Measuring event-level intersectional stigma among gender diverse youth

在美国，变性人和性别膨胀青年(TGEY)，包括青少年和新兴成年人(即16-29岁)经历了不成比例的负面心理健康结果。有色人种带来的后果负担最大，与非西班牙裔白人相比，他们经历了最高的自杀、抑郁、焦虑和创伤相关应激障碍的发生率。文献表明，耻辱是造成这些差异的一个重要原因。肤色体验加剧了与影响其心理健康的多重边缘化身份(即种族/民族身份、性别身份和性别身份)相关的、完全独特的污名体验。要在科学严谨和真实的管理者中审视这些经验，必须以最大化内容和生态有效性的方式来捕捉这些经验。然而，缺乏心理测量学验证的交叉污名的测量，这些测量是从颜色的TGEY经验中获得信息的。这反映了使用严格的量化方法来理解交叉经验的局限性。一个真正的跨部门方法来衡量和理解颜色的污名体验，需要一种事件级别的方法，能够捕捉到跨部门污名经验的背景方面，以及有助于充分充实这些污名经验的任何微妙的背景要素的质量细微差别。本论文的目标是使用为PRISM项目(PRISM；R21-MH121311；PI：Rendina)开发的方法和措施进行两部分研究。PRISM最初的措施旨在利用正在进行的对150名有艾滋病毒风险的YSMM进行的全国队列研究，记录顺性年轻少数性男性(YSMM)中跨部门耻辱的事件级经历。本论文的研究一旨在迭代增强棱镜测量的题库，以便于在色彩的TGEY中使用。在这项研究中，我们将进行认知访谈，以收集来自10tgey颜色的反馈，以确保题库代表tgey日常污名经历的范围。研究二旨在检验棱镜测量在不同颜色类型中的心理测量学效度。在此，我们将建立PRISM测量的信度和效度，并在我们的TGEY样本中检验其条目与心理健康结果的同时效度。研究2还将包括一个定性部分，其目的是将量化结果与背景联系起来。这些访谈将在随机挑选的15名参与者中进行，并将结合AIM#2中量化捕捉到的跨部门耻辱和精神健康影响的经历。指导这一计划的研究和培训计划经过精心设计，以优化我正在进行的博士培训经验，并促进我作为未来独立研究科学家的发展。

Transgender and gender expansive youth (TGEY), including adolescents and emerging adults (i.e. ages 16-29) experience disproportionately negative mental health outcomes in the United States. TGEY of color carry the greatest burden of outcomes, experiencing the highest rates of suicide, depression, anxiety, and trauma-related stress disorders when compared to their non-Hispanic white counterparts. Literature indicates stigma as a significant driver of these disparities. TGEY of color experience heightened and altogether unique experiences of stigma associated with their multiple marginalized identities (i.e. racial/ethnic identity, gender identity, and sexual identity) that impact their mental health. To examine these experiences in a scientifically rigorous and authentic manger, it is imperative that these experiences be captured in a way that maximizes content and ecological validity. There is, however, a lack of psychometrically validated measures of intersectional stigma that are informed by the experiences of TGEY of color. This reflects a limitation of using strictly quantitative methods for understanding intersectional experiences. A true intersectional approach to measuring and understanding stigma experiences of TGEY of color requires an events-level approach that can capture the contextual aspects of intersectional stigma experiences, as well as the qualitative nuances that help to fully flesh out any subtle, contextual elements of these stigma experiences. The goal of this dissertation study is to conduct a two-part study using methodology and measures developed for the PRISM project (PRISM; R21-MH121311; PI: Rendina). The original PRISM measure aimed to capture event-level experiences of intersectional stigma among cisgender young sexual minority men (YSMM) utilizing an ongoing nationwide cohort study of 150 YSMM who were at risk for HIV. Study 1 of this dissertation project will aim to iteratively enhance the item pool of the PRISM measure for utility among TGEY of color. For this study, we will conduct cognitive interviewing to gather feedback from 10 TGEY of color to ensure the item bank represents the range of daily stigma experiences of TGEY. Study 2 will aim to test the psychometric validity of the PRISM measure among TGEY of color. Here, we will establish reliability and validity of the PRISM measure and test the concurrent validity of its items with mental health outcomes among our sample of TGEY. Study 2 will also include a qualitative component that aims to contextualize quantitative findings. These interviews will be conducted among 15 randomly selected participants and will contextualize the experiences of intersectional stigma and mental health impacts that were quantitatively captured in Aim #2. The research and training plans guiding this proposal have been carefully crafted to optimize my ongoing doctoral training experiences and foster my development as a future independent research scientist.