ArticleBehavioral medicine (Washington, D.C.)
The Roles of Gender Affirmation and Discrimination in the Resilience of Transgender Individuals in the US.
Article in Behavioral medicine (Washington, D.C.). The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 33 papers.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
33 citing papers in PubMed.
- Gender affirmation among transgender and gender-diverse people in middle age and late life: a scoping review.The Gerontologist · 2026Article
- 'I Would Feel Failed By the Medical Community Entirely': Transgender Americans' Calls for Advocacy From Health Professionals in a Care-Restricted World.Health expectations : an international journal of public participation in health care and health policy · 2026Article
- PrEP Intentions, Heavy Substance Use, and Gender Affirmation among Black and Latine Transgender and Gender-Expansive Youth: A Structural Equation Modeling Analysis.AIDS and behavior · 2026Article
- Gender-Affirming identification documents are associated with positive health-related outcomes for transgender people in Bolivia.International journal of transgender health · 2026Article
- Mental health and wellbeing outcomes associated with social, medical, and legal gender affirmation among trans young people in Australia.International journal of transgender health · 2026Article
- Intimate Partner Violence and HIV Prevention Among Transgender and Nonbinary Persons: Protocol for a Prospective Mixed Methods Cohort Study.JMIR research protocols · 2025Article
- Forms of transphobia and their influence on health outcomes among transgender, nonbinary, and gender diverse individuals: a global systematic review.International journal of transgender health · 2025Article
- Medical gender affirmation appears protective against problematic substance use among transgender women and transfeminine adults: Findings from The LITE Study.Drug and alcohol dependence · 2025Article
- A Pilot Trial of an LGBTQ-Affirmative Cognitive-Behavioral Therapy for Transgender and Gender Expansive Individuals' Mental, Behavioral, and Sexual Health.Behavior therapy · 2025Article
- Multilevel Factors Affecting Health Equity for Transgender and Gender Diverse Older Adults.Qualitative health research · 2025Article
- Minority Stress Across Proximal Contexts and Suicide in Transgender Young Adults: A Critical Scoping Review.Transgender health · 2025Review
- Intentions to Use PrEP Among a National Sample of Transgender and Gender-Expansive Youth and Emerging Adults: Examining Gender Minority Stress, Substance Use, and Gender Affirmation.AIDS and behavior · 2025Article
- Naturalistic psychedelic experiences and gender-based self-acceptance in transgender and gender-expansive people.International journal of transgender health · 2025Article
- HIV prevention among adolescents travestis and transgender women in three Brazilian capitals, 2019-2023.Epidemiologia e servicos de saude : revista do Sistema Unico de Saude do Brasil · 2025Article
- The roles of protective factors in facing gender-related interpersonal stigma among Chinese transgender and gender diverse individuals: A mixed-method study.International journal of transgender health · 2025Article
- Ketamine-assisted group psychotherapy integrating cognitive processing therapy to address identity-based trauma: a pilot study.Frontiers in psychiatry · 2025Article
- Using stated preference methods to design gender-affirming long-acting PrEP programs for transgender and nonbinary adults.Scientific reports · 2024Article
- Article
- Experiences of and recommendations for LGBTQ+-affirming substance use services: an exploratory qualitative descriptive study with LGBTQ+ people who use opioids and other drugs.Substance abuse treatment, prevention, and policy · 2024Article
- Online Group Psychotherapy to Increase Self-acceptance and Reduce Shame Among Transgender Migrants: An Observational Report.Turk psikiyatri dergisi = Turkish journal of psychiatry · 2024Observational
Corrections and comments
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Authors and funding
3 authors.
Funding
Abstract
Transgender individuals face severe stigma-driven health inequities structurally, institutionally, and interpersonally, yielding poor individual-level outcomes. Gender affirmation, or being recognized based on one's gender identity, expression, and/or role, may be considered a manifestation of resilience. To provide intervention and policy guidelines, we examined latent constructs representative of gender affirmation (legal documentation changes, transition-related medical procedures, familial support) and discrimination (unequal treatment, harassment, and attacks), and tested their impact on mental, physical, and behavioral health outcomes among 17,188 binary-identified transgender participants in the 2015 US Transgender Survey. Confirmatory factor analyses revealed high standardized factor loadings for both latent variables, on which we regressed outcomes using structural equation modeling. Fit indices suggested good model fit. Affirmation was associated with lower odds of suicidal ideation and psychological distress, and higher odds of substance use, and past-year healthcare use and HIV-testing. Discrimination was associated with higher odds of suicidal ideation, psychological distress, substance use, and past-year HIV-testing. Affirmation and discrimination interaction analyses showed lower odds of past-year suicidal ideation, with affirmation having a significant moderating protective effect against discrimination. Gender affirmation is paramount in upholding transgender health. Clarification of affirmation procedures, and increases in its accessibility, equitably across racial/ethnic groups, should become a priority, from policy to the family unit. The impact of discrimination demands continued advocacy via education and policy.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.