Identity Development, Risk, and Resilience among Gender Diverse Populations

描述（由申请人提供）：跨性别者是一群性别认同与其出生时的性别不同的个体。他们以各种方式和通过大量的自我标签来表达自己的性别变异身份，这些标签既存在于性别/性别的二元概念之内，也存在于二元概念之外，即男性或女性、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，但由于缺乏对变性人身份发展的系统研究，我们对变性人经历的理解受到限制。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%）和企图自杀（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）。人们认为，与性别不一致有关的社会耻辱是造成这些卫生不平等的一个主要因素。之前的研究发现，绝大多数变性人都遭受过歧视。然而，由于使用了从艾滋病和社会服务机构招募的有过性工作史的跨性别女性的小样本，许多数据都受到了限制。本研究的目标是超越这些限制，通过使用有目的的、基于地点的抽样，在美国3个城市——纽约、旧金山和亚特兰大招募广泛、多样化的跨性别者样本，并将他们纳入混合方法纵向研究，以测试少数族裔压力模型的适应性，调查身份发展背景下的脆弱性、风险和恢复力。本研究的目的是：(1)通过对90名年龄在16岁及以上的跨性别者进行定性生命线访谈，描述跨性别认同的发展过程，并确定急性脆弱期和恢复力特征；(2)根据目标1的发现，完善一个结合身份发展、少数民族压力和弹性的模型，并制定/调整措施来评估模型的关键结构；(3)对480名跨性别者（N = 480）按城市、性别和年龄分层的心理弹性模型进行检验，并对其进行长期随访（基线，1- 1）。

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.