, J. E., & Jones, R. T. (2021) · Clinical Child and Family Psychology Review · doi:10.1007/s10567-021-00344-6 · Cited by 190 · see citing works
Social isolation and connectedness as determinants of well-being: Global evidence mapping focused on LGBTQ youth
García, J., Vargas, N., Clark, J. L., Álvarez, M. M., Nelons, D., & Parker, R. G. (2019) · Global Public Health · doi:10.1080/17441692.2019.1682028 · Cited by 177 · see citing works
“The Internet was an especially critical site for interventions that addressed cyberbullying (Veale et al., 2017).”
BackgroundInfluential
Supporting Transgender and Gender Diverse Youth: Protection Against Emotional Distress and Substance Use
Gower, A. L., Rider, G. N., Brown, C., McMorris, B. J., Coleman, E., Taliaferro, L. A., & Eisenberg, M. E. (2018) · American Journal of Preventive Medicine · doi:10.1016/j.amepre.2018.06.030 · Cited by 173 · see citing works
Invalidation experiences among non-binary adolescents
Johnson, K. C., LeBlanc, A. J., Deardorff, J., & Bockting, W. O. (2020) · The Journal of Sex Research · doi:10.1080/00224499.2019.1608422 · Cited by 142 · see citing works
“…of non-binary adolescents show similar trends: A study of transgender adolescents and young adults ages 14 to 25 in Canada (N = 923) concluded that non-binary participants consistently reported worse mental health outcomes compared to their binaryidentified counterparts (Veale et al., 2017b).”
BackgroundResult
In Addition to Stigma: Cognitive and Autism-Related Predictors of Mental Health in Transgender Adolescents
Strang, J. F., Anthony, L. G., Song, A. Y., Lai, M., Knauss, M., Sadikova, E., Graham, E. K., Zaks, Z., Wimms, H., Willing, L. M., et al. (2021) · Journal of Clinical Child & Adolescent Psychology · doi:10.1080/15374416.2021.1916940 · Cited by 110 · see citing works
“This line of research has revealed significant associations, generally with medium effect sizes, between transgender stigma- and rejectionrelated experiences and mental health/wellbeing (Pariseau et al., 2019; Toomey et al., 2010; Veale et al., 2017).”
BackgroundMethodInfluential
Exploring Cross-Sectional Predictors of Suicide Ideation, Attempt, and Risk in a Large Online Sample of Transgender and Gender Nonconforming Youth and Young Adults
Kuper, L. E., Adams, N. S., & Mustanski, B. S. (2018) · LGBT Health · doi:10.1089/lgbt.2017.0259 · Cited by 109 · see citing works
“Results are more mixed within (primarily adult) TGNC samples, with some studies finding higher rates of suicide outcomes among participants who were younger(20,21,46) and assigned female at birth (AFAB)(20,25,28) and other studies failing to find these relationships.(3,5,15,23,25,47) Rates of suicide appear lowest in…”
The Relationship Between Family Acceptance-Rejection and Transgender Youth Psychosocial Functioning
Pariseau, E. M., Chevalier, L., Long, K. A., Clapham, R. B., Edwards-Leeper, L. A., & Tishelman, A. C. (2019) · Clinical Practice in Pediatric Psychology · doi:10.1037/cpp0000291 · Cited by 107 · see citing works
“Trans-gender youth with higher family connectedness have better overall mental health and are less likely to engage in self-harm or attempt suicide (Veale, Peter, Travers, & Saewyc, 2017).”
It’s my safe space: The life-saving role of the internet in the lives of transgender and gender diverse youth
Austin, A., Craig, S. L., Navega, N., & McInroy, L. B. (2020) · International Journal of Transgender Health · doi:10.1080/15532739.2019.1700202 · Cited by 106 · see citing works
Suicidal Thoughts and Behaviors Among Transgender Adults in Relation to Education, Ethnicity, and Income: A Systematic Review
Adams, N. S., & Vincent, B. (2019) · Transgender Health · doi:10.1089/trgh.2019.0009 · Cited by 106 · see citing works
Next Steps in Puberty Research: Broadening the Lens Toward Understudied Populations
Deardorff, J., Hoyt, L. T., Carter, R., & Shirtcliff, E. A. (2019) · Journal of Research on Adolescence · doi:10.1111/jora.12402 · Cited by 98 · see citing works
“A second study, the 2015 Canadian Transgender Youth Health Study, focused specifically on transgender individuals, and included 923 youth between the ages of 14-25 years (Veale et al., 2017; Veale et al., 2015).”
Background
Social Support and Internalizing Psychopathology in Transgender Youth
Durwood, L., Eisner, L., Fladeboe, K., Ji, C. (., Barney, S., McLaughlin, K. A., & Olson, K. R. (2021) · Journal of Youth and Adolescence · doi:10.1007/s10964-020-01391-y · Cited by 98 · see citing works
“2018) and generalized social support (Grossman et al. 2011; Veale et al. 2017).”
Background
Perspectives of Transgender Youth on Parental Support: Qualitative Findings From the Resilience and Transgender Youth Study
Andrzejewski, J., Pampati, S., Steiner, R. J., Boyce, L. S., & Johns, M. M. (2020) · Health Education & Behavior · doi:10.1177/1090198120965504 · Cited by 88 · see citing works
“Among transgender youth, parental support appears to be protective for psychological distress, posttraumatic stress disorder, depression, suicide, eating disorders, condom use, quality of life, and perceived burden of being transgender (Bauer et al., 2015; Johns et al., 2018; Olson et al., 2016; Simons et al., 2013; V…”
Background
Predictors of self-harm and suicide in LGBT youth: The role of gender, socio-economic status, bullying and school experience
Jadva, V., Guasp, A., Bradlow, J. H., Bower‐Brown, S., & Foley, S. (2021) · Journal of Public Health · doi:10.1093/pubmed/fdab383 · Cited by 88 · see citing works
Bullying Victimization Among LGBTQ Youth: Critical Issues and Future Directions
Gower, A. L., Rider, G. N., McMorris, B. J., & Eisenberg, M. E. (2018) · Current Sexual Health Reports · doi:10.1007/s11930-018-0169-y · Cited by 89 · see citing works
Binary-trans, non-binary and gender-questioning adolescents’ experiences in UK schools
Bower‐Brown, S., Zadeh, S., & Jadva, V. (2021) · Journal of LGBT Youth · doi:10.1080/19361653.2021.1873215 · Cited by 79 · see citing works
“…shown that gender-diverse youth experience worse mental health than their cisgender counterparts (e.g. Eisenberg et al., 2017), with research finding an association between perceptions of school connectedness and mental health outcomes, including self-harm and suicide attempts (Veale et al., 2017).”
Peer support as a protective factor against suicide in trans populations: A scoping review
Kia, H., MacKinnon, K. R., Abramovich, A., & Bonato, S. (2021) · Social Science & Medicine · doi:10.1016/j.socscimed.2021.114026 · Cited by 74 · see citing works
Risk factors for psychological functioning in German adolescents with gender dysphoria: poor peer relations and general family functioning
Levitan, N., Barkmann, C., Richter‐Appelt, H., Schulte‐Markwort, M., & Becker-Hébly, I. (2019) · European Child & Adolescent Psychiatry · doi:10.1007/s00787-019-01308-6 · Cited by 74 · see citing works
Setting a research agenda in trans health: An expert assessment of priorities and issues by trans and nonbinary researchers
Veale, J. F., Deutsch, M. B., Devor, A., Kuper, L. E., Motmans, J., Radix, A. E., & Amand, C. S. (2022) · International Journal of Transgender Health · doi:10.1080/26895269.2022.2044425 · Cited by 74 · see citing works
Self-citation
Overlooked and Invisible: Everyday Experiences of Microaggressions for LGBTQ Adolescents
Munro, L., Travers, R., & Woodford, M. R. (2019) · Journal of Homosexuality · doi:10.1080/00918369.2018.1542205 · Cited by 71 · see citing works
“…gender minority adolescents report high rates of family violence, including physical abuse and inappropriate sexual touching (Saewyc et al., 2006; Veale et al., 2017), and rejection from their homes, leading to an overrepresentation of LGBTQ youth on the streets of North America’s biggest cities…”
BackgroundSelf-citation
Suicidality among sexual minority and transgender adolescents: a nationally representative population-based study of youth in Canada
Kingsbury, M. K., Hammond, N. G., Johnstone, F. C. W., & Colman, I. (2022) · Canadian Medical Association Journal · doi:10.1503/cmaj.212054 · Cited by 73 · see citing works
Evaluating the Experience of LGBTQ+ People Using Large Language Model Based Chatbots for Mental Health Support
Ma, Z., Mei, Y., Long, Y., Su, Z., & Gajos, K. Z. (2024) · CHI Conference on Human Factors in Computing Systems · doi:10.1145/3613904.3642482 · Cited by 75 · see citing works
“LGBTQ+ Individuals The LGBTQ+ community experiences greater mental health challenges such as higher levels of depressive symptoms, engaging in more non-suicidal-self-injury, and having more suicidal thoughts and behaviors compared with heterosexual, cisgender peers [4, 53, 89, 100, 101, 107].”
Background
A systematic review and meta‐analysis investigating the impact of childhood adversities on the mental health of LGBT+ youth
Jonas, L., de Pablo, G. S., Shum, M., Nosarti, C., Abbott, C., & Vaquerizo‐Serrano, J. (2022) · JCPP Advances · doi:10.1002/jcv2.12079 · Cited by 65 · see citing works
“…reported physical abuse (n = 7 studies; Button et al., 2016; D’Augelli et al., 2006; Donahue et al., 2017; Huebner et al., 2015; Lowry et al., 2020; Veale et al., 2017; Zhao et al., 2020) and 11% (Lowry et al., 2020) to 78% (D’Augelli et al., 2006) reported verbal abuse (n = 7; Button et al.,…”
BackgroundInfluential
Protective Factors for LGBTI+ Youth Wellbeing: A Scoping Review Underpinned by Recognition Theory
Ceatha, N., Koay, A. C. C., Buggy, C., James, O., Tully, L., Bustillo, M., & Crowley, D. (2021) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph182111682 · Cited by 64 · see citing works
“…• Buffered negative effects of victimization • Predicted lower psychological distress for Black and gay/lesbian youth • However, potential risk factor for bisexual youth Veale et al., 2017 Canada Enacted Stigma, Mental Health, and Protective Factors Among Transgender Youth in…”
BackgroundInfluential
Exploring the mental health experiences of young trans and gender diverse people during the Covid-19 pandemic
Jones, B. A., Bowe, M., McNamara, N., Guerin, E., & Carter, T. (2021) · International Journal of Transgender Health · doi:10.1080/26895269.2021.1890301 · Cited by 59 · see citing works
“Challenges with estrangement, non-affirming relationships, and access to healthcare are common among trans and gender diverse youth (e.g., Hoffman et al., 2009; Veale et al., 2017).”
BackgroundInfluential
Situated Vulnerabilities, Sexual Risk, and Sexually Transmitted Infections' Diagnoses in a Sample of Transgender Youth in the United States
Reisner, S. L., Jadwin-Cakmak, L. A., Sava, L. M., Liu, S., & Harper, G. W. (2019) · AIDS Patient Care and STDs · doi:10.1089/apc.2018.0249 · Cited by 61 · see citing works
The Gender Minority Youth Study: Overview of Methods and Social Media Recruitment of a Nationwide Sample of U.S. Cisgender and Transgender Adolescents
Salk, R. H., Thoma, B. C., & Choukas‐Bradley, S. (2020) · Archives of Sexual Behavior · doi:10.1007/s10508-020-01695-x · Cited by 59 · see citing works
Promoting “Zest for Life”: A Systematic Literature Review of Resiliency Factors to Prevent Youth Suicide
Shahram, S., Smith, M. L., Ben‐David, S., Feddersen, M., Kemp, T. E., & Plamondon, K. (2021) · Journal of Research on Adolescence · doi:10.1111/jora.12588 · Cited by 58 · see citing works
Psychosocial mediators of perceived stigma and suicidal ideation among transgender women
Kota, K. K., Salazar, L. F., Culbreth, R. E., Crosby, R. A., & Jones, J. (2020) · BMC Public Health · doi:10.1186/s12889-020-8177-z · Cited by 57 · see citing works
Evidence-Based Psychological Practice for Transgender and Non-Binary Youth: Defining the Need, Framework for Treatment Adaptation, and Future Directions
Coyne, C. A., Poquiz, J. L., Janssen, A. C., & Chen, D. (2020) · Evidence-Based Practice in Child and Adolescent Mental Health · doi:10.1080/23794925.2020.1765433 · Cited by 57 · see citing works
Transgender Youth Referred to Clinics for Gender-Affirming Medical Care in Canada
Bauer, G. R., Pacaud, D., Couch, R., Metzger, D. L., Gale, L., Gotovac, S., Mokashi, A. S., Feder, S., Raiche, J., Speechley, K. N., et al. (2021) · PEDIATRICS · doi:10.1542/peds.2020-047266 · Cited by 56 · see citing works
“It just feels right”: Perceptions of the effects of community connectedness among trans individuals
Bowling, J., Barker, J., Gunn, L. H., & Lace, T. (2020) · PLoS ONE · doi:10.1371/journal.pone.0240295 · Cited by 53 · see citing works
Review of current 2SLGBTQIA+ inequities in the Canadian health care system
Comeau, D., Johnson, C., & Bouhamdani, N. (2023) · Frontiers in Public Health · doi:10.3389/fpubh.2023.1183284 · Cited by 51 · see citing works
Health and well-being of trans and non-binary participants in a community-based survey of gay, bisexual, and queer men, and non-binary and Two-Spirit people across Canada
Rutherford, L. L., Stark, A., Ablona, A., Klassen, B., Higgins, R., Jacobsen, K., Draenos, C., Card, K. G., & Lachowsky, N. J. (2021) · PLoS ONE · doi:10.1371/journal.pone.0246525 · Cited by 46 · see citing works
“However, supportive environments and social connections with family, friends, and school reduced the negative effects of enacted stigma on trans youth’s mental health [11].”
Background
Understanding Factors Associated with Suicidality Among Transgender and Gender-Diverse Identified Youth
Bochicchio, L., Reeder, K., Aronson, L., McTavish, C., & Stefancic, A. (2021) · LGBT Health · doi:10.1089/lgbt.2019.0338 · Cited by 45 · see citing works
“20,21,25,27”
Influential
First- and Second-Hand Experiences of Enacted Stigma Among LGBTQ Youth
Gower, A. L., Valdez, C. A. B., Watson, R. J., Eisenberg, M. E., Mehus, C. J., Saewyc, E., Corliss, H. L., Sullivan, R., & Porta, C. M. (2019) · The Journal of School Nursing · doi:10.1177/1059840519863094 · Cited by 44 · see citing works
Self-citation
Transgender and Gender Diverse Youth’s Experiences of Gender-Related Adversity
Price, M. A., Hollinsaid, N. L., Bokhour, E. J., Johnston, C., Skov, H. E., Kaufman, G. W., Sheridan, M., & Olezeski, C. L. (2021) · Child and Adolescent Social Work Journal · doi:10.1007/s10560-021-00785-6 · Cited by 43 · see citing works
What Even Is Gender?
Briggs, R., & George, B. R. (2023) · Routledge eBooks · doi:10.4324/9781003053330 · Cited by 45 · see citing works
Recommendations from Transgender Healthcare Consumers in Rural Areas
Knutson, D., Martyr, M. A., Mitchell, T., Arthur, T., & Koch, J. M. (2018) · Transgender Health · doi:10.1089/trgh.2017.0052 · Cited by 40 · see citing works
“In fact, social networking within communities of transgender individuals is linked to resilience and to positive healthcare experiences.(16,17) Aside from the general benefits of social support,(18) interpersonal connections allow for the transmission of vital information and resources.”
Background
Loneliness and Social Isolation among Transgender and Gender Diverse People
Hajek, A., König, H., Blessmann, M., & Grupp, K. (2023) · Healthcare · doi:10.3390/healthcare11101517 · Cited by 40 · see citing works
“Several stressors have a negative impact on the ability to cope and consequently, their health-averse behaviors increase leading to further victimization and discrimination [41].”
Background
Diversidade sexual: uma leitura do impacto do estigma e discriminação na adolescência
da Silva, J. C. P., Cardoso, R. R., Cardoso, Â. M. R., et al. (2021) · Ciência & Saúde Coletiva · doi:10.1590/1413-81232021267.08332021 · Cited by 39 · see citing works
“Veale et al.10 compared the condition of psychic illness among the LGBT population and “heterocisnormative” young people, highlighting the higher rate of depression, suicide, anxiety, eating disorders, and substance abuse in the first group, and fewer opportunities for work and education 2645 C iên cia & Saú de C olet…”
Background
Using family and ecological systems approaches to conceptualize family- and community-based experiences of transgender and/or nonbinary youth from the trans teen and family narratives project.
Katz‐Wise, S. L., Godwin, E. G., Parsa, N., Brown, C. A., Sansfaçon, A. P., Goldman, R. E., MacNish, M., Rosal, M. C., & Austin, S. B. (2020) · Psychology of Sexual Orientation and Gender Diversity · doi:10.1037/sgd0000442 · Cited by 37 · see citing works
Differential Experiences of Mental Health among Trans/Gender Diverse Adults in Michigan
Kattari, S. K., Kattari, L., Johnson, I. M., Lacombe‐Duncan, A., & Misiolek, B. A. (2020) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph17186805 · Cited by 38 · see citing works
“Alternately, social support and resilience are associated with positive mental health outcomes [58,62].”
Background
Strategies used by transmasculine and non-binary adults assigned female at birth to resist transgender stigma in healthcare
Seelman, K. L., & Poteat, T. (2020) · International Journal of Transgender Health · doi:10.1080/26895269.2020.1781017 · Cited by 36 · see citing works
Application of an intersectional lens to bias-based bullying among LGBTQ+ youth of color in the United States.
Gower, A. L., Rider, G. N., del Río‐González, A. M., Erickson, P. J., Thomas, D., Russell, S. T., Watson, R. J., & Eisenberg, M. E. (2022) · Stigma and Health · doi:10.1037/sah0000415 · Cited by 62 · see citing works
Enacted stigma experiences and protective factors are strongly associated with mental health outcomes of transgender people in Aotearoa/New Zealand
Tan, K. K. H., Treharne, G. J., Ellis, S. J., Schmidt, J. M., & Veale, J. F. (2020) · International Journal of Transgender Health · doi:10.1080/15532739.2020.1819504 · Cited by 32 · see citing works
Self-citation
Risk and protective factors for suicidality among lesbian, gay, bisexual, transgender, and queer (LGBTQ+) young people, from countries with a high global acceptance index (GAI), within the context of the socio‐ecological model: A scoping review
Wallace, E. R., O’Neill, S. M., & Lagdon, S. (2024) · Journal of Adolescence · doi:10.1002/jad.12308 · Cited by 37 · see citing works
Mental Health Among LGBT Youth
Choukas‐Bradley, S., & Thoma, B. C. (2022) · Focus on sexuality research · doi:10.1007/978-3-030-84273-4_18 · Cited by 31 · see citing works
School Connectedness and Suicide Among High School Youth: A Systematic Review
Welty, C. W., Bingham, L., Morales, M., Gerald, L. B., Ellingson, K., & Haynes, P. L. (2024) · Journal of School Health · doi:10.1111/josh.13445 · Cited by 31 · see citing works
Mental health among transgender women living with HIV in Canada: findings from a national community-based research study
Lacombe‐Duncan, A., Warren, L., Kay, E. S., Persad, Y., Soor, J., Kia, H., Underhill, A., Logie, C. H., Kazemi, M., Kaida, A., et al. (2020) · AIDS Care · doi:10.1080/09540121.2020.1737640 · Cited by 31 · see citing works
Children with autism in a sport and physical activity context: a collaborative autoethnography by two parents outlining their experiences
McMahon, J., Wiltshire, G.-E., McGannon, K. R., & Rayner, C. S. (2019) · Sport Education and Society · doi:10.1080/13573322.2019.1680535 · Cited by 28 · see citing works
Risk and Protective Factors for Sexual Health Outcomes Among Black Bisexual Men in the U.S.: Internalized Heterosexism, Sexual Orientation Disclosure, and Religiosity
Watson, R. J., Allen, A. M., Pollitt, A. M., & Eaton, L. A. (2018) · Archives of Sexual Behavior · doi:10.1007/s10508-018-1216-5 · Cited by 28 · see citing works
Testing the minority stress model across gender identity, race, and ethnicity among U.S. gender minority adolescents.
Jardas, E. S., Ladd, B. A., Maheux, A. J., Choukas‐Bradley, S., Salk, R. H., & Thoma, B. C. (2023) · Journal of Psychopathology and Clinical Science · doi:10.1037/abn0000834 · Cited by 27 · see citing works
Towards an integrative self: a digital photo elicitation study of resilience among key marginalized populations of sexual and gender minority youth
Craig, S. L., Eaton, A. D., Kirkland, A., Egag, E., Pascoe, R. V., King, K., & Krishnan, S. (2021) · International Journal of Qualitative Studies on Health and Well-Being · doi:10.1080/17482631.2021.1961572 · Cited by 28 · see citing works
“Compared to the general youth population, TGD youth are at increased risk of depression, suicidality, substance use, and self-harm (Rimes et al., 2019; Veale et al., 2017).”
Background
Gender minority stress in education: Protecting trans children’s mental health in UK schools
Horton, C. (2022) · International Journal of Transgender Health · doi:10.1080/26895269.2022.2081645 · Cited by 36 · see citing works
“Trans children and adolescents are known to be at risk of poor mental health, with studies noting high levels of depression, anxiety or suicidal ideation (Srivastava et al., 2021; Strauss et al., 2020; Veale et al., 2017).”
Background
Effects of sexual and gender minority stress on depressive symptoms among adolescents of color in the United States.
Ching, T. H. W., Finkelstein‐Fox, L., Lee, S. Y., & Watson, R. J. (2022) · Cultural Diversity & Ethnic Minority Psychology · doi:10.1037/cdp0000562 · Cited by 27 · see citing works
Reduction of Gender Identity Stigma and Improvements in Mental Health Among Transgender Women Initiating HIV Treatment in a Trans-Sensitive Clinic in Argentina
Radusky, P. D., Zalazar, V., Cardozo, N. F., Fabian, S., Duarte, M., Frola, C. E., Cahn, P. E., Sued, O. G., & Arístegui, I. (2020) · Transgender Health · doi:10.1089/trgh.2020.0005 · Cited by 28 · see citing works
The Mental Health of Transgender Young People in Secondary Schools: A Scoping Review
Mackie, G., Lambert, K., & Patlamazoglou, L. (2021) · School Mental Health · doi:10.1007/s12310-020-09403-9 · Cited by 26 · see citing works
Invalidation and mental health among nonbinary individuals.
Johnson, K. C., LeBlanc, A. J., Dolezal, C. L., Singh, A. A., & Bockting, W. O. (2023) · Psychology of Sexual Orientation and Gender Diversity · doi:10.1037/sgd0000621 · Cited by 25 · see citing works
Maternal Support Is Protective Against Suicidal Ideation Among a Diverse Cohort of Young Transgender Women
Jin, H., Restar, A., Goedel, W. C., Ogunbajo, A., Biello, K. B., Operario, D., Kuhns, L. M., Reisner, S. L., Garofalo, R., & Mimiaga, M. J. (2020) · LGBT Health · doi:10.1089/lgbt.2020.0219 · Cited by 24 · see citing works
“A study of transgender youth in Canada found that family connectedness was associated with lower rates of mental health problems.(13) While several studies have examined the impact of parental support on the mental health of transgender youth,(12,14,15) we are unaware of studies that have examined how maternal and pat…”
Background
Exploring the psychological and physiological impacts of digital microaggressions and hostile online climates on LGBTQ + youth
McInroy, L. B., Beer, O. W. J., Scheadler, T. R., Craig, S. L., & Eaton, A. D. (2023) · Current Psychology · doi:10.1007/s12144-023-04435-1 · Cited by 24 · see citing works
“Transgender and other gender expansive (a flexible umbrella term to describe those who do not self-identify along the gender binary) youth may be at particularly elevated risk, reporting high levels of self-injury, suicidal ideation, and extreme stress (Veale et al., 2017).”
Systematic Review of Interventions to Reduce Suicide Risk in Transgender and Gender Diverse Youth
Christensen, J. A., Oh, J., Linder, K., Imhof, R. L., Croarkin, P. E., Bostwick, J. M., & McKean, A. J. S. (2023) · Child Psychiatry & Human Development · doi:10.1007/s10578-023-01541-w · Cited by 24 · see citing works
“Veale et al. in 2017 found that family connectedness was the strongest protective predictor amongst 14 to 18-year-old gender diverse adolescents in terms of reducing extreme stress, extreme despair, and suicide attempts [18].”
Suicidality Among Psychiatrically Hospitalized Lesbian, Gay, Bisexual, Transgender, Queer, and/or Questioning Youth: Risk and Protective Factors
VanBronkhorst, S. B., Edwards, E., Roberts, D. E., Kist, K., Evans, D. L., Mohatt, J. W., & Blankenship, K. M. (2021) · LGBT Health · doi:10.1089/lgbt.2020.0278 · Cited by 23 · see citing works
“20,21 In fact, in post-hoc analysis, we found there was no statistical difference in suicide attempts between LGBTQ youth with high adult support and non-LGBTQ youth with high adult support.”
Transgender and Gender Diverse Youth’s Experiences of Gender-Related AdversityPreprint
Price, M. A., Hollinsaid, N. L., Bokhour, E. J., et al. (2021) · doi:10.31219/osf.io/sa492 · Cited by 22 · see citing works
LGBQ Youth’s Experiences of General and Bias-Based Bullying Victimization: the Buffering Role of Supportive School and Community Environments
Gower, A. L., Watson, R. J., Erickson, D. J., Saewyc, E., & Eisenberg, M. E. (2020) · International Journal of Bullying Prevention · doi:10.1007/s42380-020-00065-4 · Cited by 22 · see citing works
Self-citation
Improving School Outcomes for Transgender and Gender-Diverse Youth: A Rapid Review
Feijó, M., Fontanari, A. M. V., Boeira, L. D. S., Wendt, G. W., Bloniewski, T., & Costa, Â. B. (2022) · Policy Insights from the Behavioral and Brain Sciences · doi:10.1177/23727322211068021 · Cited by 22 · see citing works
Parental Challenges, Facilitators and Needs Associated with Supporting and Accepting Their Trans Child’s Gender
Morgan, H., Wells, L., Lin, A. P., Strauss, P., & Perry, Y. (2022) · LGBTQ+ Family An Interdisciplinary Journal · doi:10.1080/27703371.2022.2142717 · Cited by 22 · see citing works
Factors Associated With Age of Presentation to Gender-Affirming Medical Care
Sorbara, J., Ngo, H. L., & Palmert, M. R. (2021) · PEDIATRICS · doi:10.1542/peds.2020-026674 · Cited by 21 · see citing works
Support Saves Lives: Exploring the Relationship Between Age of Transition, Family Support, and Retrospective K-12 Educational Experiences in Transgender Suicidality
Miller, G. H., Márquez-Velarde, G., Suárez, M. I., & Glass, C. (2023) · Transgender Health · doi:10.1089/trgh.2022.0073 · Cited by 20 · see citing works
Perceptions of Support Among Transgender and Gender-Expansive Adolescents and Their Parents
Hale, A. E., Chertow, S. Y., Weng, Y., Tabuenca, A. C., & Aye, T. (2021) · Journal of Adolescent Health · doi:10.1016/j.jadohealth.2020.11.021 · Cited by 21 · see citing works
Therapy Experiences of Transgender and Gender Diverse Adolescents and Their Caregivers
Price, M. A., Bokhour, E. J., Hollinsaid, N. L., Kaufman, G. W., Sheridan, M., & Olezeski, C. L. (2021) · Evidence-Based Practice in Child and Adolescent Mental Health · doi:10.1080/23794925.2021.1981177 · Cited by 17 · see citing works
“…and contextualized, whenever possible), representative (i.e., providing multiple perspectives to elucidate similarities and differences between and within codes; e.g., from adolescents and caregivers), and applicable to the research question (Cypress, 2017; Morse, 2015; Whittemore et al., 2001).”
Background
Eighteen months into the COVID-19 pandemic: The prevalence of depression, anxiety, and stress symptoms in Southeast Asia and the associated demographic factors
Tay, W. W. Y., Jesuthasan, J., Wan, K. S., Ong, T., & Mustapha, F. I. (2022) · Frontiers in Public Health · doi:10.3389/fpubh.2022.863323 · Cited by 19 · see citing works
“Moreover, the COVID-19 pandemic is likely to have exacerbated the mental health challenges experienced by non-binary individuals as protective factors against psychological problems, including gender-affirming healthcare and social connectedness (34, 37), were less available during the pandemic.”
Background
Family Characteristics, Transgender Identity and Emotional Symptoms in Adolescence: A Population Survey Study
Kaltiala‐Heino, R., Heino, E., MARTTUNEN, M. J., & Fröjd, S. A. (2023) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph20042948 · Cited by 20 · see citing works
‘It’s how the world around you treats you for being trans’: mental health and wellbeing of transgender people in Aotearoa New Zealand
Tan, K. K. H., Schmidt, J. M., Ellis, S. J., et al. (2021) · Psychology and Sexuality · doi:10.1080/19419899.2021.1897033 · Cited by 19 · see citing works
“…with known protective influences on transgender people’s mental health are family and peer support (Fuller & Riggs, 2018; Olson et al., 2016; Singh et al., 2014; Veale et al., 2017) and a sense of connection to a transgender community (Brennan et al., 2017; Singh et al., 2014; Testa et al., 2015).”
BackgroundInfluentialSelf-citation
Mental health support experiences of rainbow rangatahi youth in Aotearoa New Zealand: results from a co‐designed online survey
Fraser, G., Brady, A., & Wilson, M. (2022) · Journal of the Royal Society of New Zealand · doi:10.1080/03036758.2022.2061019 · Cited by 17 · see citing works
Discrimination keeps transgender people awake at night: A nationwide cross-sectional survey of 583 transgender adults in South Korea
Eom, Y., Lee, H., Kim, R., Choo, S., Yi, H., & Kim, S. (2022) · Sleep Health · doi:10.1016/j.sleh.2022.06.012 · Cited by 18 · see citing works
Knowledge is Power: Trans Young People’s Perceptions of Parental Reactions to Their Gender Identity, and Perceived Barriers and Facilitators to Parental Support
Morgan, H., Raab, D., Lin, A. P., Strauss, P., & Perry, Y. (2022) · LGBTQ+ Family An Interdisciplinary Journal · doi:10.1080/27703371.2022.2135660 · Cited by 18 · see citing works
Differences in Patient and Parent Informant Reports of Depression and Anxiety Symptoms in a Clinical Sample of Transgender and Gender Diverse Youth
McGuire, F. H., Carl, A., Woodcock, L., Frey, L., Dake, E., Matthews, D. D., Russell, K., & Adkins, D. W. (2021) · LGBT Health · doi:10.1089/lgbt.2020.0478 · Cited by 17 · see citing works
“It felt like they were trying to destabilise us”: Parent assessment in UK children’s gender services
Horton, C. (2021) · International Journal of Transgender Health · doi:10.1080/26895269.2021.2004569 · Cited by 17 · see citing works
Schools Often Fail to Expect Trans and Nonbinary Elementary Children: What Gender Independent, Nonbinary, and Trans Children Desire
skelton, J. W. (2022) · Teachers College Record The Voice of Scholarship in Education · doi:10.1177/01614681221126243 · Cited by 16 · see citing works
“Veale et al. (2017) specifically analyzed the experiences of Canadian trans youth for signs of minority stress and found that transphobia was emotionally, physically, and academically harmful, while the creation of affirming home and school environments was protective.”
Background
Health and service utilization among a sample of gender-diverse youth of color: the TRUTH study
Rusow, J. A., Hidalgo, M. A., Calvetti, S., Quint, M., Wu, S., Bray, B. C., & Kipke, M. D. (2022) · BMC Public Health · doi:10.1186/s12889-022-14585-9 · Cited by 17 · see citing works
The Impact of Family Support and Rejection on Suicide Ideation and Attempt among Transgender Adults in the U.S.
Márquez-Velarde, G., Miller, G. H., Shircliff, J. E., & Suárez, M. I. (2023) · LGBTQ+ Family An Interdisciplinary Journal · doi:10.1080/27703371.2023.2192177 · Cited by 16 · see citing works
“…mental health outcomes, including depression (Yadegarfard et al., 2014), substance use (Klein & Golub, 2016), self-harm (Grossman & D’Augelli, 2007; Veale et al., 2017), and suicidality (Bariola et al., 2015; Grossman & D’Augelli, 2007; James et al., 2016; Klein & Golub, 2016; Olson et al., 2016;…”
Programs and interventions promoting health equity in LGBTQ2+ populations in Canada through action on social determinants of health
Higgins, R., Hansen, B. B., Jackson, B. E., Shaw, A. Y., & Lachowsky, N. J. (2021) · Health Promotion and Chronic Disease Prevention in Canada · doi:10.24095/hpcdp.41.12.04 · Cited by 14 · see citing works
Gender and Sexual Health-Related Knowledge Gaps and Educational Needs of Parents of Transgender and Non-Binary Youth
Kantor, L. Z., Tordoff, D. M., Haley, S. G., Crouch, J. M., & Ahrens, K. R. (2023) · Archives of Sexual Behavior · doi:10.1007/s10508-023-02611-9 · Cited by 16 · see citing works
“However, family connectedness and parental support has consistently been associated with improved outcomes across many of these domains for TNB youth, including lower rates of depression, suicidal ideation, disordered eating, PTSD, and perceived burden of being transgender, as well as improved self-esteem, quality of…”
Background
Psychological distress, self-harm and suicide attempts in gender minority compared with cisgender adolescents in the UK
White, J., Trinh, M.-H., & Reynolds, C. A. (2023) · BJPsych Open · doi:10.1192/bjo.2023.534 · Cited by 13 · see citing works
Gender-related stigma toward individuals with a history of sexual or physical violence in childhood
Rechenberg, T., Fleischer, T., Sander, C., & Schomerus, G. (2024) · BMC Public Health · doi:10.1186/s12889-024-19913-9 · Cited by 14 · see citing works
“…focuses on the gender of victims and survivors, the inclusion of persons who identify as trans or non-binary might prove relevant in terms of diversity considerations, as they are at increased risk of experiencing violence in youth [7] and already belong to a highly stigmatized group [33, 63].”
Background
Factors Influencing Parental Acceptance of Trans Children and Young People: Findings from Trans Pathways
Morgan, H., Heritage, B., Lin, A. P., Perry, Y., Cook, A. G., Winter, S., Watson, V., Toussaint, D. W., O’Donovan, A., Almeida, R. A., et al. (2022) · LGBTQ+ Family An Interdisciplinary Journal · doi:10.1080/27703371.2022.2125470 · Cited by 13 · see citing works
Gender Nonconformity During Adolescence: Links with Stigma, Sexual Minority Status, and Psychosocial Outcomes
Martin‐Storey, A., & Baams, L. (2019) · Springer eBooks · doi:10.1007/978-3-030-12228-7_33 · Cited by 15 · see citing works
Gender-Affirming Nutrition: An Overview of Eating Disorders in the Transgender Population
Yeşildemir, Ö., & Akbulut, G. (2023) · Current Nutrition Reports · doi:10.1007/s13668-023-00504-w · Cited by 13 · see citing works
The Critical Role of Coping Strategies in Moderating Loneliness and Quality of Life: Parallel and Unique Processes among Transgender and Heterosexual Cisgender People in Pakistan
Batool, S., & Rowland, D. L. (2021) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph18179109 · Cited by 13 · see citing works
“Multiple stressors may negatively impact their ability to cope; as a result, their health-protective behaviors diminish and health-averse behaviors increase, placing them at-risk for further victimization and exploitation [37].”
Background
Somatic Health and Psychosocial Background Among Finnish Adolescents with Gender Dysphoria Seeking Hormonal Interventions
Vehmas, N., Holopainen, E., Suomalainen, L., & Savolainen-Peltonen, H. M. (2021) · Transgender Health · doi:10.1089/trgh.2021.0084 · Cited by 12 · see citing works
Rainbow experiences of accessing mental health support in Aotearoa New Zealand: A community-based mixed methods study
Fraser, G. (2020) · doi:10.26686/wgtn.17147873.v1 · Cited by 14 · see citing works
Cass Review does not guide care for trans young people
Moore, J. K., Rayner, C., Skinner, S. R., Wynne, K., Cavve, B. S., Fraser, B., Ganti, U., McAllister, C., Meyerowitz‐Katz, G., Nguyen, T. N. B., et al. (2025) · The Medical Journal of Australia · doi:10.5694/mja2.70035 · Cited by 10 · see citing works
“53 • Better mental health in trans young people is associated with loving acceptance by family, school and community, 29,54 freedom from bullying and discrimination, 29 being called by their chosen name, 55 peer support, 54 and timely access to GAMT where needed.”
Global Burden of Violence Against Transgender and Gender-Diverse Adults
McLellan, C., Yeh, P. T., Kennedy, C. E., Barre-Quick, M., Rich, A. J., Poteat, T., & Cooney, E. E. (2026) · JAMA Network Open · doi:10.1001/jamanetworkopen.2025.52953 · Cited by 10 · see citing works
Depression as a Function of Social Support in Transgender and Cisgender Individuals with Sexually Transmitted Diseases
Yousuf, T., Naz, M., Roberson, C. B., Wise, S. M., & Rowland, D. L. (2021) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph18052462 · Cited by 10 · see citing works
“They become at risk for further victimization and exploitation, especially the younger and more under-resourced they are [17].”
Background
Transgender Dependent Adolescents in the U.S. Military Health Care System: Demographics, Treatments Sought, and Health Care Service Utilization
Donge, N. V., Schvey, N. A., Roberts, T. A., & Klein, D. A. (2018) · Military Medicine · doi:10.1093/milmed/usy264 · Cited by 10 · see citing works

Measuring the dynamics of global business cycle connectedness
Diebold, F. X., & Yılmaz, K. (2015) · doi:10.1093/acprof:oso/9780199683666.003.0005 · Cited by 71 · see citing works
Understanding Social Connectedness in College Women and Men
Lee, R. M., & Robbins, S. B. (2000) · Journal of Counseling & Development · doi:10.1002/j.1556-6676.2000.tb01932.x · Cited by 239 · see citing works
Mental health in transgender adults: The role of proximal minority stress, community connectedness, and gender nonconformity.
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Authors: Veale, J. F., Peter, T., Travers, R., & Saewyc, E. M.
Affiliations: University of Waikato (NZ)
University of Manitoba (CA)
Wilfrid Laurier University (CA)
University of British Columbia (CA)
Corresponding author: Veale, Jaimie F.
ORCID: Veale, Jaimie F.
Peter, Tracey
Travers, Robb
Saewyc, Elizabeth M.
Venue: Transgender Health
Publisher: SAGE Publications
Published: 2017-12
Volume: 2
Issue: 1
Pages: 207-216
ISSN: 2380-193X (ISSN-L)
DOI: 10.1089/trgh.2017.0031
PMC: PMC5734137
OpenAlex: W2774228466
Semantic Scholar: da326060f274143f4fce3ca6106e0ae7cb5b5ffe
Cited by: 228
References: 34
Citations by year: 2026: 27 · 2025: 30 · 2024: 28 · 2023: 30 · 2022: 21 · 2021: 40 · 2020: 30 · 2019: 14 · 2018: 8
FWCI: 15.26
Type: journal article
Language: en
Open access: bronze
doi.org
Licence: www.liebertpub.com/nv/resources-tools/text-and-data-mining-policy/121/ (tdm)
Locations: Transgender Health (publishedVersion)
PubMed (publishedVersion)
Research Commons (University of Waikato) (submittedVersion, cc-by)
Europe PMC (PubMed Central) (submittedVersion)
PubMed Central (submittedVersion)
DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion)
Topics: Social Sciences › Psychology › Social Psychology › LGBTQ Health, Identity, and Policy
Physical Sciences › Computer Science › Artificial Intelligence › Hate Speech and Cyberbullying Detection
Social Sciences › Psychology › Clinical Psychology › Sexuality, Behavior, and Technology
Keywords: transgender youth, enacted stigma, minority stress model, mental health, protective factors, discrimination, harassment, violence

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Enacted Stigma, Mental Health, and Protective Factors Among Transgender Youth in Canada

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