Identity Development, Risk, and Resilience among Gender Diverse Populations

描述(申请人提供)：变性人是一群不同性别的人，他们的性别认同与他们出生时指定的性别不同。他们以不同的方式和通过大量的自我标签来表达他们的性别差异身份，无论是在性别/性别的二元概念之内还是之外，要么是男性，要么是女性，要么是男性，要么是女性。虽然公众对这种多样性的认识有所提高，但我们对变性人经历的理解受到缺乏对他们身份发展的系统研究的限制。美国变性人人群中记录的健康不平等包括抑郁(44%)、自杀意念(54%)和企图(31%)、焦虑(33%)、吸烟(36%)和艾滋病毒感染(12%基于自我报告；28%基于检测)。与性别不一致有关的社会耻辱被认为是造成这些健康不平等的一个主要因素。之前的研究发现，绝大多数跨性别者都经历了歧视。然而，由于使用了从艾滋病和社会服务机构招募的有性工作历史的变性人女性的小样本，许多数据受到了限制。这项研究的目标是通过使用有目的的、基于地点的抽样，在纽约、旧金山和亚特兰大这三个美国城市招募广泛、多样化的变性人样本，并将他们纳入一项混合方法的纵向研究，以测试少数群体压力模型的适应性，在身份发展的背景下调查脆弱性、风险和韧性。这项研究的目的是：(1)基于对90名16岁及以上的变性人样本的定性生活访谈，描述变性人身份发展的过程，并确定急性脆弱时期和复原力特征；(2)受目标1的发现启发，提炼一个结合身份发展、少数族裔压力和复原力的模型，并制定/调整措施来评估该模型的关键结构；(3)在按城市、性别和年龄分层的一组变性人(N=480)中测试复原力模型，并随着时间的推移(基线，1-， 两年和三年的跟踪访谈)；和(4)对身份发展和少数群体压力过程的定性和定量数据进行三角测量，以便为旨在促进复原力和减少污名和歧视的干预战略的未来发展和测试提供信息。通过实现这些目标，这项研究将在以下方面的科学知识方面取得重大进展：性别认同的发展、少数群体的压力过程(制定的耻辱、毛毡羞辱、掩饰、羞耻及其对健康和心理社会调整的影响)、少数群体的应对(对个人和社区一级的影响)以及随着时间的推移复原力的发展。这项研究的创新之处在于，它侧重于研究不足的少数群体，将生命线访谈方法应用于这一群体，以及对少数群体的适应和测试 变性人身份发展背景下的压力模型。

DESCRIPTION (provided by applicant): Transgender people are a diverse group of individuals whose gender identity differs from their sex assigned at birth. They express their gender-variant identity in various ways and through a multitude of self- labels, both within and outside of binary conceptualizations of sex/gender as either male or female, man or woman, masculine or feminine. While public awareness of this diversity has grown, our understanding of transgender people's experience is limited by a lack of systematic research on their identity development. Health inequities documented among the U.S. transgender population include depression (44%), suicidal ideation (54%) and attempts (31%), anxiety (33%), smoking (36%), and HIV infection (12% based on self- report; 28% on testing). Social stigma attached to gender nonconformity has been proposed as a major contributing factor to these health inequities. Previous research found that the vast majority of transgender individuals experienced discrimination. Much of the data, however, is limited by the use of small convenience samples of transgender women with a history of sex work, recruited from AIDS and social service agencies. The goal of this study is to move beyond these limitations by using purposive, venue-based sampling to recruit a broad, diverse sample of transgender people in 3 U.S. cities--New York, San Francisco, and Atlanta-and enroll them into a mixed-method longitudinal study to test an adaptation of the minority stress model, investigating vulnerability, risk and resilience in the context of identity development. The aims of the study are: (1) To describe the process of transgender identity development based on qualitative lifeline interviews with a sample of 90 transgender individuals ages 16 and older, and identify periods of acute vulnerability and characteristics of resilience; (2) Informed by findings from Aim 1, to refine a model combining identity development, minority stress, and resilience, and to develop/adapt measures to assess the model's key constructs; (3) To test the model of resilience in a cohort of transgender individuals (N = 480) stratified by city, gender, and age, and follow them over time (baseline, 1-, 2-, and 3-year follow up interviews); and (4) To triangulate qualitative and quantitative data on identity development and minority stress processes in order to inform the future development and testing of intervention strategies aimed at fostering resilience and reducing stigma and discrimination. By achieving these aims, this study will make a significant advance in scientific knowledge about gender identity development, minority stress processes (enacted stigma, felts stigma, concealment, shame and their impact on health and psychosocial adjustment), minority coping (on an individual as well as community level), and the development of resilience over time. The study is innovative in its focus on an understudied minority population, the application of the lifeline interview method to this population, and the adaptation and testing of the minority stress model within the context of transgender identity development.