Gender Dysphoria as a Measure of Proximal Stress: Development and Psychometric Evaluation of a Novel Measure of Social Gender Dysphoria

性别焦虑症作为近端应激的一种测量方法：发展和心理测量学评估 社交性别焦虑症的新测量。 摘要 拟议的研究将集中在一种新的社会衡量标准的开发和心理测量评估上。 性别焦虑症和苦恼。对性别焦虑症的临床/科学理解及其测量， 主要是通过性别认同和分配的性别的不一致而概念化的。我们的 发展工作的重点是跨性别者和非二元(TGNB)个体对现有量表的批评 以及他们对自己的性别焦虑症生活经历的描述。我们的发现表明，科学上 定义过于狭隘，不能反映社区内体验的异质性 (Galupo&Pulice-Farrow，2020)，并且未能捕捉到性别焦虑症的移动性和非二元性方面 (Galupo，Pulice-Farrow，&Cusack，2020；Galupo，Pulice-Farrow，&Pehl，2021)。我们还记录了 社会压力因素(如歧视和性别不匹配)引发性别焦虑症的方式，并已理论化 社交焦虑症是身体和心理健康差异的近端应激源(Galupo，Pulice- Farrow，&Lindley，2019)。我们随后为性别焦虑症提供了经验支持，作为一种 近端应激源(Lindley&Galupo，2020)，并使用这个模型来表明社交焦虑症与其他 在TGNB个体中预测问题物质使用的近端应激源(Lindley，Bauerband，& 加卢波，2020)。我们建议利用这项试点工作来开发和评估一种新的社会性别衡量标准 烦躁不安和苦恼。我们的研究团队将与专家顾问和社区小组成员合作 生成并评估初始量表条目(目标1)，测试并确认结构、信度、效度和不变性 我们的社会性别焦虑症的新测量(目标2)，并调查社会性别之间的关系 烦躁不安和精神健康结果(目标3)。我们提出的社交性别焦虑症的衡量标准将允许 在少数族裔压力模型中捕捉性别焦虑症作为独特的近端应激源的作用的方法 TGNB个人。我们的措施代表了一项关键的理论和方法创新，将使 对性别焦虑症的作用进行评估，因为性别焦虑症是由歧视和微攻击引起的(即远端 应激源)，并与公认的TGNB个人心理健康差异有关，包括 抑郁、焦虑、药物使用和饮食失调。这样的措施不仅将提供一个重要的工具 用于调查TGNB个人的精神健康状况，但提供焦虑症的临床评估工具- 相关的苦恼。

Gender dysphoria as a measure of proximal stress: Development and psychometric evaluation of a novel measure of social gender dysphoria. ABSTRACT The proposed research will focus on the development and psychometric evaluation of a new measure of social gender dysphoria and distress. Clinical/scientific understandings of gender dysphoria, and its measurement, have been conceptualized primarily through the incongruence of gender identity and assigned sex. Our developmental work has focused on transgender and nonbinary (TGNB) individuals’ critique of existing scales and their descriptions regarding their lived experience of gender dysphoria. Our findings suggest that scientific definitions are too narrowly defined, do not reflect the heterogeneity of experience within the community (Galupo & Pulice-Farrow, 2020), and fail to capture shifting and nonbinary aspects of gender dysphoria (Galupo, Pulice-Farrow, & Cusack, 2020; Galupo, Pulice-Farrow, & Pehl, 2021). We have also documented the ways that social stressors (e.g. discrimination and misgendering) elicit gender dysphoria, and have theorized that social dysphoria acts as a proximal stressor for physical and mental health disparities (Galupo, Pulice- Farrow, & Lindley, 2019). We have subsequently provided empirical support for gender dysphoria as a proximal stressor (Lindley & Galupo, 2020) and used this model to show that social dysphoria works with other proximal stressors to predict problematic substance use among TGNB individuals (Lindley, Bauerband, & Galupo, 2020). We propose to use this pilot work to develop and evaluate a novel measure of social gender dysphoria and distress. Our research team will work with both expert consultants and community panelists to generate and evaluate initial scale items (Aim 1), test and confirm structure, reliability, validity, and invariance of our novel measure of social gender dysphoria (Aim 2), and investigate the relation between social gender dysphoria and mental health outcomes (Aim 3). Our proposed measure of social gender dysphoria will allow a way to capture the role of gender dysphoria as a unique proximal stressor in models of minority stress for TGNB individuals. Our measure represents a critical theoretical and methodological innovation that will allow assessment of the role of gender dysphoria as it is elicited by discrimination and microaggressions (i.e., distal stressors) and is related to well established mental health disparities for TGNB individuals including depression, anxiety, substance use, and disordered eating. Such a measure will not only provide a critical tool for investigating mental health among TGNB individuals, but provide a clinical assessment tool of dysphoria- related distress.