Date on Master's Thesis/Doctoral Dissertation


Document Type

Doctoral Dissertation

Degree Name

Ph. D.


Counseling and Human Development

Degree Program

Counseling and Personnel Services, PhD

Committee Chair

Snyder, Kate

Committee Co-Chair (if applicable)

Leach, Mark

Committee Member

Leach, Mark

Committee Member

Adelson, Jill

Committee Member

Budge, Stephanie

Committee Member

Hopkins, Katy

Author's Keywords

trauma; transgender; bias; PTSD; mental health; shame


Transgender people’s increased risk for negative mental health outcomes, when compared to cisgender peers or the general public, has been well documented in the psychological literature. Researchers have begun to establish empirical support for a relationship between anti-transgender bias, non-affirmation of gender identity, internalized transphobia, and other transgender-specific minority stressors. Although little work has explored the mechanisms of this relationship, some psychologists have proposed conceptualizing these factors as potentially traumatic experiences and understanding the poor mental health outcomes as manifestations of complex post-traumatic stress. In this dissertation, I examine whether there is empirical support for this framework by evaluating the relationships between anti-transgender bias experiences, non-affirmation, internalized transphobia, and severity of symptoms of post-traumatic disorder. In Chapter 1, I review the literature on transgender mental health and conduct an in-depth exploration of the field of trauma psychology, offering critical reflections on the history of the field as well as the current etiological models of post-traumatic stress, while considering how these might apply to transgender mental health. Drawing primarily from feminist and multicultural theories of trauma, as well as theories of shame-based post-traumatic stress, I develop a theoretical framework supporting my model in which: a) non-affirmation and anti-transgender bias experience are related to the severity of PTSD symptoms, and b) this relationship is mediated by experiences of internalized transphobia. In Chapter 2, I discuss the methodology I utilized to assess my research questions, noting recruitment strategies, psychometric properties of measures I selected, and appropriateness of the analytic method of structural equation modeling. In Chapter 3, I present the results, which include the main findings that all hypothesized relationships were found to be significant: greater levels of non-affirmation and exposure to anti-transgender bias were related to greater levels of PTSD symptom severity, both indirectly through internalized transphobia and directly. In Chapter 4, I discuss my findings in the context of my theoretical framework and literature review, offer clinical and research implications, and caution readers about the limitations of this study.