Development and validation of the Transgender Adolescent Stress Survey-Minority Stress (TASS-MS)

Jeremy T Goldbach; Sheree M Schrager; Jules K Wood; Rory P O'Brien; Shannon L Dunlap; Harmony Rhoades

doi:10.3389/fpsyg.2024.1448693

Development and validation of the Transgender Adolescent Stress Survey-Minority Stress (TASS-MS)

Front Psychol. 2024 Dec 4:15:1448693. doi: 10.3389/fpsyg.2024.1448693. eCollection 2024.

Authors

Jeremy T Goldbach¹, Sheree M Schrager², Jules K Wood¹, Rory P O'Brien³, Shannon L Dunlap⁴, Harmony Rhoades¹

Affiliations

¹ Sexuality, Health and Gender Center, George Warren Brown School of Social Work, Washington University in St Louis, Saint Louis, MO, United States.
² Office of Graduate Studies and Research, California State University-Dominguez Hills, Carson, CA, United States.
³ School of Social Work, University of Michigan, Ann Arbor, MI, United States.
⁴ Luskin School of Public Affairs, University of California, Los Angeles, Los Angeles, CA, United States.

Abstract

Objective: This study aimed to create and validate a novel measure of gender-related minority stress in transgender and non-binary adolescents (TNBA). TNBA face higher risks of varied behavioral health concerns compared to their cisgender peers, a disparity often attributed to the presence of minority stress due to discrimination. To date, no comprehensive measures of gender-related minority stress exist for use with TNBA.

Method: The present study recruited a U.S. national sample (N = 444, aged 12-17; 65.5% White, 9.5% Black, 9.5% Latine, 15.5% other ethnicity; 34.7% transmasculine, 17.3% transfeminine, 38.3% non-binary, 9.5% agender) of TNBA. An initial item pool was developed from life history calendars, a modified Delphi process, and cognitive interviews with TNBA. Analytic methods including principal components analysis, item response theory, measurement invariance testing, and reliability analyses were conducted to establish the final scale. Concurrent validity was established across behavioral outcomes (mental health, suicidal thoughts and behavior, substance use), and convergent and divergent validity compared the Transgender Adolescent Stress Survey-Minority Stress (TASS-MS) to existing measures of gender-related minority stress.

Results: The TASS-MS and its subscales (disaffirmation, visibility and internalized transnegativity, family) were significantly associated with anxiety and depressive symptoms, PTSD symptoms, suicidal behaviors, non-suicidal self-injury, marijuana, and prescription drug use. The TASS-MS was moderately and weakly correlated with convergent and divergent measures, respectively, indicating specificity to minority stress.

Conclusion: The TASS-MS is a reliable and valid measure for future research with TNBA. It is inclusive and usable by all gender minority adolescents, uses a standard simple scoring system, and assesses adolescent-specific stressors.

Keywords: behavioral health; measure development (psychometrics); minority stress; non-binary adolescents; transgender adolescents.

Grants and funding

The author(s) declare that financial support was received for the research, authorship, and/or publication of this article. This work was supported by the National Institutes on Minority Health and Health Disparities under award numbers 5R21MD015945–02 and 1F31HD091981. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.