A moderated mediation model of minority stress in Appalachian transgender and nonbinary individuals

Transgender and nonbinary (TNB) individuals encounter distal minority stressors (e.g., discrimination, rejection, and victimization) attributable to gender identity. Consistently, this distal gender minority stress has been associated with increased risk for negative mental health outcomes (e.g., psychological distress). Furthermore, it is commonly understood that the impact of distal minority stressors on psychological distress can be explained by additional stressors more proximal to the self, no prior work has examined gender incongruence as a possible explanatory mechanism. Additionally, whereas some geographic locations (rural, Appalachia) are characterized as both high-stigma and low-resource for TNB individuals, this research is extremely limited. Therefore, the present study tested the mediating role of gender incongruence in explaining distal minority stressors and psychological distress in TNB individuals living in South Central Appalachia, and whether social support or community connectedness could mitigate the impact of gender minority stressors in this geographic context. Mediation as well as moderated mediation was tested in a sample of 150 TNB adults who completed an online survey in South Central Appalachia (Eastern Tennessee and Western North Carolina). Overall, findings supported the mediating role of gender incongruence in explaining why distal minority stressors are strongly linked with psychological distress. However, whereas support and community resources did not protect individuals from the harmful impact of distal minority stressors on increased gender incongruence, social support (but not community connectedness) protected individuals from psychological distress more directly rather than through reductions in incongruence in the face of distal minority stressors. (PsycInfo Database Record (c) 2024 APA, all rights reserved) (Source: journal abstract)