Social Support, Trans Community Connectedness, and Mental Health
Symptoms Among Transgender and Gender Nonconforming Adults
Samantha R. Pflum, Rylan J. Testa,
Kimberly F. Balsam, and Peter B. Goldblum
Palo Alto University
Bruce Bongar
Palo Alto University and Stanford University
School of Medicine
For those identifying as transgender or gender nonconforming (TGNC), the support of others can be
instrumental in mitigating the challenges associated with cross-gender transition and identification.
Social support and connectedness to the TGNC community can positively impact psychological well-
being, facilitate resilience, and buffer against external stigmatization, prejudice, and discrimination (Frost
& Meyer, 2012; Hendricks & Testa, 2012). The present study seeks to improve understanding of
relationships among general social support (GSS), trans community connectedness (TCC), depressive
symptoms, and anxiety symptoms. The inclusion of 2 forms of social support allows for greater
examination of the differential impact of perceived general support (i.e., from both cisgender and TGNC
friends and family members) and TGNC-specific social support (i.e., feeling connected to other TGNC
people). To honor the diversity within the TGNC community, the impact of social support was examined
among TGNC participants differentiated by gender identity, ethnicity, and living environment. As part
of the Internet-based Trans Health Survey, standardized measures of depression, generalized anxiety, and
social support were administered to 865 TGNC adults. For both trans male spectrum (TMS) and trans
female spectrum (TFS) participants, general social support was significantly negatively associated with
symptoms of anxiety and depression. However, the negative correlation between trans community
connectedness and mental health symptoms was significant only for TFS participants. Variations in
perceived TCC among ethnicity and living environment groups— distinguished by gender identity—are
also explored. Finally, targets for future minority stress and social support research with the TGNC
population are discussed.
Keywords: anxiety, depression, social support, transgender
Although research on transgender and gender nonconforming
(TGNC) populations is in its infancy, extant findings have eluci-
dated certain themes. First, TGNC individuals are frequently sub-
jected to the effects of societal transphobia, including gender-
based discrimination, rejection, and violence (Grant et al., 2011;
Hendricks & Testa, 2012; Lombardi, 2009). Second, these external
stressors are associated with a higher prevalence of psychiatric
symptoms in TGNC individuals (Hendricks & Testa, 2012; Lom-
bardi, 2009; Meyer, 2003). Although strengths-based research
examining protective and resilience-bolstering factors has been
limited, preliminary evidence suggests that social support may be
particularly important (Budge, Adelson, & Howard, 2013). In this
paper, we examine the effects of both general social support (GSS)
and TGNC-specific community support on the mental health of
TGNC people.
General Social Support
The support of others can be instrumental in mitigating the
challenges associated with being TGNC. Social support catalyzes
the use of healthy coping mechanisms (e.g., humor, hobbies,
spirituality, gender-affirming psychotherapy), reduces psycholog-
ical distress related to transphobia and discrimination, and predicts
positive mental health (Budge et al., 2013; Sanchez & Vilain,
2009) and physical health (Grant et al., 2011) outcomes among
TGNC people. Family and peer networks that embrace nonbinary
gender identities allow TGNC individuals to develop greater self-
acceptance and congruence with their internal sense of gender
(Budge et al., 2013).
Studies of cisgender
1
adults suggest that utilization of social
support may vary based on gender. Cisgender women are more
likely than cisgender men to utilize social support and to view it as
more important; men may view peer support as “feminine” and
feel obligated to cope with difficult situations independently.
These gender differences likely result from gender-based social-
ization (Budge et al., 2013; Dwyer & Cummings, 2001), thus it is
unclear how social support may be viewed or utilized by different
1
The term cisgender, derived from the Latin prefix cis (“on the same
side”), describes people who are not transgender or gender nonconforming
(Stryker, 2008).
Samantha R. Pflum, Rylan J. Testa, Kimberly F. Balsam, and Peter B.
Goldblum, Department of Clinical Psychology, Palo Alto University;
Bruce Bongar, Department of Clinical Psychology, Palo Alto University,
and Department of Psychiatry and Behavioral Sciences, Stanford Univer-
sity School of Medicine.
Rylan J. Testa is now at Department of Psychology, Rhodes College.
Correspondence concerning this article should be addressed to Samantha
R. Pflum, 1791 Arastradero Road, Palo Alto, CA 94304. E-mail: spflum@
paloaltou.edu
This document is copyrighted by the American Psychological Association or one of its allied publishers.
This article is intended solely for the personal use of the individual user and is not to be disseminated broadly.
Psychology of Sexual Orientation and Gender Diversity © 2015 American Psychological Association
2015, Vol. 2, No. 3, 281–286 2329-0382/15/$12.00 http://dx.doi.org/10.1037/sgd0000122
281