Minority gender stress and its effects on mental health as a risk factor for depression in transgender persons: Literature review

Authors

DOI:

https://doi.org/10.33448/rsd-v10i3.13693

Keywords:

Sexual and Gender Minorities; Transgender Persons; Mental health; Social stigma.

Abstract

Transgender people experience disparities in mental health when compared to the general population, studies claim that this behavior may impact the well-being of this population. However, little is known about how multilevel stigma is experienced throughout life and that it can be especially vulnerable to its cumulative effects. Objective: To highlight the effects of minority stress on the life of the transgender population. Method: This is an integrative literature review that followed the PICO strategy to identify factors associated with gender minority stress. The search for the articles was carried out in three electronic databases: Medline, Lilacs and Scielo. The descriptors "Sexual and Gender Minorities", "Transgender People", "Social Stigma", "Mental Health" were used, with complete texts, published in the period from 2011 to 2021, in English, Portuguese and Spanish. Boolean AND operator. Result: 157 articles were found. Thirty-five articles were selected to be read in full and 15 met the criteria of this review. Evidence shows that the transgender population is at higher risk for mental disorders, including anxiety, when compared to heterosexuals. The appearance of signs and symptoms of anxiety are related to the shame and avoidance of this population due to strong discrimination and the lack of social and family support, which causes high levels of distress.

References

Adelson, S. L., Walker-Cornetta, E., & Kalish, N. (2019). LGBT Youth, Mental Health, and Spiritual Care: Psychiatric Collaboration With Health Care Chaplains. J Am Acad Child Adolesc Psychiatry, 58(7), 651–655. MEDLINE.

Anderssen, N., Sivertsen, B., Lønning, K. J., & Malterud, K. (2020). Life satisfaction and mental health among transgender students in Norway. BMC Public Health, 20(1), 138. https://doi.org/10.1186/s12889-020-8228-5

Barbosa, I. de S. F. ., Mendonça, C. de F. de S. ., Silva, R. R. da, Silva, L. A. ., Silva, M. V. G. da ., Neves, M. P. das ., Souza, M. V. L. de ., Alencar, Ícaro F. de ., Fontes, T. V. ., Ignácio, L. P. ., Oliveira, J. V. E., Souza, M. das G. G. de, Paulino, E. de F. R. ., Araujo, M. S. ., & Souza, D. A. C. (2020). Care for people with a problem related to alcohol abuse: an integrative literature review study. Research, Society and Development, 9(11), e52091110062. https://doi.org/10.33448/rsd-v9i11.10062

Bockting, W. O., Miner, M. H., Swinburne Romine, R. E., Hamilton, A., & Coleman, E. (2013). Stigma, mental health, and resilience in an online sample of the US transgender population. American Journal of Public Health, 103(5), 943–951. https://doi.org/10.2105/AJPH.2013.301241

Chakrapani, V., Vijin, P. P., Logie, C. H., Newman, P. A., Shunmugam, M., Sivasubramanian, M., & Samuel, M. (2017). Understanding How Sexual and Gender Minority Stigmas Influence Depression Among Trans Women and Men Who Have Sex with Men in India. LGBT Health, 4(3), 217–226. MEDLINE.

Downing, J. M., & Przedworski, J. M. (2018). Health of Transgender Adults in the U.S., 2014-2016. Am J Prev Med, 55(3), 336–344. MEDLINE.

Fabbre, V. D., & Gaveras, E. (2020). The manifestation of multilevel stigma in the lived experiences of transgender and gender nonconforming older adults. Am J Orthopsychiatry, 90(3), 350–360. MEDLINE.

Fredriksen-Goldsen, K. I., Cook-Daniels, L., Kim, H.-J., Erosheva, E. A., Emlet, C. A., Hoy-Ellis, C. P., Goldsen, J., & Muraco, A. (2014). Physical and mental health of transgender older adults: An at-risk and underserved population. The Gerontologist, 54(3), 488–500. https://doi.org/10.1093/geront/gnt021

Gamarel, K. E., Reisner, S. L., Laurenceau, J.-P., Nemoto, T., & Operario, D. (2014). Gender minority stress, mental health, and relationship quality: A dyadic investigation of transgender women and their cisgender male partners. Journal of Family Psychology : JFP : Journal of the Division of Family Psychology of the American Psychological Association (Division 43), 28(4), 437–447. https://doi.org/10.1037/a0037171

Glick, J. L., Lopez, A., Pollock, M., & Theall, K. P. (2019). “Housing Insecurity Seems to Almost Go Hand in Hand with Being Trans”: Housing Stress among Transgender and Gender Non-conforming Individuals in New Orleans. Journal of Urban Health : Bulletin of the New York Academy of Medicine, 96(5), 751–759. https://doi.org/10.1007/s11524-019-00384-y

Goldhammer, H., Krinsky, L., & Keuroghlian, A. S. (2019). Meeting the Behavioral Health Needs of LGBT Older Adults. J Am Geriatr Soc, 67(8), 1565–1570. MEDLINE.

Hoy-Ellis, C. P., & Fredriksen-Goldsen, K. I. (2017). Depression Among Transgender Older Adults: General and Minority Stress. American Journal of Community Psychology, 59(3–4), 295–305. https://doi.org/10.1002/ajcp.12138

Hoy-Ellis, C. P., Shiu, C., Sullivan, K. M., Kim, H.-J., Sturges, A. M., & Fredriksen-Goldsen, K. I. (2017). Prior Military Service, Identity Stigma, and Mental Health Among Transgender Older Adults. The Gerontologist, 57(suppl 1), S63–S71. https://doi.org/10.1093/geront/gnw173

Jones, C., Hayter, M., & Jomeen, J. (2017). Understanding asexual identity as a means to facilitate culturally competent care: A systematic literature review. J Clin Nurs, 26(23–24), 3811–3831. MEDLINE.

Lyons, C., Stahlman, S., Holland, C., Ketende, S., Van Lith, L., Kochelani, D., Mavimbela, M., Sithole, B., Maloney, L., Maziya, S., & Baral, S. (2019). Stigma and outness about sexual behaviors among cisgender men who have sex with men and transgender women in Eswatini: A latent class analysis. BMC Infectious Diseases, 19(1), 211. https://doi.org/10.1186/s12879-019-3711-2

Mark, K. M., McNamara, K. A., Gribble, R., Rhead, R., Sharp, M.-L., Stevelink, S. A. M., Schwartz, A., Castro, C., & Fear, N. T. (2019). The health and well-being of LGBTQ serving and ex-serving personnel: A narrative review. Int Rev Psychiatry, 31(1), 75–94. MEDLINE.

McCann, E., & Brown, M. (2019a). Homelessness among youth who identify as LGBTQ+: A systematic review. J Clin Nurs, 28(11–12), 2061–2072. MEDLINE.

McCann, E., & Brown, M. J. (2019b). The mental health needs and concerns of older people who identify as LGBTQ+: A narrative review of the international evidence. J Adv Nurs, 75(12), 3390–3403. MEDLINE.

McCann, E., Lee, R., & Brown, M. (2016). The experiences and support needs of people with intellectual disabilities who identify as LGBT: A review of the literature. Res Dev Disabil, 57, 39–53. MEDLINE.

McCave, E. L., Aptaker, D., Hartmann, K. D., & Zucconi, R. (2019). Promoting Affirmative Transgender Health Care Practice Within Hospitals: An IPE Standardized Patient Simulation for Graduate Health Care Learners. MedEdPORTAL, 15, 10861–10861. MEDLINE.

Miller, L. R., & Grollman, E. A. (2015). The Social Costs of Gender Nonconformity for Transgender Adults: Implications for Discrimination and Health. Sociological forum (Randolph, N.J.), 30(3), 809–831. https://doi.org/10.1111/socf.12193

Moher, D., Liberati, A., Tetzlaff, J., & Altman, D. G. (2019). PRISMA Group. Preferred reporting items for systematic review sand meta-analyses: the PRISMA statement. Ann Intern Med 151: 264-9. Available from: http://www.ncbi.nlm.nih. gov/ pubmed/19622511.

Nascimento, F. K., Reis, R. A., Saadeh, A., Demétrio, F., Rodrigues, I. L. A., Galera, S. A. F., & Santos, C. B. (2020). Brazilian transgender children and adolescents: Attributes associated with quality of life. Rev. Latino-Am. Enfermagem. Access feb 2021; Available in: DOI: http://dx.doi.org/10.1590/1518-8345.3504.3351.

Nascimento, M. I. C. (2014) Manual diagnóstico e estatístico de transtornos mentais: DSM-5 / American Psychiatric Association. a 5. Ed Porto Alegre Ed. Artmed,

Neves, M. P. das ., Silva , R. R., Silva, L. A. da ., Silva, M. V. G. da ., Silva, M. M. dos S. da ., Francisco, M. T. R. ., & Marta, C. B. (2020). Adição à drogas, o consumo de substâncias psicoativas por jovens, utilizando o instrumento assist. Saúde Coletiva (Barueri), 9(51), 1913-1919. https://doi.org/10.36489/saudecoletiva.2019v9i51p1913-1919

Peng, K., Zhu, X., & Gillespie, A. (2019). Self-reported Rates of Abuse, Neglect, and Bullying Experienced by Transgender and GenderNonbinary Adolescents in China. JAMA Netw Open. Access Feb 2021; Available: doi:10.1001/jamanetworkopen.2019.11058

Reisner, S. L., Poteat, T., Keatley, J., Cabral, M., Mothopeng, T., Dunham, E., Holland, C. E., Max, R., & Baral, S. D. (2016). Global health burden and needs of transgender populations: A review. Lancet (London, England), 388(10042), 412–436. https://doi.org/10.1016/S0140-6736(16)00684-X

Reisner, S. L., Radix, A., & Deutsch, M. B. (2016). Integrated and Gender-Affirming Transgender Clinical Care and Research. Journal of Acquired Immune Deficiency Syndromes (1999), 72 Suppl 3(Suppl 3), S235-242. https://doi.org/10.1097/QAI.0000000000001088

Scandurra, C., Bochicchio, V., Amodeo, A. L., Esposito, C., Valerio, P., Maldonato, N. M., Bacchini, D., & Vitelli, R. (2018). Internalized Transphobia, Resilience, and Mental Health: Applying the Psychological Mediation Framework to Italian Transgender Individuals. International Journal of Environmental Research and Public Health, 15(3). https://doi.org/10.3390/ijerph15030508

Scheim, A., Lyons, C., Ezouatchi, R., Liestman, B., Drame, F., Diouf, D., Ba, I., Bamba, A., Kouame, A., & Baral, S. (2019). Sexual behavior stigma and depression among transgender women and cisgender men who have sex with men in Côte d’Ivoire. Annals of Epidemiology, 33, 79-83.e1. https://doi.org/10.1016/j.annepidem.2019.03.002

Scorgie, F., Vasey, K., Harper, E., Vasey, K., Harper, E., Marlise R., Prínce N., , Maseko, S., & Chersich, M. F. (2013). Human rights abuses and collective resilience among sex workers in four African countries: a qualitative study. Global Health. (9) 33. Recuperado de: https://doi.org/10.1186/1744-8603-9-33

Silva, J. F., & Costa, G. M. C. (2020). Health care of sexual and gender minorities: an integrative literature review. Rev Bras Enferm. 73(Suppl 6). Recuperado de: doi http://dx.doi.org/10.1590/0034-7167-2019-0192

Silva, R. R., Silva, L. A, Silva, M. V. G., Neves, M. P., Silva, M. M. S, & Francisco, M. T. R. (2019). Os Impactos do Chemsex na saúde pública mundial: um estudo sobre uma perigosa prática sexual entre homens. Rev Saúde Coletiva Barueri. (2) 51 1920-5. Recuperado de: https://doi.org/10.36489/saudecoletiva.2019v9i51p1920-1925.

Silva, R.R., Neves, M. P., Silva, L. A., Silva, M. V. G., Hipolito, R. L., & Marta, C. B. (2020). Consumo de drogas psicoativas em contexto sexual entre homens gays como fator de risco para transmissão de HIV/Aids. Glob Acad Nurs. 1(3):e57. Recuperado de: https://dx.doi.org/10.5935/2675-5602.20200057

Souza, M. V. L. de ., Silva, R. R. da, Oliveira, M. C. P. de ., Silva, L. A. da ., Silva, M. V. G. da ., Vargas, D. de, Hipólito, R. L. ., Souza, M. das G. G. de ., Silveira, M. L. F. G. da ., Mesquita, L. M. F. de ., Araújo, M. S. ., Ignácio, L. P. ., Fontes, T. V. ., Alencar, Ícaro F. de ., Souza, D. A. C. ., Oliveira, J. V. E. ., Neves, M. P. das ., Pereira, A. V. ., Soares Filho, M. O. ., & Dutra, V. de C. de A. . (2021). Access to PrEP by cisgender mens and transsexual person: A qualitative study. Research, Society and Development, 10(1), e44310111843. https://doi.org/10.33448/rsd-v10i1.11843

Thomas, R., Pega, F., Khosla, R., Verster, A., Hana, T., & Say, L. (2018). Ensuring an inclusive global health agenda for transgender people. Bulletin of the World Health Organization, 95(2), 154–156. https://doi.org/10.2471/BLT.16.183913

Valentine, S. E., & Shipherd, J. C. (2018). A systematic review of social stress and mental health among transgender and gender non-conforming people in the United States. Clin Psychol Rev, 66, 24–38. MEDLINE.

Veale, J. F., Watson, R. J., Peter, T., & Saewyc, E. M. (2017). Mental Health Disparities Among Canadian Transgender Youth. The Journal of Adolescent Health : Official Publication of the Society for Adolescent Medicine, 60(1), 44–49. https://doi.org/10.1016/j.jadohealth.2016.09.014

Veltman, A., & Chaimowitz, G. (2014). Mental health care for people who identify as lesbian, gay, bisexual, transgender, and (or) queer. Canadian journal of psychiatry. Revue canadienne de psychiatrie, 59(11), 1–7, 1–8.

Verbeek, M., Hommes, M. A., Stutterheim, S. E., van Lankveld, J., & Bos, A. (2020). Experiences with stigmatization among transgender individuals after transition: A qualitative study in the Netherlands. International journal of transgender health, 21(2), 220–233. https://doi.org/10.1080/26895269.2020.1750529

White Hughto, J. M., Clark, K. A., Altice, F. L., Reisner, S. L., Kershaw, T. S., & Pachankis, J. E. (2018). Creating, reinforcing, and resisting the gender binary: A qualitative study of transgender women’s healthcare experiences in sex-segregated jails and prisons. International Journal of Prisoner Health, 14(2), 69–88. https://doi.org/10.1108/IJPH-02-2017-0011

White Hughto, J. M., Pachankis, J. E., Willie, T. C., & Reisner, S. L. (2017). Victimization and depressive symptomology in transgender adults: The mediating role of avoidant coping. Journal of Counseling Psychology, 64(1), 41–51. https://doi.org/10.1037/cou0000184

White Hughto, J. M., Reisner, S. L., & Pachankis, J. E. (2015). Transgender stigma and health: A critical review of stigma determinants, mechanisms, and interventions. Social Science & Medicine (1982), 147, 222–231. https://doi.org/10.1016/j.socscimed.2015.11.010

Wilson, E. C., Chen, Y.-H., Arayasirikul, S., Raymond, H. F., & McFarland, W. (2016). The Impact of Discrimination on the Mental Health of Trans*Female Youth and the Protective Effect of Parental Support. AIDS and Behavior, 20(10), 2203–2211. https://doi.org/10.1007/s10461-016-1409-7

Wood, S., Gross, R., Shea, J. A., Bauermeister, J. A., Franklin, J., Petsis, D., Swyryn, M., Lalley-Chareczko, L., Koenig, H. C., & Dowshen, N. (2019). Barriers and Facilitators of PrEP Adherence for Young Men and Transgender Women of Color. AIDS and behavior, 23(10), 2719–2729. https://doi.org/10.1007/s10461-019-02502-y

Yang, M.-F., Manning, D., van den Berg, J. J., & Operario, D. (2015). Stigmatization and Mental Health in a Diverse Sample of Transgender Women. LGBT Health, 2(4), 306–312. https://doi.org/10.1089/lgbt.2014.0106

Zhang, Y., Akl, E. A. & Schünemann, H. J. (2018). Using systematic reviews in guideline development: the GRADE approach. Res Synth Methods. Recuperado de: https://doi.org/10.1002/jrsm.1313

Published

24/03/2021

How to Cite

SILVA, R. R. da; SILVA, L. A. da .; SOUZA, M. V. L. de .; SILVA, M. V. G. da .; NEVES, M. P. das .; VARGAS, D. de; HIPOLITO, R. L. .; SOUZA, D. A. C.; DUTRA, V. de C. de A.; OLIVEIRA, E. S. de; LIPARI, C. da C.; GARCIA, W.; CORTES, T.; MATTOS, C. M. . Minority gender stress and its effects on mental health as a risk factor for depression in transgender persons: Literature review . Research, Society and Development, [S. l.], v. 10, n. 3, p. e51610313693, 2021. DOI: 10.33448/rsd-v10i3.13693. Disponível em: https://www.rsdjournal.org/index.php/rsd/article/view/13693. Acesso em: 23 apr. 2024.

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Health Sciences