Transgender Health Disparities: Experiences of Societal Pressure, Gender Dysphoria, and Body Dissatisfaction

Transgender populations display disproportionately poorer health outcomes compared to the general population. On average, these populations tend to experience decreased well-being in part through increased mental health concerns (e.g., anxiety, depression) and poorer physical and behavioral health status. Understanding the process by which these deleterious outcomes occur for this population is integral to developing interventions. This thesis aimed to examine whether experiences of gender dysphoria and body dissatisfaction influenced the association of felt pressure to conform to gender norms with mental health and quality of life outcomes. Specifically, I hypothesized that greater pressure to conform to gender norms would be directly related to worse mental health and quality of life outcomes, and that gender dysphoria and body dissatisfaction would indirectly mediate this relationship. Furthermore, I hypothesized that participants' gender identity would moderate this relationship, such that transgender individuals would show stronger associations on all pathways as compared to cisgender individuals. The sample consisted of 211 individuals – 109 being transgender and 102 being cisgender. Participants completed a 15-minute online survey including a consent form. Results indicated partial support of hypotheses – pressure to conform to gender norms directly predicted outcomes of compromised mental health (i.e., depression, anxiety, and stress), but did not predict well-being or quality of life. Furthermore, gender dysphoria (but not body dissatisfaction) mediated the relationship between felt pressure for gender conformity and compromised mental health outcomes for cisgender participants, but unexpectedly not for transgender participants. Post hoc analyses suggest that perceived discrimination mediated the relation between felt pressure and all mental health measures and quality of life measures for both transgender and cisgender participants.