Modeling Resilience as a Multidimensional Protective Factor for Transgender Health Disparities: Measure Development and Longitudinal Evaluation of Resilience

点击翻译按钮获取中文摘要

ABSTRACT The proposed research will focus on understanding the role of resilience in addressing mental health disparities for transgender and gender diverse (TGD) individuals. Clinical and scientific understandings of TGD health have been conceptualized primarily through the minority stress model (Brooks, 1981; Meyer, 1995; 2003; Testa et al., 2015) which disproportionately focuses on deficit and risk. In contrast, resilience moves beyond risk identification and has the potential to inform the development of interventions to help protect TGD people from minority stressors and heal from the consequent harm (Meyer, 2015). Matsuno & Israel (2018) recently proposed the Transgender Resilience Intervention Model (TRIM) as an expanded version of the minority stress model (Meyer, 2003; Testa et al., 2015). TRIM presents a promising theoretical framework from which to understand the role of resilience in mitigating the impact of minority stressors on mental health for TGD individuals. However, current measures do not provide a comprehensive way to assess TGD resilience as outlined in the TRIM. Our preliminary work significantly broadens the conceptualization of resilience and provides an important starting point from which to develop items for our proposed Multidimensional TGD- Resilience Scale. We incorporate findings from our review (Puckett et al., 2022) with recent research and preliminary data from each of the MPIs in order to map onto NIMHD’s health disparities research framework. We will use this framework as a conceptual map for developing initial items for our Multidimensional TGD- Resilience Scale that reflect individual, interpersonal, community, and societal levels of influence. In order to broaden the utility of our measure to address the unique needs of TGD POC, we propose a fifth level of influence related to intersectional resilience. In this 4-year MPI project, Drs. Puckett, Matsuno, and Galupo will work with expert and community panelists to develop and evaluate initial scale items for our Multidimensional TGD-Resilience Scale (Aim 1), psychometrically investigate our novel measure (Aim 2), and investigate the protective function of resilience in relation to TGD health disparities using a longitudinal design (Aim 3). This project is poised to broaden our conceptualization and measurement practices for TGD Resilience, reframe the overall approach to TGD health to incorporate a strengths-based focus, and inform the development of targeted mental health interventions to bolster resilience. This application is in response to PAR-22-072, which calls for research on measures and methods to advance research on minority health and health disparities- related constructs. The factors influencing TGD health disparities are under-researched and there are no measures that reflect multidimensional manifestations of resilience or the unique characteristics of resilience for TGD people. Our focus on protective factors directly aligns with NIMHD’s areas of interest and our community-participatory approach provides an avenue for future research to better reflect TGD people’s lives.