Psychology of Sexual Orientation and Gender Diversity, Vol 9(4), Dec 2022, 410-421; doi:10.1037/sgd0000500
Transgender people have higher rates of posttraumatic stress disorder (PTSD) than the general population. This risk can be partially understood by conceptualizing day-to-day bias-related stressors and non-affirmation as potentially traumatic, but there is currently limited empirical evidence to support such a framework. This study aimed to explore this framework by testing the hypothesis that exposure to anti-transgender bias and non-affirmation are related to PTSD symptom severity, even after controlling for exposure to traditionally defined potentially traumatic events. Drawing upon shame-based models of PTSD, this study also tested the hypothesis that internalized transphobia partially mediates the relationships between both bias and non-affirmation and PTSD symptom severity. Cross-sectional data were collected online from 575 individuals who identified as having a gender different from their sex assigned at birth. Data were analyzed utilizing structural equation modeling. As hypothesized, participants with greater exposure to anti-transgender bias and higher levels of non-affirmation experiences had increased PTSD symptom severity, even after controlling for exposure to other trauma. These relationships were partially explained by internalized transphobia. These findings document meaningful relationships between anti-transgender bias, non-affirmation, internalized transphobia, and posttraumatic stress. They provide initial support for conceptualizing anti-transgender bias and non-affirmation experiences as potentially traumatic themselves and/or as trauma response triggers and highlight a potential role of internalized transphobia in PTSD symptoms. Clinical implications for working with trans populations are discussed. (PsycInfo Database Record (c) 2022 APA, all rights reserved)