The Role of Distal Minority Stress and Internalized Transnegativity in Suicidal Ideation and Nonsuicidal Self-Injury Among Transgender Adults

TLDR

Transgender people, defined as those whose gender identity differs from their sex assigned at birth, experience higher rates of nonsuicidal self‑injury and suicidal ideation, and minority stress theory links anti‑trans prejudice to increased stress and poorer mental health. This study examined how internalized transnegativity mediates and moderates the relationship between distal trans stress and suicidal ideation/NSSI. Using a national U.S. sample of 237 trans adults, the authors collected online measures and applied structural equation modeling to compare mediation and moderation models.

Abstract

Transgender people are at elevated risk for nonsuicidal self-injury (NSSI) and suicidal ideation compared to the general population. Transgender (trans) refers to a diverse group of people who experience incongruence between their gender identity and sex assigned at birth. The present study is guided by the minority stress model and the psychological mediation framework, which postulate that sexual minority groups experience elevated stress as a result of anti-minority prejudice, contributing to negative mental health outcomes. This study utilized these theories to investigate the role of internalized transnegativity—internalization of negative societal attitudes about one's trans identity—in the relationships of distal trans stress to suicidal ideation and NSSI. A U.S. national sample of trans adults (N = 237) completed a battery of online measures. Structural equation modeling (SEM) was used to compare models with mediation and moderation effects. Results suggested that internalized transnegativity acts as both a mediator and a moderator in the relationship between distal trans stress and suicidal ideation. Log likelihood comparisons suggested moderation models had the superior fit for these data. Results suggest that clinical interventions should directly target individuals' internalized transnegativity as well as societal-level transnegativity.