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

性别焦虑作为近端压力的一种测量方法：一种新的性别焦虑量表的发展和心理测量学评价 社会性别焦虑症的一种新方法 摘要 拟议的研究将集中在发展和心理测量评估的一个新的措施，社会 性别焦虑和痛苦。性别焦虑的临床/科学理解及其测量， 主要是通过性别认同和指定性别的不一致来概念化的。我们 发展工作的重点是跨性别和非二元（TGNB）个人对现有量表的批评 以及他们对性别焦虑的生活经历的描述。我们的研究结果表明， 定义过于狭隘，不能反映社区内经验的多样性 （Galupo & Pulice-Farrow，2020年），未能捕捉到性别焦虑的变化和非二元方面 （Galupo，Pulice-Farrow，& Cusack，2020; Galupo，Pulice-Farrow，& Pehl，2021）。我们还记录了 社会压力（例如歧视和性别歧视）引发性别焦虑的方式，并从理论上阐明了 社会焦虑症作为身体和精神健康差异的近端压力源（Galupo，Pulice- Farrow，& Lindley，2019）.我们随后提供了性别焦虑的实证支持， 近端压力源（Lindley & Galupo，2020），并使用该模型表明社交焦虑与其他 近端压力源来预测TGNB个体中有问题的物质使用（Lindley，Bauerband，& Galupo，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测量方法 烦躁和痛苦。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项目（目标1），测试并确认结构、信度、效度和不变性 我们的新措施的社会性别焦虑（目标2），并调查社会性别之间的关系， 焦虑和心理健康结果（目标3）。我们提出的社会性别焦虑的措施将允许一个 在少数民族压力模型中，性别焦虑作为一种独特的近端压力源， TGNB个人。我们的措施代表了一个关键的理论和方法创新， 评估性别焦虑的作用，因为它是由歧视和微攻击引起的（即，远侧 压力源），并与TGNB个体的既定心理健康差异有关，包括 抑郁焦虑物质滥用和饮食失调这样的措施不仅将提供一个关键的工具， 用于调查TGNB个体的心理健康，但提供了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.