Legal Gender Affirmation, Psychological Distress, and Physical Health Issues: Indirect Effects via Enacted Stigma

Publication Date

9-1-2024

Document Type

Article

Publication Title

Sexuality Research and Social Policy

Volume

21

Issue

3

DOI

10.1007/s13178-024-00971-y

First Page

1112

Last Page

1122

Abstract

Introduction: One way that transgender and gender diverse (TGD) people may affirm their gender is through a legal name and/or gender marker change. Legal gender affirmation is associated with less psychological distress, but research has yet to expand upon the mechanisms that may help explain this association. We examined associations between legal gender affirmation, psychological distress, and physical health in TGD people, as well as the mediating effect of exposure to enacted stigma. Methods: Data are from the baseline portion of a longitudinal mixed-methods study of how sociopolitical contexts influence marginalization, health, and resilience for TGD people. The study included 158 TGD participants from Oregon, Michigan, Nebraska, and Tennessee. Baseline data were collected September 2019–March 2020 (the overall study concluded Fall 2021). Results: Latent variable structural equation model analyses revealed that participants who had legally affirmed their gender reported less enacted stigma, which was associated with less psychological distress and physical health issues. There was a significant indirect effect via enacted stigma, such that this variable may partially help explain why legal gender affirmation is associated with better health outcomes. Conclusions: Legal gender affirmation is likely to influence TGD people’s health and well-being by shaping exposure to minority stress—specifically, enacted stigma. Our findings demonstrate the importance of sociopolitical factors in health outcomes for TGD people. Policy Implications: Given the health benefits of legal gender affirmation and the potential protection from enacted stigma, policies should be revised to make legal name and/or gender marker changes more accessible for TGD people.

Keywords

Gender minorities, Legal gender affirmation, Name change, Stigma, Transgender

Department

Research Foundation

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