McNeil, Jay and Eccles, Fiona and Ellis, Sonja J. (2016) An exploration of transgender people's mental health. PhD thesis, Lancaster University.
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Abstract
This thesis explores trans-minority mental health, and in particular the application of the Minority Stress Hypothesis (MSH) as a framework for understanding the high rates of poor mental health, suicidal ideation and suicide attempts, seen in trans populations. It is comprised of four sections. The first section consists of a systematic literature review exploring factors which relate to suicidal ideation and attempts (SIA) in trans people. A systematic search of nine databases resulted in 27 papers. Discrimination and other negative experiences were related to increased SIA, whereas social interactions and access to support were protective, although some limitations to the study are also discussed. The second section is an empirical cross-sectional study to test aspects of the MSH. Specifically it examines the relationship between discrimination, internalised transphobia and negative expectations with the outcomes of depression, anxiety and stress. It also explores whether functional social support moderates these relationships. The study found high rates of poor mental health among the 250 participants, which were indeed related to the three predictor variables. Multiple regression analyses demonstrated that these outcomes were predicted by discrimination and internalised transphobia, but not negative expectations. Social support did not moderate the relationships between predictors and outcomes. The third section comprises of a critical appraisal of the thesis process and studies herein. However, a substantial focus of this concerns issues specific to research with trans populations, and limitations of the current available evidence base. The final section collates the ethical application process and study materials. Overall, the studies reported here highlight the need for psychologists to work at structural and community levels, rather than simply at the individual level, if the mental health of these marginalised and oppressed groups is truly to improve.