Understanding differences in types of social support and their effects on mental health over time for trans and nonbinary adults.

Although research has shown that social support generally is beneficial to mental health among trans and nonbinary (TNB) adults, less is known regarding what forms of support and the degree to which they mitigate the harms of minority stress on mental health over time. This study investigated differences in types of social support and their association with mental health over time in a sample of 2,411 TNB adults, predominantly younger in age (53% 18-30 years old), diverse in sexual orientation (97.5%, LGBQA+, 2.5% straight/heterosexual), gender identity (53.3% non-binary, 26% trans man, 12.4% trans woman), and similar in race and ethnicity to the US national population. We conducted a latent profile analysis (LPA) to identify social support typologies. A three-profile solution classified participants into a Low (39.6%), Moderate (40.7%), or High Support profile (19.7%). Significant variability in gender-related support experiences was noted for those in the Moderate and High Support profiles, while those in the Low Support profile had almost uniformly little to no support from family. Mental health outcomes differed between the profiles; Low Support participants reported significantly worse depression and PTSD symptoms; demographically, the greatest proportion of participants with marginalized identities clustered in the Low Support profile. Finally, we tested profile membership as a moderating variable in the association of minority stressors with mental health over time. Few significant differences emerged between groups, suggesting that being in a higher support profile may not necessarily buffer the harms of minority stress on mental health over time. Intervention implications are discussed.