Identity Development, Risk, and Resilience among Gender Diverse Populations

描述（由申请人提供）：跨性别者是一个多元化的群体，其性别认同与出生时指定的性别不同。他们以各种方式并通过众多的自我标签来表达其性别差异身份，既包括在性别二元概念的内部，也包括在性别二元概念的外部，即男性或女性、男性或女性。虽然公众对这种多样性的认识有所提高，但我们对跨性别者经历的理解受到缺乏对其身份发展的系统研究的限制。在美国跨性别人群中记录的健康不平等包括抑郁症（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%基于测试）。与性别不一致有关的社会耻辱被认为是造成这些卫生不平等的主要因素。先前的研究发现，绝大多数跨性别者都经历过歧视。然而，大部分数据都是有限的，因为使用了从艾滋病和社会服务机构招募的有性工作史的变性妇女的小样本。本研究的目标是超越这些限制，通过使用有目的的，基于场地的抽样招募一个广泛的，不同的样本的跨性别的人在3个美国城市-纽约，旧金山弗朗西斯科，和亚特兰大-并将他们纳入一个混合方法的纵向研究，以测试适应少数民族压力模型，调查的脆弱性，风险和弹性的背景下，身份发展。这项研究的目的是：（1）描述跨性别身份发展的过程，基于对90名16岁及以上跨性别者的定性生命线访谈，并确定严重脆弱时期和弹性特征;（2）根据目标1的研究结果，完善一个结合身份发展、少数民族压力和复原力的模型，并制定/调整措施，以评估模型的关键结构;（3）在按城市，性别和年龄分层的跨性别个体队列（N = 480）中测试弹性模型，并随时间推移（基线，1-， （4）对关于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分析，以便为今后制定和测试旨在培养复原力和减少污名化和歧视的干预战略提供信息。通过实现这些目标，本研究将在性别认同发展，少数民族压力过程（制定的耻辱，感觉耻辱，隐瞒，羞耻及其对健康和心理社会调整的影响），少数民族应对（在个人和社区层面）的科学知识方面取得重大进展，并随着时间的推移发展弹性。该研究的创新之处在于它关注的是一个研究不足的少数民族人口，生命线访谈方法应用于这一人口，以及少数民族的适应和测试 跨性别认同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.