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GGZ3026 Afstudeerscriptie // COMPLETE BACHELOR'S THESIS

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Mijn afstudeerscriptie voor de bachelor Gezondheidswetenschappen, richting Geestelijke Gezondheidszorg aan Maastricht University. Ik heb de transgender personen gekozen als mijn doelgroep en onderzocht hoe minderheidsstressoren en veerkrachtigheid gerelateerd zijn aan de mentale gezondheid van deze...

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  • 17 augustus 2021
  • 44
  • 2021/2022
  • Scriptie
  • Jeffrey roelofs
  • Onbekend

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Associations between Minority Stress, Resilience, and the Mental Health of Transgender

Individuals: A Systematic Review of Reviews on Socially Produced Mental Health

Disparities



Arnoldina A. Rutten

I6198638

Faculty of Health, Medicine, and Life Sciences, Maastricht University

Bachelor Health Sciences, Mental Health

GGZ3026: Bachelor’s Thesis

Dr Jeffrey Roelofs

July 2, 2021

, 2


Abstract

With awareness of gender diversity increasing, more attention is being paid to transgender

individuals and their social environments. Transgender individuals are likely to experience

prejudice, as their identity does not conform to the traditional social view of gender. The aim

of the current review is to summarize evidence concerning associations between minority

stressors, resilience, and the mental health of transgender individuals. Guided by the minority

stress theory, this review systematically analysed eight reviews that addressed rates and

correlates of mental health issues, experiences of minority stress, and resilience-promoting

factors amongst self-identified and professionally diagnosed transgender participants. The

findings show that the mental health of transgender individuals is poor relative to the

cisgender population. The minority stressors experienced by transgender individuals are

widespread, and research consistently reports a positive association between such experiences

and various mental health problems. This population however may seek resilience-promoting

factors, including trans-specific factors, that could ameliorate minority stressors’ impact on

their mental health. In conclusion, this paper underscores the importance of considering

minority stress and resilience to better understand, protect, and treat the mental health of trans

individuals.

Keywords: transgender, gender dysphoria, minority stress, resilience

, 3


Table of Contents

Gender Dysphoria...................................................................................................................5

Minority Stress Theory............................................................................................................8

Methodology............................................................................................................................10

Eligibility Criteria.................................................................................................................10

Search Strategy......................................................................................................................11

Review Selection....................................................................................................................11

Data Collection and Analysis................................................................................................12

Results......................................................................................................................................14

Characteristics of Included Reviews.....................................................................................14

Results of the Literature Review............................................................................................15
General Overview of Transgender Mental Health.............................................................16
Minority Stress Processes in Relation to Transgender Mental Health..............................18
Resilience-Promoting Factors in Relation to Transgender Mental Health........................21

Discussion.................................................................................................................................25

Limitations.............................................................................................................................31

Recommendations for Future Research and Practice...........................................................32

Conclusion................................................................................................................................34

References................................................................................................................................35

, 4


Associations between Minority Stress, Resilience, and the Mental Health of Transgender
Individuals: A Systematic Review of Reviews on Socially Produced Mental Health
Disparities

In many societies, sex and gender are often converged and perceived as binary with

the two sole categories being male and female (Matsuno & Budge, 2017). The gender binary

system assumes that one’s sex assigned at birth, which is thought to be either male or female,

determines the traits and identity of this individual to be either masculine or feminine,

respectively (Hyde et al., 2019). Despite this being the sociocultural context, sex and gender

are distinct concepts. Sex refers to an individual’s biological status as being either male or

female, whereas gender refers to the attitudes, feelings, and behaviours associated with those

sex categories based on sociocultural stereotypes and norms (Winter et al., 2016).

Furthermore, neither sex nor gender is in fact binary. The process of sex determination is

more complex than initially thought, with research showing that more factors than only the

sex chromosomes X and Y play a role in the development of the biological sex (Ainsworth,

2015). Therefore, sex traits of humans spread across a spectrum of what is thought to

represent typical males and typical females. For instance, disorders of sex development, or

intersex, is a condition involving an atypical development of the chromosomal, gonadal, or

anatomical sex (Hughes, 2008). While this condition is rare, it is one of the various examples

indicating that there is not necessarily a sharp division into two sexes at the level of sexual

morphology. As some individuals do not identify themselves as being either exclusively

woman or man, also known as non-binary, it is clear that also gender is not a binary construct.

Non-binary individuals may identify as being both man and woman, in between the two

traditional gender categories, or neither man nor woman (Richards et al., 2016).

Except for intersex individuals, newborn babies are usually classified as either male or

female on the basis of their external genitalia. Assuming that the newborn babies’ gender is

evident based on their sex, their binary identity assignment determines both how the

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