Stressed Out

There have been a number of research studies done on the effect of stress on the human body, such as living next to an airport or a busy highway. Now there is a study of the effect of stress on trans people in Transgender Health, “Expecting Rejection: Understanding the Minority Stress Experiences of Transgender and Gender-Nonconforming Individuals”

The introduction begins,

Transgender and gender nonconforming (TGNC) individuals have a current gender identity or expression that differs from their assigned sex at birth. Although research investigations that focus specifically on the health and well-being of TGNC individuals remain limited, peer-reviewed published articles have documented the pervasiveness with which TGNC people face enacted experiences of stigma, discrimination, and victimization. Prevalence estimates of discrimination among TGNC individuals are shown to be extraordinarily high, exceeding 60% in several published studies. Similarly, estimates for victimization are commonly greater than 40% for TGNC people. Emerging research also has highlighted an association between enacted stressors and indicators of negative mental and physical health. For example, TGNC individuals who reported having experienced physical or sexual abuse, compared to those who did not, are significantly more likely to report a history of suicidal ideation and suicide attempts. Likewise, experiences of gender-related discrimination are shown to be significantly associated with elevated levels of psychological distress for TGNC individuals. Thus, enacted stressors appear to be detrimental to the health of TGNC individuals and continued and ongoing research, particularly longitudinal studies examining the relationship of such stressors to health over time, is needed.

Enacted stressors, however, represent only the external processes and experiences faced by TGNC individuals. TGNC individuals likely experience internal stressors and processes in response to these and other external stressors. Consistent with the theory and empirical research underlying Meyer's Minority Stress Model, internal or proximal stressors are considered more subjective and related to self-identity. According to the model, the three specific proximal stressors recognized are as follows: (1) identity concealment, (2) internalized stigma, and (3) expectations of rejection.

Expecting rejection—the focus of the present article—is described in the literature as a form of felt stigma, which is understood as an individual's knowledge of society's stance toward nonmajority individuals, and expectations regarding the likelihood of stigma being enacted in a given situation as a result of having a minority status, for example, for sexual and gender minority individuals. Notably, research has demonstrated that having a dual minority status (e.g., being a person of color who is also a sexual minority) can further complicate and heighten experiences of enacted stigma, which has implications for expecting rejection, especially among individuals who represent more than one marginalized identity.

And their conclusion…

This research represents one of the few studies designed to qualitatively investigate proximal stressors in TGNC individuals. These data demonstrate the extent to which expecting rejection might operate as a pervasive daily experience in the lives of TGNC individuals. Furthermore, this study provides evidence regarding the adverse impact of expecting rejection, as shown by the stressful cognitive and emotional responses reported by participants. Although emerging research has shown the deleterious impact of distal stressors (i.e., violence, discrimination, and stigma) on the health of TGNC individuals, the current finding demonstrate that proximal stressors likely have a similar devastating impact.

Given the frequency with which proximal stressors were reported by TGNC participants—and the reported experiences of fear, hypervigilance, sadness, and anger, in particular—there is a clear need and urgency to further evaluate the cumulative impact of the stress over time and identify future targets to intervene upon to mitigate potential harms. This is especially relevant given the current cultural climate in which TGNC individuals continue to remain targets for violence and discrimination—which has resulted in the murder of countless TGNC individuals worldwide, and the suicide of individuals who can no longer withstand the experience. Future research, including clinical intervention development and testing, should begin to prioritize the needs of this vulnerable population.

One of my questions is does the stress lessen over time? Is the stress more when a person first comes out and over time does the person become more relax as their transition becomes familiar to them? Or does each new situation generate new stressors?

I would think it is a blend, that each new situation generates new stresses such as having a repair man come into your house or if you are in a car accident and wondering how the police and the people in the other car going to treat you. But the familiar would reduce the stress, such as going to work every day or going grocery shopping at the same store would cause the stress to abate.