1. Binaohan, B.Decolonizing Trans/gender 101 (Biyuti Publishing, 2014).

2. American Psychological Association. Guidelines for psychological practice with transgender and gender nonconforming people.Am. Psychol.70, 832–864 (2015).

   Article  Google Scholar 

3. Trans 101: glossary of trans words and how to use them.Gender Minorities Aotearoahttps://genderminorities.com/glossary-transgender/ (2020).

4. Bethea, M. S. & McCollum, E. E. The disclosure experiences of male-to-female transgender individuals: a systems theory perspective.J. Couple Relatsh. Ther.12, 89–112 (2013).

   Article  Google Scholar 

5. Stryker, S.Transgender History: The Roots Of Today’s Revolution (Seal Press, 2017).

6. Riggs, D. W. et al. Transnormativity in the psy disciplines: constructing pathology in the diagnostic and statistical manual of mental disorders and standards of care.Am. Psychol.74, 912–924 (2019).

   Article PubMed  Google Scholar 

7. Beemyn, G. A presence in the past: a transgender historiography.J. Women’s Hist.25, 113–121 (2013).

   Article  Google Scholar 

8. Human Rights Campaign staff. Two spirit and LGBTQ identities: today and centuries ago.Human Rights Campaignhttps://www.hrc.org/news/two-spirit-and-lgbtq-idenitites-today-and-centuries-ago (2020).

9. Deutsch, M. B. Making it count: improving estimates of the size of transgender and gender nonconforming populations.LGBT Health.3, 181–185 (2016).

   Article PubMed  Google Scholar 

10. Reisner, S. L. et al. Advancing methods for U.S. transgender health research.Curr. Opin. Endocrinol. Diabetes Obes.23, 198–207 (2016).

    Article PubMed PubMed Central  Google Scholar 

11. Reisner, S. L. et al. Monitoring the health of transgender and other gender minority populations: validity of natal sex and gender identity survey items in a U.S. national cohort of young adults.BMC Public Health14, 1224–1234 (2014).

    Article PubMed PubMed Central  Google Scholar 

12. Deutsch, M. B. & Buchholz, D. Electronic health records and transgender patients — practical recommendations for the collection of gender identity data.J. Gen. Intern. Med.30, 843–847 (2015).

    Article PubMed PubMed Central  Google Scholar 

13. Reisner, S. L. et al. Global health burden and needs of transgender populations: a review.Lancet388, 412–436 (2016).

    Article PubMed PubMed Central  Google Scholar 

14. Thomas, R. et al. Ensuring an inclusive global health agenda for transgender people.Bull. World Health Organ.95, 154–156 (2017).

    Article PubMed PubMed Central  Google Scholar 

15. Winter, S. et al. Transgender people: health at the margins of society.Lancet388, 390–400 (2016).

    Article PubMed  Google Scholar 

16. Flores, A. R., Brown, T. N. T. & Herman, J. L. Race and ethnicity of adults who identify as a transgender in the United States.UCLA: The Williams Institutehttps://escholarship.org/uc/item/69j3q4n0 (2016).

17. Flores, A. R., Herman, J. L., Gates, G. J. & Brown, T. N. T.How Many Adults Identify As Transgender In The United States? (The Williams Institute, 2016).

18. Herman, J. L., Flores, A. R., Brown, T. N. T., Wilson, B. D. M. & Conron, K. J. Age of individuals who identify as transgender in the United States.UCLA: The Williams Institutehttps://escholarship.org/uc/item/45f0k759 (2017).

19. Wilson, B. D. M. & Meyer, I. H.Nonbinary LGBTQ Adults in the United States (The Williams Institute, 2021).

20. Feldman, J. L., Luhur, W. E., Herman, J. L., Poteat, T. & Meyer, I. H. Health and health care access in the US transgender population health (TransPop) survey.Andrology9, 1707–1718 (2021).

    Article PubMed PubMed Central  Google Scholar 

21. Budge, S. L. et al. Transgender emotional and coping processes: facilitative and avoidant coping throughout gender transitioning.Couns. Psychol.41, 601–647 (2013).

    Article  Google Scholar 

22. Singh, A. A. Transgender youth of color and resilience: negotiating oppression and finding support.Sex Roles68, 690–702 (2013).

    Article  Google Scholar 

23. Evans, S., Crawley, J., Kane, D. & Edmunds, K. The process of transitioning for the transgender individual and the nursing imperative: a narrative review.J. Adv. Nurs.77, 4646–4660 (2021).

    Article PubMed  Google Scholar 

24. Dewey, J. M. & Gesbeck, M. M. (Dys)functional diagnosing: mental health diagnosis, medicalization, and the making of transgender patients.Humanity Soc.41, 37–72 (2017).

    Article  Google Scholar 

25. Beek, T. F., Cohen-Kettenis, P. T. & Kreukels, B. P. C. Gender incongruence/gender dysphoria and its classification history.Int. Rev. Psychiat.28, 5–12 (2016).

    Article  Google Scholar 

26. Davy, Z. & Toze, M. What is gender dysphoria? A critical systematic narrative review.Transgender Health3, 159–169 (2018).

    Article PubMed PubMed Central  Google Scholar 

27. Brooks, V.Minority Stress And Lesbian Women (Free Press, 1981).

28. Meyer, I. H. Minority stress and mental health in gay men.J. Health Soc. Behav.36, 38–56 (1995).

    Article PubMed  Google Scholar 

29. Meyer, I. H. Prejudice, social stress, and mental health in lesbian, gay, and bisexual populations: conceptual issues and research evidence.Psychol. Bull.129, 674–697 (2003).

    Article PubMed PubMed Central  Google Scholar 

30. Testa, R. J., Habarth, J., Peta, J., Balsam, K. & Bockting, W. Development of the gender minority stress and resilience measure.Psychol. Sex Orient. Gend. Divers.2, 65–77 (2015).

    Google Scholar 

31. Tebbe, E. A. & Moradi, B. Suicide risk in trans populations: an application of minority stress theory.J. Couns. Psychol.63, 520–533 (2016).

    Article PubMed  Google Scholar 

32. Jefferson, K., Neilands, T. B. & Sevelius, J. Transgender women of color: discrimination and depression symptoms.Ethn. Inequal. Health Soc. Care6, 121–136 (2013).

    Article PubMed PubMed Central  Google Scholar 

33. Barr, S. M., Snyder, K. E., Adelson, J. L. & Budge, S. L. Posttraumatic stress in the trans community: the roles of anti-transgender bias, non-affirmation, and internalized transphobia.Psychol. Sex Orient. Gend. Divers.https://doi.org/10.1037/sgd0000500 (2021).

    Article  Google Scholar 

34. Pellicane, M. J. & Ciesla, J. A. Associations between minority stress, depression, and suicidal ideation and attempts in transgender and gender diverse (TGD) individuals: systematic review and meta-analysis.Clin. Psychol. Rev.91, 102–113 (2022).

    Article  Google Scholar 

35. Botha, M. & Frost, D. M. Extending the minority stress model to understand mental health problems experienced by the autistic population.Soc. Ment. Health10, 20–34 (2020).

    Article  Google Scholar 

36. Lund, E. M. Examining the potential applicability of the minority stress model for explaining suicidality in individuals with disabilities.Rehab. Psychol.66, 183–191 (2021).

    Article  Google Scholar 

37. Goldbach, J. T., Tanner-Smith, E. E., Bagwell, M. & Dunlap, S. Minority stress and substance use in sexual minority adolescents: a meta-analysis.Prev. Sci.15, 350–363 (2014).

    Article PubMed  Google Scholar 

38. Kuyper, L. & Fokkema, T. Minority stress and mental health among Dutch LGBs: examination of differences between sex and sexual orientation.J. Couns. Psychol.58, 222–233 (2011).

    Article PubMed  Google Scholar 

39. Lea, T., Reynolds, R. & Wit, Jde Alcohol and club drug use among same-sex attracted young people: associations with frequenting the lesbian and gay scene and other bars and nightclubs.Subst. Use Misuse48, 129–136 (2013).

    Article PubMed  Google Scholar 

40. Rabasco, A. & Andover, M. Suicidal ideation among transgender and gender diverse adults: a longitudinal study of risk and protective factors.J. Affect. Disord.278, 136–143 (2021).

    Article PubMed  Google Scholar 

41. Katz-Wise, S. L., Sarda, V., Austin, S. B. & Harris, S. K. Longitudinal effects of gender minority stressors on substance use and related risk and protective factors among gender minority adolescents.PLOS One16, e0250500 (2021).

    Article PubMed PubMed Central  Google Scholar 

42. Budge, S. L., Sinnard, M. T. & Hoyt, W. T. Longitudinal effects of psychotherapy with transgender and nonbinary clients: a randomized controlled pilot trial.Psychotherapy58, 1–11 (2021).

    Article PubMed  Google Scholar 

43. Riggs, D. & Treharne, G. Decompensation: a novel approach to accounting for stress arising from the effects of ideology and social norms.J. Homosex.64, 592–605 (2017).

    Article PubMed  Google Scholar 

44. Riggs, D. W., Ansara, G. Y. & Treharne, G. J. An evidence-based model for understanding the mental health experiences of transgender Australians.Aust. Psychol.50, 32–39 (2015).

    Article  Google Scholar 

45. Tan, K. K. H., Treharne, G. J., Ellis, S. J., Schmidt, J. M. & Veale, J. F. Gender minority stress: a critical review.J. Homosex.67, 1471–1489 (2020).

    Article PubMed  Google Scholar 

46. Lindley, L. & Galupo, M. P. Gender dysphoria and minority stress: support for inclusion of gender dysphoria as a proximal stressor.Psychol. Sex. Orient. Gend. Divers.7, 265–275 (2020).

    Google Scholar 

47. Crenshaw, K. Mapping the margins: intersectionality, identity politics, and violence against women of color.Stanford Law Rev.43, 1241–1299 (1991).

    Article  Google Scholar 

48. Moradi, B. & Grzanka, P. R. Using intersectionality responsibly: toward critical epistemology, structural analysis, and social justice activism.J. Couns. Psychol.64, 500–513 (2017).

    Article PubMed  Google Scholar 

49. Schuller, K.The Biopolitics Of Feeling: Race, Sex, And Science In The Nineteenth Century (Duke Univ. Press, 2018).

50. Snorton, C. R.Black On Both Sides: A Racial History Of Trans Identity (Univ. Minnesota Press, 2017).

51. Puckett, J. A. An ecological approach to therapy with gender minorities.Cogn. Behav. Pract.26, 647–655 (2019).

    Article  Google Scholar 

52. White Hughto, J. M., Reisner, S. L. & Pachankis, J. E. Transgender stigma and health: a critical review of stigma determinants, mechanisms, and interventions.Soc. Sci. Med.147, 222–231 (2015).

    Article PubMed PubMed Central  Google Scholar 

53. Tebbe, E. A., Allan, B. A. & Bell, H. L. Work and well-being in TGNC adults: the moderating effect of workplace protections.J. Couns. Psychol.https://doi.org/10.1037/cou0000308 (2018).

    Article PubMed  Google Scholar 

54. Tebbe, E. A., Simone, M., Wilson, E. & Hunsicker, M. A dangerous visibility: moderating effects of antitrans legislative efforts on trans and gender-diverse mental health.Psychol. Sex Orient. Gend. Divers.https://doi.org/10.1037/sgd0000481 (2021).

    Article  Google Scholar 

55. Price-Feeney, M., Green, A. E. & Dorison, S. H. Impact of bathroom discrimination on mental health among transgender and nonbinary youth.J. Adolesc. Health68, 1142–1147 (2021).

    Article PubMed  Google Scholar 

56. Horne, S. G., McGinley, M., Yel, N. & Maroney, M. R. The stench of bathroom bills and anti-transgender legislation: anxiety and depression among transgender, nonbinary, and cisgender LGBQ people during a state referendum.J. Couns. Psychol.69, 1–13 (2022).

    Article PubMed  Google Scholar 

57. Scheim, A. I., Perez-Brumer, A. G. & Bauer, G. R. Gender-concordant identity documents and mental health among transgender adults in the USA: a cross-sectional study.Lancet Public Health5, e196–e203 (2020).

    Article PubMed  Google Scholar 

58. Roberts, T. K. & Fantz, C. R. Barriers to quality health care for the transgender population.Clin. Biochem.47, 983–987 (2014).

    Article PubMed  Google Scholar 

59. Bakko, M. & Kattari, S. K. Transgender-related insurance denials as barriers to transgender healthcare: differences in experience by insurance type.J. Gen. Intern. Med.35, 1693–1700 (2020).

    Article PubMed PubMed Central  Google Scholar 

60. Hatzenbuehler, M. L. How does sexual minority stigma “get under the skin”? A psychological mediation framework.Psychol. Bull.135, 707–730 (2009).

    Article PubMed PubMed Central  Google Scholar 

61. Reitzel, L. R., Smith, N. G., Obasi, E. M., Forney, M. & Leventhal, A. M. Perceived distress tolerance accounts for the covariance between discrimination experiences and anxiety symptoms among sexual minority adults.J. Anxiety Disord.48, 22–27 (2017).

    Article PubMed  Google Scholar 

62. Fitzpatrick, S., Dworkin, E. R., Zimmerman, L., Javorka, M. & Kaysen, D. Stressors and drinking in sexual minority women: the mediating role of emotion dysregulation.Psychol. Sex Orient. Gend. Divers.7, 46–54 (2020).

    Google Scholar 

63. Wang, S. B. & Borders, A. Rumination mediates the associations between sexual minority stressors and disordered eating, particularly for men.Eat. Weight Disord.22, 699–706 (2017).

    Article PubMed  Google Scholar 

64. Argyriou, A., Goldsmith, K. A. & Rimes, K. A. Mediators of the disparities in depression between sexual minority and heterosexual individuals: a systematic review.Arch. Sex Behav.50, 925–959 (2021).

    Article PubMed PubMed Central  Google Scholar 

65. Scandurra, C. et al. Internalized transphobia, resilience, and mental health: applying the psychological mediation framework to Italian transgender individuals.Int. J. Environ. Res. Public. Health15, 508–527 (2018).

    Article PubMed PubMed Central  Google Scholar 

66. Tucker, R. P. et al. Current and military-specific gender minority stress factors and their relationship with suicide ideation in transgender veterans.Suicide Life Threat. Behav.49, 155–166 (2019).

    Article PubMed  Google Scholar 

67. Bauerband, L. A. & Galupo, M. P. The gender identity reflection and rumination scale: development and psychometric evaluation.J. Couns. Dev.92, 219–231 (2014).

    Article  Google Scholar 

68. Sarno, E. L., Mohr, J. J., Jackson, S. D. & Fassinger, R. E. When identities collide: conflicts in allegiances among LGB people of color.Cultur. Divers Ethnic Minor. Psychol.21, 550–559 (2015).

    Article PubMed  Google Scholar 

69. Timmins, L., Rimes, K. A. & Rahman, Q. Minority stressors and psychological distress in transgender individuals.Psychol. Sex Orient. Gend. Divers.4, 328–340 (2017).

    Google Scholar 

70. Fredrickson, B. L. & Roberts, T.-A. Objectification theory.Psychol. Women Q.21, 173–206 (1997).

    Article  Google Scholar 

71. Van Orden, K. A. et al. The interpersonal theory of suicide.Psychol. Rev.117, 575–600 (2010).

    Article PubMed PubMed Central  Google Scholar 

72. Joiner, T.Why People Die By Suicide (Harvard Univ. Press, 2005).

73. Testa, R. J. et al. Suicidal ideation in transgender people: gender minority stress and interpersonal theory factors.J. Abnorm. Psychol.126, 125–136 (2017).

    Article PubMed  Google Scholar 

74. Moradi, B. et al. A content analysis of literature on trans people and issues: 2002–2012.Couns. Psychol.44, 960–995 (2016).

    Article  Google Scholar 

75. Hendricks, M. L. & Testa, R. J. A conceptual framework for clinical work with transgender and gender nonconforming clients: an adaptation of the minority stress model.Prof. Psychol. Res. Pract.43, 460–467 (2012).

    Article  Google Scholar 

76. Budge, S. L., Adelson, J. L. & Howard, K. A. S. Anxiety and depression in transgender individuals: the roles of transition status, loss, social support, and coping.J. Consult. Clin. Psychol.81, 545–557 (2013).

    Article PubMed  Google Scholar 

77. Hwahng, S. J. & Nuttbrock, L. Adolescent gender-related abuse, androphilia, and HIV risk among transfeminine people of color in New York City.J. Homosex.61, 691–713 (2014).

    Article PubMed PubMed Central  Google Scholar 

78. Klemmer, C. L., Arayasirikul, S. & Raymond, H. F. Transphobia-based violence, depression, and anxiety in transgender women: the role of body satisfaction.J. Interpers. Violence36, 2633–2655 (2021).

    Article PubMed  Google Scholar 

79. Depression.World Health Organizationhttps://www.who.int/news-room/fact-sheets/detail/depression (2021).

80. Millet, N., Longworth, J. & Arcelus, J. Prevalence of anxiety symptoms and disorders in the transgender population: a systematic review of the literature.Int. J. Transgend.18, 27–38 (2017).

    Article  Google Scholar 

81. Witcomb, G. L. et al. Levels of depression in transgender people and its predictors: results of a large matched control study with transgender people accessing clinical services.J. Affect. Disord.235, 308–315 (2018).

    Article PubMed  Google Scholar 

82. Bouman, W. P. et al. Transgender and anxiety: a comparative study between transgender people and the general population.Int. J. Transgend.18, 16–26 (2017).

    Article  Google Scholar 

83. Barr, S. M., Budge, S. L. & Adelson, J. L. Transgender community belongingness as a mediator between strength of transgender identity and well-being.J. Couns. Psychol.63, 87–97 (2016).

    Article PubMed  Google Scholar 

84. Reisner, S. L. et al. Discriminatory experiences associated with posttraumatic stress disorder symptoms among transgender adults.J. Couns. Psychol.63, 509–519 (2016).

    Article PubMed PubMed Central  Google Scholar 

85. Shipherd, J. C., Maguen, S., Skidmore, W. C. & Abramovitz, S. M. Potentially traumatic events in a transgender sample: frequency and associated symptoms.Traumatology17, 56–67 (2011).

    Article  Google Scholar 

86. Wolford-Clevenger, C. A daily diary study of intrusive PTSD symptoms and suicidal ideation among transgender and gender diverse adults.Psychol. Trauma. Theory Res. Pract. Policyhttps://doi.org/10.1037/tra0001103 (2021).

    Article  Google Scholar 

87. Kessler, R. C., Berglund, P., Demler, O., Jin, R. & Walters, E. E. Lifetime prevalence and age-of-onset distributions of DSM-IV disorders in the National Comorbidity Survey Replication.Arch. Gen. Psychiat.62, 593–602 (2005).

    Article PubMed  Google Scholar 

88. Watkins, L. E., Sprang, K. R. & Rothbaum, B. O. Treating PTSD: a review of evidence-based psychotherapy interventions.Front. Behav. Neurosci.12, 258–267 (2018).

    Article PubMed PubMed Central  Google Scholar 

89. Empson, S. et al. Seeking safety group therapy for co-occurring substance use disorder and PTSD among transgender women living with HIV: a pilot study.J. Psychoact. Drugs49, 344–351 (2017).

    Article  Google Scholar 

90. Keuroghlian, A. S., Reisner, S. L., White, J. M. & Weiss, R. D. Substance use and treatment of substance use disorders in a community sample of transgender adults.Drug Alcohol Depend.152, 139–146 (2015).

    Article PubMed PubMed Central  Google Scholar 

91. Nuttbrock, L. et al. Psychiatric impact of gender-related abuse across the life course of male-to-female transgender persons.J. Sex Res.https://doi.org/10.1080/00224490903062258 (2009).

    Article  Google Scholar 

92. Rowe, C., Santos, G.-M., McFarland, W. & Wilson, E. C. Prevalence and correlates of substance use among trans*female youth ages 16–24 years in the San Francisco Bay Area.Drug Alcohol Depend.147, 160–166 (2015).

    Article PubMed  Google Scholar 

93. Sherman, A. D. F. et al. Association of depression and post-traumatic stress with polyvictimization and emotional transgender and gender diverse community connection among Black and Latinx transgender women.LGBT Health.7, 358–366 (2020).

    Article PubMed  Google Scholar 

94. Dickey, L. M. & Budge, S. L. Suicide and the transgender experience: a public health crisis.Am. Psychol.75, 380–390 (2020).

    Article PubMed  Google Scholar 

95. Treharne, G. J., Riggs, D. W., Ellis, S. J., Flett, J. A. M. & Bartholomaeus, C. Suicidality, self-harm, and their correlates among transgender and cisgender people living in Aotearoa/New Zealand or Australia.Int. J. Transgender Health21, 440–454 (2020).

    Article  Google Scholar 

96. Boyer, T. L. et al. Suicide, homicide, and all-cause mortality among transgender and cisgender patients in the Veterans Health Administration.LGBT Health.8, 173–180 (2021).

    Article PubMed  Google Scholar 

97. Lefevor, G. T., Boyd-Rogers, C. C., Sprague, B. M. & Janis, R. A. Health disparities between genderqueer, transgender, and cisgender individuals: an extension of minority stress theory.J. Couns. Psychol.66, 385–395 (2019).

    Article PubMed  Google Scholar 

98. Kessler, R. C., Borges, G. & Walters, E. E. Prevalence of and risk factors for lifetime suicide attempts in the National Comorbidity Survey.Arch. Gen. Psychiat.56, 617–626 (1999).

    Article PubMed  Google Scholar 

99. Bazargan, M. & Galvan, F. Perceived discrimination and depression among low-income Latina male-to-female transgender women.BMC Publ. Health12, 663–671 (2012).

    Article  Google Scholar 

100. James, S. E. et al.The Report of the 2015 U.S. Trans Survey.http://www.ustranssurvey.org/report/ (National Centre For Transgender Equality, 2016).

101. Toomey, R. B., Syvertsen, A. K. & Shramko, M. Transgender adolescent suicide behavior.Pediatrics142, e20174218 (2018).

     Article PubMed  Google Scholar 

102. Thoma, B. C. et al. Suicidality disparities between transgender and cisgender adolescents.Pediatrics144, e20191183 (2019).

     Article PubMed  Google Scholar 

103. Veale, J. F., Watson, R. J., Peter, T. & Saewyc, E. M. Mental health disparities among Canadian transgender youth.J. Adolesc. Health60, 44–49 (2017).

     Article PubMed PubMed Central  Google Scholar 

104. Wichaidit, W., Assanangkornchai, S. & Chongsuvivatwong, V. Disparities in behavioral health and experience of violence between cisgender and transgender Thai adolescents.PLOS One16, e0252520 (2021).

     Article PubMed PubMed Central  Google Scholar 

105. Reisner, S. et al. Mental health of transgender youth in care at an adolescent urban community health center: a matched retrospective cohort study.J. Adolesc. Health56, 274–279 (2015).

     Article PubMed PubMed Central  Google Scholar 

106. Bockting, W. O., Miner, M. H., Swinburne Romine, R. E., Hamilton, A. & Coleman, E. Stigma, mental health, and resilience in an online sample of the US transgender population.Am. J. Public Health103, 943–951 (2013).

     Article PubMed PubMed Central  Google Scholar 

107. Dispenza, F., Watson, L. B., Chung, Y. B. & Brack, G. Experience of career-related discrimination for female-to-male transgender persons: a qualitative study.Career Dev. Q.60, 65–81 (2012).

     Article  Google Scholar 

108. Puckett, J. A., Maroney, M. R., Wadsworth, L. P., Mustanski, B. & Newcomb, M. E. Coping with discrimination: the insidious effects of gender minority stigma on depression and anxiety in transgender individuals.J. Clin. Psychol.76, 176–194 (2020).

     Article PubMed  Google Scholar 

109. Sadiq, S. & Bashir, A. Relationship between perceived discrimination and depression: moderating role of belief in just world among transgender in Punjab.J. Indian. Acad. Appl. Psychol.41, 203–211 (2015).

     Google Scholar 

110. Williams, C. C. et al. Depression and discrimination in the lives of women, transgender and gender liminal people in Ontario, Canada.Health Soc. Care Community25, 1139–1150 (2017).

     Article PubMed  Google Scholar 

111. Zhang, J., Lo, H. H. & Au, A. M. The buffer of resilience in the relations of gender-related discrimination, rejection, and victimization with depression among Chinese transgender and gender non-conforming individuals.J. Affect. Disord.283, 335–343 (2021).

     Article PubMed  Google Scholar 

112. Goldblum, P. et al. The relationship between gender-based victimization and suicide attempts in transgender people.Prof. Psychol. Res. Pract.43, 468–475 (2012).

     Article  Google Scholar 

113. Testa, R. J. et al. Effects of violence on transgender people.Prof. Psychol. Res. Pract.43, 452–459 (2012).

     Article  Google Scholar 

114. Scanlon, K., Travers, R., Coleman, T., Bauer, G. & Boyce, M. Ontario’s trans communities and suicide: transphobia is bad for our health.Trans PULSEhttps://transpulseproject.ca/research/ontarios-trans-communities-and-suicide/ (2010).

115. McClain, Z. & Peebles, R. Body image and eating disorders among lesbian, gay, bisexual, and transgender youth.Pediatr. Clin.63, 1079–1090 (2016).

     Google Scholar 

116. Nagata, J. M., Ganson, K. T. & Austin, S. B. Emerging trends in eating disorders among sexual and gender minorities.Curr. Opin. Psychiat.33, 562–567 (2020).

     Article  Google Scholar 

117. Watson, R. J., Veale, J. F. & Saewyc, E. M. Disordered eating behaviors among transgender youth: probability profiles from risk and protective factors.Int. J. Eat. Disord.50, 515–522 (2017).

     Article PubMed  Google Scholar 

118. Smith, A. & Saewyc, E.From Hastings Street To Haida Gwaii: Provincial Results Of The 2013 Bc Adolescent Health Surveyhttps://www.mcs.bc.ca/pdf/From_Hastings_Street_To_Haida_Gwaii.pdf (McCreary Centre Society, 2014).

119. Roberts, S. R. et al. Disparities in disordered eating between gender minority and cisgender adolescents.Int. J. Eat. Disord.54, 1135–1146 (2021).

     Article PubMed  Google Scholar 

120. Brewster, M. E., Velez, B. L., Breslow, A. S. & Geiger, E. F. Unpacking body image concerns and disordered eating for transgender women: The roles of sexual objectification and minority stress.J. Couns. Psychol.66, 131–142 (2019).

     Article PubMed  Google Scholar 

121. Watson, L. B., Grotewiel, M., Farrell, M., Marshik, J. & Schneider, M. Experiences of sexual objectification, minority stress, and disordered eating among sexual minority women.Psychol. Women Q.39, 458–470 (2015).

     Article  Google Scholar 

122. Uniacke, B., Glasofer, D., Devlin, M., Bockting, W. & Attia, E. Predictors of eating-related psychopathology in transgender and gender nonbinary individuals.Eat. Behav.42, 101527 (2021).

     Article PubMed PubMed Central  Google Scholar 

123. Jones, B. A., Haycraft, E., Murjan, S. & Arcelus, J. Body dissatisfaction and disordered eating in trans people: a systematic review of the literature.Int. Rev. Psychiat.28, 81–94 (2016).

     Article  Google Scholar 

124. Velez, B. L., Breslow, A. S., Brewster, M. E., Cox, R. Jr. & Foster, A. B. Building a pantheoretical model of dehumanization with transgender men: integrating objectification and minority stress theories.J. Couns. Psychol.63, 497–508 (2016).

     Article PubMed  Google Scholar 

125. Day, J. K., Fish, J. N., Perez-Brumer, A., Hatzenbuehler, M. L. & Russell, S. T. Transgender youth substance use disparities: results from a population-based sample.J. Adolesc. Health61, 729–735 (2017).

     Article PubMed PubMed Central  Google Scholar 

126. Hughto, J. M. W. et al. Negative transgender-related media messages are associated with adverse mental health outcomes in a multistate study of transgender adults.LGBT Health.8, 32–41 (2021).

     Article PubMed PubMed Central  Google Scholar 

127. Wolfe, H. L. et al. Transgender-related discrimination and substance use, substance use disorder diagnosis and treatment history among transgender adults.Drug Alcohol Depend.223, 108711 (2021).

     Article PubMed PubMed Central  Google Scholar 

128. Puckett, J. A., Brown, N. C., Dunn, T., Mustanski, B. & Newcomb, M. E. Perspectives from transgender and gender diverse people on how to ask about gender.LGBT Health.7, 305–311 (2020).

     Article PubMed PubMed Central  Google Scholar 

129. Singh, A. A. & McKleroy, V. S. ‘Just getting out of bed is a revolutionary act’: the resilience of transgender people of color who have survived traumatic life events.Traumatology17, 34–44 (2011).

     Article  Google Scholar 

130. Katz-Wise, S. L. et al. Using family and ecological systems approaches to conceptualize family- and community-based experiences of transgender and/or nonbinary youth from the trans teen and family narratives project.Psychol. Sex. Orient. Gend. Divers.https://doi.org/10.1037/sgd0000442 (2020).

     Article  Google Scholar 

131. Selkie, E., Adkins, V., Masters, E., Bajpai, A. & Shumer, D. Transgender adolescents’ uses of social media for social support.J. Adolesc. Health66, 275–280 (2020).

     Article PubMed  Google Scholar 

132. Zeeman, L., Aranda, K., Sherriff, N. & Cocking, C. Promoting resilience and emotional well-being of transgender young people: research at the intersections of gender and sexuality.J. Youth Stud.20, 382–397 (2017).

     Article  Google Scholar 

133. Devor, A. Witnessing and mirroring: a fourteen stage model of transsexual identity formation.J. Gay Lesbian Psychother.8, 41–67 (2008).

     Google Scholar 

134. Cannon, Y. et al. Transition, connection, disconnection, and social media: examining the digital lived experiences of transgender individuals.J. LGBT Issues Couns.11, 68–87 (2017).

     Article  Google Scholar 

135. Cipolletta, S., Votadoro, R. & Faccio, E. Online support for transgender people: an analysis of forums and social networks.Health Soc. Care Commun.25, 1542–1551 (2017).

     Article  Google Scholar 

136. Haimson, O. L. Mapping gender transition sentiment patterns via social media data: toward decreasing transgender mental health disparities.J. Am. Med. Inform. Assoc.26, 749–758 (2019).

     Article PubMed PubMed Central  Google Scholar 

137. Pflum, S. R., Testa, R. J., Balsam, K. F., Goldblum, P. B. & Bongar, B. Social support, trans community connectedness, and mental health symptoms among transgender and gender nonconforming adults.Psychol. Sex Orient. Gend. Divers.2, 281–286 (2015).

     Google Scholar 

138. Austin, A. & Goodman, R. The impact of social connectedness and internalized transphobic stigma on self-esteem among transgender and gender non-conforming adults.J. Homosex.64, 825–841 (2017).

     Article PubMed  Google Scholar 

139. Stanton, M. C., Ali, S. & Chaudhuri, S. Individual, social and community-level predictors of wellbeing in a US sample of transgender and gender non-conforming individuals.Cult. Health Sex19, 32–49 (2017).

     Article PubMed  Google Scholar 

140. Sherman, A. D. F. et al. Transgender and gender diverse community connection, help-seeking, and mental health among Black transgender women who have survived violence: a mixed-methods analysis.Violence Women28, 890–921 (2022).

     Article  Google Scholar 

141. Sherman, A. D. F., Clark, K. D., Robinson, K., Noorani, T. & Poteat, T. Trans* community connection, health, and wellbeing: a systematic review.LGBT Health.7, 1–14 (2020).

     Article PubMed  Google Scholar 

142. Fuller, K. A. & Riggs, D. W. Family support and discrimination and their relationship to psychological distress and resilience amongst transgender people.Int. J. Transgend.19, 379–388 (2018).

     Article  Google Scholar 

143. Katz-Wise, S. L., Ehrensaft, D., Vetters, R., Forcier, M. & Austin, S. B. Family functioning and mental health of transgender and gender-nonconforming youth in the trans teen and family narratives project.J. Sex. Res.55, 582–590 (2018).

     Article PubMed PubMed Central  Google Scholar 

144. McConnell, E. A., Birkett, M. & Mustanski, B. Families matter: social support and mental health trajectories among lesbian, gay, bisexual, and transgender youth.J. Adolesc. Health59, 674–680 (2016).

     Article PubMed PubMed Central  Google Scholar 

145. Simons, L., Schrager, S. M., Clark, L. F., Belzer, M. & Olson, J. Parental support and mental health among transgender adolescents.J. Adolesc. Health53, 791–793 (2013).

     Article PubMed  Google Scholar 

146. Puckett, J. A., Matsuno, E., Dyar, C., Mustanski, B. & Newcomb, M. E. Mental health and resilience in transgender individuals: what type of support makes a difference?J. Fam. Psychol.33, 954–964 (2019).

     Article PubMed PubMed Central  Google Scholar 

147. Westerhof, G. J. & Keyes, C. L. M. Mental illness and mental health: the two continua model across the lifespan.J. Adult Dev.17, 110–119 (2010).

     Article PubMed  Google Scholar 

148. Beischel, W. J., Gauvin, S. E. M. & van Anders, S. M. “A little shiny gender breakthrough”: community understandings of gender euphoria.Int. J. Transgender Health0, 1–21 (2021).

     Article  Google Scholar 

149. Benestad, E. E. P. From gender dysphoria to gender euphoria: an assisted journey.Sexologies19, 225–231 (2010).

     Article  Google Scholar 

150. Budge, S. L., Orovecz, J. J. & Thai, J. L. Trans men’s positive emotions.Couns. Psychol.https://doi.org/10.1177/0011000014565715 (2015).

     Article  Google Scholar 

151. Clements, Z. A., Rostosky, S. S., McCurry, S. & Riggle, E. D. B. Piloting a brief intervention to increase positive identity and well-being in transgender and nonbinary individuals.Prof. Psychol. Res. Pract.https://doi.org/10.1037/pro0000390 (2021).

     Article  Google Scholar 

152. Goffnett, J. & Paceley, M. S. Challenges, pride, and connection: a qualitative exploration of advice transgender youth have for other transgender youth.J. Gay Lesbian Soc. Serv.32, 328–353 (2020).

     Article  Google Scholar 

153. Riggle, E. D. B., Rostosky, S. S., McCants, L. E. & Pascale-Hague, D. The positive aspects of a transgender self-identification.Psychol. Sex.2, 147–158 (2011).

     Google Scholar 

154. Riggle, E. D. B. & Mohr, J. J. A proposed multi-factor measure of positive identity for transgender identified individuals.Psychol. Sex Orient. Gend. Divers2, 78–85 (2015).

     Google Scholar 

155. Ashley, F. Gatekeeping hormone replacement therapy for transgender patients is dehumanising.J. Med. Ethics45, 480–482 (2019).

     Article PubMed  Google Scholar 

156. Ashley, F. & Ells, C. In favor of covering ethically important cosmetic surgeries: facial feminization surgery for transgender people.Am. J. Bioeth.18, 23–25 (2018).

     Article PubMed  Google Scholar 

157. Bradford, N. J., Rider, G. N. & Spencer, K. G. Hair removal and psychological well-being in transfeminine adults: associations with gender dysphoria and gender euphoria.J. Dermatol. Treat.0, 1–8 (2019).

     Google Scholar 

158. De Cuypere, G. et al. Sexual and physical health after sex reassignment surgery.Arch. Sex. Behav.34, 679–690 (2005).

     Article PubMed  Google Scholar 

159. Krege, S., Bex, A., Lümmen, G. & Rübben, H. Male-to-female transsexualism: a technique, results and long-term follow-up in 66 patients.BJU Int.88, 396–402 (2001).

     Article PubMed  Google Scholar 

160. Rehman, J., Lazer, S., Benet, A. E., Schaefer, L. C. & Melman, A. The reported sex and surgery satisfactions of 28 postoperative male-to-female transsexual patients.Arch. Sex. Behav.28, 71–89 (1999).

     Article PubMed  Google Scholar 

161. Wierckx, K. et al. Quality of life and sexual health after sex reassignment surgery in transsexual men.J. Sex. Med.8, 3379–3388 (2011).

     Article PubMed  Google Scholar 

162. Almazan, A. N. & Keuroghlian, A. S. Association between gender-affirming surgeries and mental health outcomes.JAMA Surg.https://doi.org/10.1001/jamasurg.2021.0952 (2021).

     Article PubMed PubMed Central  Google Scholar 

163. Achille, C. et al. Longitudinal impact of gender-affirming endocrine intervention on the mental health and well-being of transgender youths: preliminary results.Int. J. Pediatr. Endocrinol.2020, 8 (2020).

     Article PubMed PubMed Central  Google Scholar 

164. Akhavan, A. A., Sandhu, S., Ndem, I. & Ogunleye, A. A. A review of gender affirmation surgery: what we know, and what we need to know.Surgery170, 336–340 (2021).

     Article PubMed  Google Scholar 

165. Allen, L. R., Watson, L. B., Egan, A. M. & Moser, C. N. Well-being and suicidality among transgender youth after gender-affirming hormones.Clin. Pract. Pediatr. Psychol.7, 302–311 (2019).

     Article  Google Scholar 

166. Butler, R. M. et al. Social anxiety among transgender and gender nonconforming individuals: the role of gender-affirming medical interventions.J. Abnorm. Psychol.128, 25–31 (2019).

     Article PubMed  Google Scholar 

167. Carew, L., Dacakis, G. & Oates, J. The effectiveness of oral resonance therapy on the perception of femininity of voice in male-to-female transsexuals.J. Voice21, 591–603 (2007).

     Article PubMed  Google Scholar 

168. Costa, R. & Colizzi, M. The effect of cross-sex hormonal treatment on gender dysphoria individuals’ mental health: a systematic review.Neuropsychiat. Dis. Treat.12, 1953–1966 (2016).

     Article  Google Scholar 

169. Esmonde, N. et al. What is “nonbinary” and what do I need to know? A primer for surgeons providing chest surgery for transgender patients.Aesthet. Surg. J.39, NP106–NP112 (2019).

     Article PubMed  Google Scholar 

170. Glynn, T. R. et al. The role of gender affirmation in psychological well-being among transgender women.Psychol. Sex. Orientat. Gend. Divers.3, 336–344 (2016).

     Article PubMed PubMed Central  Google Scholar 

171. Hancock, A. B., Krissinger, J. & Owen, K. Voice perceptions and quality of life of transgender people.J. Voice25, 553–558 (2011).

     Article PubMed  Google Scholar 

172. Massie, J. P. M. D., Morrison, S. D. M. D., Van Maasdam, J. M. A. & Satterwhite, T. M. D. Predictors of patient satisfaction and postoperative complications in penile inversion vaginoplasty.Plast. Reconstr. Surg.141, 911e–921e (2018).

     Article PubMed  Google Scholar 

173. Mehringer, J. E. et al. Experience of chest dysphoria and masculinizing chest surgery in transmasculine youth.Pediatrics147, e2020013300 (2021).

     Article PubMed  Google Scholar 

174. Moody, T. D. et al. Predicting outcomes of cross-sex hormone therapy in transgender individuals with gender incongruence based on pre-therapy resting-state brain connectivity.NeuroImage Clin.29, 102517 (2020).

     Article PubMed PubMed Central  Google Scholar 

175. Nobili, A., Glazebrook, C. & Arcelus, J. Quality of life of treatment-seeking transgender adults: a systematic review and meta-analysis.Rev. Endocr. Metab. Disord.19, 199–220 (2018).

     Article PubMed PubMed Central  Google Scholar 

176. Owen-Smith, A. A. et al. Association between gender confirmation treatments and perceived gender congruence, body image satisfaction, and mental health in a cohort of transgender individuals.J. Sex Med.15, 591–600 (2018).

     Article PubMed PubMed Central  Google Scholar 

177. Tomita, K. K., Testa, R. J. & Balsam, K. F. Gender-affirming medical interventions and mental health in transgender adults.Psychol. Sex Orient. Gend. Divers.6, 182–193 (2019).

     Google Scholar 

178. van de Grift, T. C. et al. Effects of medical interventions on gender dysphoria and body image: a follow-up study.Psychosom. Med.79, 815–823 (2017).

     Article PubMed PubMed Central  Google Scholar 

179. Wernick, J. A., Busa, S., Matouk, K., Nicholson, J. & Janssen, A. A systematic review of the psychological benefits of gender-affirming surgery.Urol. Clin. North. Am.46, 475–486 (2019).

     Article PubMed  Google Scholar 

180. White Hughto, J. M. & Reisner, S. L. A systematic review of the effects of hormone therapy on psychological functioning and quality of life in transgender individuals.Transgender Health1, 21–31 (2016).

     Article PubMed PubMed Central  Google Scholar 

181. Comiskey, A., Parent, M. C. & Tebbe, E. A. An inhospitable world: exploring a model of objectification theory with trans women.Psychol. Women Q.44, 105–116 (2020).

     Article  Google Scholar 

182. Nowaskie, D. Z., Filipowicz, A. T., Choi, Y. & Fogel, J. M. Eating disorder symptomatology in transgender patients: differences across gender identity and gender affirmation.Int. J. Eat. Disord.54, 1493–1499 (2021).

     Article PubMed  Google Scholar 

183. Jones, B. A. et al. Risk factors for eating disorder psychopathology within the treatment seeking transgender population: the role of cross-sex hormone treatment.Eur. Eat. Disord. Rev. J. Eat. Disord. Assoc.26, 120–128 (2018).

     Article  Google Scholar 

184. Durwood, L. et al. Social support and internalizing psychopathology in transgender youth.J. Youth Adolesc.50, 841–854 (2021).

     Article PubMed PubMed Central  Google Scholar 

185. Kia, H., MacKinnon, K. R., Abramovich, A. & Bonato, S. Peer support as a protective factor against suicide in trans populations: a scoping review.Soc. Sci. Med.279, 114026 (2021).

     Article PubMed  Google Scholar 

186. Mustanski, B. & Liu, R. T. A longitudinal study of predictors of suicide attempts among lesbian, gay, bisexual, and transgender youth.Arch. Sex. Behav.42, 437–448 (2013).

     Article PubMed  Google Scholar 

187. Trujillo, M. A., Perrin, P. B., Sutter, M., Tabaac, A. & Benotsch, E. G. The buffering role of social support on the associations among discrimination, mental health, and suicidality in a transgender sample.Int. J. Transgend.18, 39–52 (2017).

     Article PubMed  Google Scholar 

188. Martinez, L. R., Sawyer, K. B., Thoroughgood, C. N., Ruggs, E. N. & Smith, N. A. The importance of being ‘me’: the relation between authentic identity expression and transgender employees’ work-related attitudes and experiences.J. Appl. Psychol.102, 215–226 (2017).

     Article PubMed  Google Scholar 

189. Knutson, D. et al. A pilot test of a text message-based transgender and nonbinary affirmative cognitive-behavioral intervention for anxiety and depression.Psychol. Sex. Orientat. Gend. Divers.8, 440–450 (2021).

     Article  Google Scholar 

190. Matsuno, E. & Israel, T. The parent support program: development and acceptability of an online intervention aimed at increasing supportive behaviors among parents of trans youth.J. GLBT Fam. Stud.0, 1–19 (2021).

     Google Scholar 

191. Israel, T. et al. Reducing internalized transnegativity: randomized controlled trial of an online intervention.Psychol. Sex Orient. Gend. Divers.8, 429–439 (2021).

     Google Scholar 

192. Austin, A., Craig, S. L. & D’Souza, S. A. An AFFIRMative cognitive behavioral intervention for transgender youth: preliminary effectiveness.Prof. Psychol. Res. Pract.49, 1–8 (2018).

     Article  Google Scholar 

193. Hill, B. J. et al. Exploring transgender legal name change as a potential structural intervention for mitigating social determinants of health among transgender women of color.Sex Res. Soc. Policy J. NSRChttps://doi.org/10.1007/s13178-017-0289-6 (2017).

     Article  Google Scholar 

194. Lange, T. M. Trans-affirmative narrative exposure therapy (TA-NET): a therapeutic approach for targeting minority stress, internalized stigma, and trauma reactions among gender diverse adults.Pract. Innov.5, 230–245 (2020).

     Article  Google Scholar 

195. Rider, G. N. et al. The gender affirmative lifespan approach (GALA): a framework for competent clinical care with nonbinary clients.Int. J. Transgend.20, 275–288 (2019).

     Article PubMed PubMed Central  Google Scholar 

196. Sloan, C. A., Berke, D. S. & Shipherd, J. C. Utilizing a dialectical framework to inform conceptualization and treatment of clinical distress in transgender individuals.Prof. Psychol. Res. Pract.48, 301–309 (2017).

     Article  Google Scholar 

197. Matsuno, E. & Israel, T. Psychological interventions promoting resilience among transgender individuals: transgender resilience intervention model (TRIM).Couns. Psychol.46, 632–655 (2018).

     Article  Google Scholar 

198. Matsuno, E. Nonbinary-affirming psychological interventions.Cogn. Behav. Pract.26, 617–628 (2019).

     Article  Google Scholar 

199. Budge, S. L., Guo, E., Mauk, E. & Tebbe, E. A. The development of an observational coding scheme to assess transgender and nonbinary clients’ reported minority stress experiences.Psychotherapy58, 288–300 (2021).

     Article PubMed  Google Scholar 

200. Pachankis, J. E. et al. A transdiagnostic minority stress intervention for gender diverse sexual minority women’s depression, anxiety, and unhealthy alcohol use: a randomized controlled trial.J. Consult. Clin. Psychol.88, 613–630 (2020).

     Article PubMed PubMed Central  Google Scholar 

201. Heck, N. C., Croot, L. C. & Robohm, J. S. Piloting a psychotherapy group for transgender clients: description and clinical considerations for practitioners.Prof. Psychol. Res. Pract.46, 30–36 (2015).

     Article  Google Scholar 

202. Cordova, J. V.The Marriage Checkup Practitioner’s Guide: Promoting Lifelong Relationship Health. xii, 268 (American Psychological Association, 2014).

203. Minten, M. J. & Dykeman, C. The impact of a marriage checkup with transgender couples.Sexologies30, e93–e99 (2021).

     Article  Google Scholar 

204. Malpas, J., Pellicane, M. J. & Glaeser, E. Family-based interventions with transgender and gender expansive youth: systematic review and best practice recommendations.Transgender Healthhttps://doi.org/10.1089/trgh.2020.0165 (2021).

     Article  Google Scholar 

205. Chen, E. C., Boyd, D. M. & Cunningham, C. A. Demarginalizing stigmatized identities of transgender and gender nonconforming individuals through affirmative group therapy.Int. J. Group. Psychother.70, 552–578 (2020).

     Article  Google Scholar 

206. Spencer, K. G. et al. The gender-affirmative life span approach: a developmental model for clinical work with transgender and gender-diverse children, adolescents, and adults.Psychotherapy58, 37–49 (2021).

     Article PubMed  Google Scholar 

207. Spencer, K. G. & Vencill, J. A. Body beyond: a pleasure-based, sex-positive group therapy curriculum for transfeminine adults.Psychol. Sex. Orient. Gend. Divers.4, 392–402 (2017).

     Google Scholar 

208. Edwards, L., Goodwin, A. & Neumann, M. An ecological framework for transgender inclusive family therapy.Contemp. Fam. Ther.41, 258–274 (2019).

     Article  Google Scholar 

Download references