Interpersonal Protective Factors and Mental Health Symptom Self-Management Among Black Transgender Women: A Mixed-Methods Study

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Proposal Summary Protective factors across the life course can have profound effects on individual health. It has been well established that adverse childhood experiences and lifetime exposure to discrimination and victimization have negative mental and physical health effects. For women who are Black and transgender, adversity can be compounded by the intersectional impact of racism and gender-based discrimination. A constellation of interpersonal protective factors throughout the lifespan, including positive childhood experiences, family acceptance, and social support, may help to improve mental health outcomes among individuals as they experience adversity throughout the life course. Additionally, mental health symptom self-management may moderate the relationship between Black transgender women's experiences with protective factors and current psychological distress symptoms. Self-management, defined as drawing upon one's own ability to promote health or manage disease, may be instrumental in improving mental health outcomes and could be vital for this population due to significant known barriers to healthcare engagement. However, there is limited exploration of protective factors and self-management on mental health outcomes among Black transgender women. To address this gap, a convergent mixed-methods study is proposed to increase our understanding of how protective factors are associated with mental health self-management and psychological distress among Black transgender women. This training grant, nested within a larger parent study, takes a strengths-based approach to examine complex relationships between the variables of interest. The specific aims are: Aim 1. Determine the associations among interpersonal protective factors (i.e., positive childhood experiences, perceived family acceptance, and current social support) and current symptoms of psychological distress for Black transgender women (N=150). Aim 2. Determine the role of mental health self-management in moderating the associations between interpersonal protective factors, symptoms of depression, and symptoms of PTSD. Aim 3. Use thematic content analysis of in-depth interviews with 30 Black transgender women from Aim 1 to analyze how interpersonal protective factors influenced Black transgender women's abilities to self-manage psychological distress symptoms. Findings will inform future recommendations for interventions aimed at decreasing the harmful effects of adversity and discrimination for racially diverse transgender youth and adults.