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Publication Date

Summer 2022

Degree Type

Thesis - Campus Access Only

Degree Name

Master of Arts (MA)




Shinchieh Duh

Subject Areas



Transgender and gender nonconforming (TGNC) adults in the United States have disproportionately higher rates of mental health issues compared to the general population. Testa et al.’s (2015) Gender Minority Stress and Resilience (GMSR) model explains this discrepancy as the result of factors unique to gender identity; however, empirical tests of the model have yielded inconclusive results. The present study examined the mediation pathways of the GMSR model while including a newly suggested mediating factor, psychological inflexibility (see Lloyd et al., 2019). It was hypothesized that gender minority proximal (internal) stress as well as psychological inflexibility would mediate the relationship between distal (external) stress factors and the outcomes of depression, anxiety, and suicidal ideation. A sample of 91 American TGNC adults completed an online survey, and their data were analyzed using a series of individual mediation pathways. Results were partially consistent with past studies, finding full support for internalized transphobia and psychological inflexibility as mediators and partial support for negative expectations and nondisclosure as mediators. This pattern of results may indicate that internal stress factors relating to the self (as opposed to other people) may be more effective in mediating the effects of distal stress factors and therefore should receive more emphasis in therapeutic treatments. However, the study’s generalizability was limited by its cross-sectional design, inability to test the entire conceptual model at once, and sample demographics.