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Purpose: In this study, we aimed to develop and test the acceptability of a minority stress psychoeducation tool for transgender and nonbinary (TNB) people. Methods: Patients in one treatment group who were enrolled in a larger randomized controlled trial received this study's minority stress psychoeducation pre-treatment. Data on the acceptability of the tool and minority stress experiences were collected post-treatment. Results: All (100%) patients reported that the psychoeducation tool was helpful and qualitative data suggested patients experienced an increased ability to externalize minority stress experiences. Conclusion: Results support the acceptability of this minority stress psychoeducation tool for TNB patients. Clinical trial number: NCT03369054. [ABSTRACT FROM AUTHOR]

This study investigates within‐group differences in body image concerns among sexual minority women and their related association with eating disorders and depression. Cross‐sectional data were collected in 2017 and analysed in 2020 from 201 sexual minority women in the United States. Latent profile analyses and post hoc comparison analyses were conducted to investigate within‐group variability in body image concerns and to understand their impact on depressive and eating disorder symptoms. Results suggested that a 5‐class solution best fit the data, with five distinct profiles emerging in patterns of interoceptive awareness, sociocultural attitudes toward appearance, body shame, body surveillance and appearance anxiety. Significant differences in mean scores of depressive and eating disorder symptomatology emerged among the profiles; groups that reported low interoceptive awareness and high body image concerns experienced greater levels of eating disorder and depressive symptoms, compared to groups with average or higher levels of interoceptive awareness and average or lower body image concerns. Results underscore the significant within‐group variability that exists for sexual minority women with regard to the prevalence of body image concerns, depressive symptoms and eating disorder symptoms. Efforts that aim to increase interoceptive awareness (for example, mindfulness) alongside strategies aimed at addressing negative body image concerns may be particularly effective avenues for future depression and eating disorder prevention in this diverse group. Our reporting adheres to the STROBE research reporting checklist. [ABSTRACT FROM AUTHOR]

Although most clinicians believe that discussing sexuality is important clinically, most clinicians do not initiate these discussions. Further, for therapists working with transgender, nonbinary, and gender expansive (TNBGE) clients, discussing sexuality may feel challenging when therapists fear inadvertently stigmatizing or mischaracterizing their clients and their concerns. We propose a sexual wellbeing framework as an adjunctive to traditional feminist therapy, in which discussions about sexuality is comfortable and appropriate to the goals of therapy. We review existing evidence that suggests sexual wellbeing of TNBGE clients may be enhanced by (a) attending to the client's larger sociocultural context in which sexual wellbeing emerges, (b) understanding that sexual wellbeing is multiply determined, the contributing factors to sexual wellbeing are unique for each person, and sexual wellbeing changes over time and across situations, (c) challenging assumptions that genitals, hormones, and sexual functioning are the most important aspects of sexual wellbeing, (d) emphasizing sexual comfort and pleasure by enhancing immersive attention and facilitating gender affirming sexual experiences, and (e) conceptualizing consent as a means to ensure safe and pleasurable experiences. We conclude by offering clinical scenarios that present practical considerations when applying the sexual wellbeing framework to illustrate the ways in which conversations with TNBGE clients about sexuality can enhance sexual wellbeing. [ABSTRACT FROM AUTHOR]

We examined how 12 transgender and nonbinary (TNB) adults experienced their gender and sexuality. Participants were recruited from four cities in the Midwestern United States. Semistructured qualitative interviews were used to explore two main research questions: (1) How do TNB individuals experience their gender, sexuality, and gender–sexuality connections? (2) How have TNB individuals experienced shifts in their sexuality over time and in connection with shifts in their gender? Using reflexive thematic analysis, we identified three major themes and 10 subthemes in the data. The three major themes included (a) language and terminology are helpful in the development of sexual and gender identities; (b) changes in gender identity correspond with changes in sexual experiences; and (c) identity and self-concept coevolve around gender and sexuality. Study findings suggest that sexuality is inextricably linked with gender and is a critical aspect of well-being for TNB people. Participants also described the dynamic coconstruction of their sexuality and gender, including how their experience of sexuality evolved over time and how affirming sexual experiences in turn opened avenues for gender affirmation and deeper self-understanding. Clinical implications include integrating sexuality discussion into gender exploration work in therapy and increasing therapist competency to hold such discussions with TNB clients. [ABSTRACT FROM AUTHOR]

Transgender and gender nonbinary (TGNB) individuals use provider information, such as websites, to ascertain whether providers are affirming of TGNB identities. Yet, providers may be unsure about what level of affirmation is sufficient to be perceived as affirming and may be concerned that cisgender people may have negative reactions to website material that is TGNB affirming. The present study undertook a user experience (UX) investigation of TGNB and cisgender participants' UX of mental health provider websites. Participants (310 cisgender, 224 TGNB) were recruited online. Participants viewed one of five mock provider websites. Results of a multivariate analysis of covariance (MANCOVA) indicated that TGNB had more positive evaluations of the three more affirming sites, compared to the less affirming sites, along UX domains related to likelihood of going to that provider, Mental Health Help-Seeking Attitudes, positive emotional UX, and negative emotional UX. Regardless of gender identity, participants rated the three more affirming sites as more welcoming. The results support the use of TGNB affirmation in the UX of TGNB individuals viewing provider websites and further suggest that TGNB affirmation does not detract from the UX of cisgender people. Implications for affirming practice with TGNB populations are reviewed. [ABSTRACT FROM AUTHOR]

In this study, we investigated key tenets of objectification theory, a prominent model of body image disturbance, as it relates to trans women's disordered eating and intention to obtain silicone injections—a specific health risk for this population. We also incorporated appearance congruence, or the degree to which an individual personally feels that their gender expression matches their gender identity, into the objectification theory model. Results of a structural equation model using data from a sample of 173 trans women from the United States indicated that the basic objectification theory model held among this sample and that appearance congruence was associated negatively with body surveillance. However, appearance congruence did not have significant direct or indirect links (via body surveillance and body shame) with disordered eating or intention to obtain silicone injections. Thus, disordered eating and intention to obtain silicone injections are potential negative outcomes of the process of objectification among trans women, and appearance congruence does not appear to be uniquely linked to health risks associated with internalization of cultural standards of attractiveness, body surveillance, and body shame. Our findings support the application of the tenets of objectification theory with trans women as they apply to disordered eating and intention to obtain silicone injections and also indicate the need to identify other positive influences on trans women's body image to counteract internalization of cultural standards of attractiveness. [ABSTRACT FROM AUTHOR]

People who identify as sexual minorities consistently face barriers to decent and meaningful employment, especially when coupled with additional constraints such as low socioeconomic status or marginalization experiences. Drawing from the psychology of working theory as our theoretical framework, this study examined the relations of economic constraints (social class) and marginalization (negative sexual minority workplace climate) to work volition, decent work, and meaningful work with a sample of working adults identifying with sexual minority identities. Consistent with hypotheses, social class and workplace climate indirectly predicted decent work, via work volition, and workplace climate also directly predicted decent work. Decent work and work volition were each direct predictors of meaningful work and decent work partially mediated the relation of work volition to meaningful work. Results highlight the importance of advocacy and adequate workplace supports for sexual minority individuals. [ABSTRACT FROM AUTHOR]

This mixed methods study aimed to examine the experiences of a calling in retirement with a sample of 196 retired adults. First, a qualitative analysis explored the types of activities participants experienced as a calling as well as the types of barriers that participants perceived as keeping them from living their calling. ‘Helping Others’ emerged as the largest category of calling that participants endorsed and ‘No Resources to Live Calling’ emerged as the most frequently endorsed barrier. Building on our qualitative findings, we conducted a quantitative analysis to examine the relation of perceiving a calling with well-being. Consistent with prior research with working adult populations and in support of our hypotheses, perceiving a calling related to life meaning and life satisfaction, and structural equation modeling demonstrated that life meaning and living a calling (via life meaning) fully mediated the perceiving calling–life satisfaction relation. Implications for research and practice are discussed. [ABSTRACT FROM PUBLISHER]

Anti-transgender policies and state legislative initiatives that focus on school bathroom use and hormone use have emerged in recent years. These policies are generally written by and voted on by cisgender people, and as such, it is crucial to understand influences on nonaffirming attitudes toward policies that can impact trans youth. The present study aimed to extend research on transphobic attitudes in general to attitudes toward policies that impact youth undergoing transition. Latent variable covariances and structural equation modeling were used to test the relations between transphobia, genderism, homophobia, need for closure, sexual orientation, social dominance orientation, attitudes toward sexual minorities, beliefs about gender roles, aggression, religious fundamentalism, and contact with sexual and gender minority individuals, as they are related to attitudes toward hormone use and bathroom use for trans youth. Analyses of data from a sample of 248 cisgender adults indicated that genderism and transphobia was associated with attitudes toward gender-affirming hormone use and bathroom use for trans youth; need for closure was associated with gender-affirming attitudes toward bathroom use, but was not associated with hormone use. Sexual orientation was linked to attitudes toward gender-affirming policies, such that nonheterosexual participants had more affirming attitudes toward trans youths' bathroom use, but not hormone use. Implications for future research, advocacy efforts to promote rights for trans youth, and clinical work with trans youth and/or parents/guardians of trans youth are discussed. [ABSTRACT FROM AUTHOR]