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Transgender-Day-of-Visibility.jpgTransgender Day of Visibility (TDOV) is an internationally recognized event held annually on March 31. The event seeks to bring awareness to the disproportionate rates of discrimination and violence experienced by transgender and gender diverse (TGD) communities, as well as to celebrate the immense contributions of TGD individuals to our society. Despite progress being made in the global recognition of the disparate impact of trauma and violence on TGD populations, anti-transgender legislation in the United States has grown in the past few years, threatening to exacerbate preexisting health disparities for TGD populations (Barbee et al., 2022). Thus, in a cultural climate that subjects TGD individuals to chronic experiences of invalidation, discrimination and harm, it is imperative that traumatic stress researchers and clinicians acknowledge, address and seek to prevent trauma and minority stress for TGD individuals.
In response to persistent experiences of invalidation, discrimination and threats of violence, TGD populations report higher rates of mental health concerns, including anxiety, depression and suicidality (e.g., Bockting et al., 2013; Brown & Jones, 2016). For example, research has demonstrated that transgender individuals who report experiencing hostility or insensitivity related to their gender identity are four times more likely to experience a suicide attempt than those who do not (Goldblum et al., 2012). Furthermore, research has demonstrated that there are significant overlaps between Criterion A traumatic events and experiences of discrimination among LGBTQIA+ populations and that in some instances, discrimination can be experienced as more disruptive than Criterion A traumatic events (Livingston et al., 2019). Thus, when considering clinical approaches to addressing the mental health needs of TGD populations, it is important to consider the limitations of our current gold-standard treatments for traumatic stress. For example, most gold standard treatments were not developed to address non-Criteria A traumatic events (e.g., discrimination) and don’t explicitly address the likely threat of re-traumatization. Therefore, additional research on the potential utility of evidence-based treatments, along with adapted or innovative approaches, is sorely needed to increase the quality of trauma-focused interventions available for TGD individuals.
Recently, the Biosocial Model of Emotion Dysregulation has been applied to TGD populations to explain how challenges with a stable sense of self, interactions with the social environment, and regulating emotion and behavior may present for TGD individuals in the context of chronic invalidation from the environment (Sloan et al., 2017). Consequently, skills training elements of Dialectical Behavior Therapy (DBT) have been proposed as a possible treatment approach to address the mental health disparities among TGD populations (Sloan et al., 2017). Trauma-informed approaches, such as this, work to destigmatize the experiences of TGD communities by highlighting how mental health symptoms experienced by this population often are an adaptive reaction to an invalidating and un-affirming environment.
Existing research on the experience of trauma among TGD populations also highlights resiliency factors that may protect against poorer mental health outcomes. For example, among TGD youth, parent connectedness, social support, school safety and belonging, and the ability to use one’s chosen name have been associated with more positive outcomes (Tankersley et al., 2021). Building social networks and community is a common theme among resilience-focused research for TGD populations—particularly for individuals who hold multiple marginalized identities (e.g., TGD people of color). Thus, in addition to bringing awareness to the myriad of disparities that TGD populations face in our communities, the field of trauma research should continue advocating to dismantle systems of oppression that cause harm and supporting systems that cultivate resilience for TGD populations. To join other ISTSS members in working towards these goals, please consider joining the Sexual Orientation and Gender Diversity Special Interest Group

The Sexual Orientation and Gender Diversity SIG

The Sexual Orientation and Gender Diversity (SOGD) Special Interest Group (SIG) of ISTSS is co-chaired by Dr. Kelly Harper, Dr. Nicholas Livingston and Leisha Beardmore. The SIG brings increased attention to issues of trauma, minority stress and resilience among LGBTQIA+ populations, as well as advocates for greater representation of this research at the ISTSS Annual Meeting and in the broader research context. The SIG also strives to create and advocate for a supportive space for LGBTQIA+ researchers and promotes the development of a diverse and representative workforce in the trauma field. Since its inception in 2008, the SOGD (formerly LGBT) SIG has supported a number of presentations at the ISTSS Annual Meeting, increased the number of articles on sexual and gender identities and trauma published in StressPoints and held free, publicly accessible panels on Trauma from an Intersectional Perspective and Minority Stress Among Transgender and Gender Diverse Populations.

About the Author

Francesca Kassing, PhD (she/her) is a former Co-Chair of the ISTSS Sexual Orientation and Gender Diversity Special Interest Group. She is a Licensed Clinical Psychologist and holds a Research Faculty position in Counseling Services at the University of Nevada, Reno. Currently, Dr. Kassing serves as a Co-Investigator for a multi-site, NIMH-funded study focused on treating suicidality in college students. Her primary clinical and research interests include trauma and adversity, suicidality, young adult populations, and working with LGBTQIA+ individuals.


Barbee, H., Deal, C., & Gonzales, G. (2022). Anti-transgender legislation—a public health concern for transgender youth. JAMA pediatrics176(2), 125-126.
Bockting, W. O., Miner, M. H., Swinburne Romine, R. E., Hamilton, A., & Coleman, E. (2013). Stigma, mental health, and resilience in an online sample of the US transgender population. American Journal of Public Health103(5), 943-951.
Brown, G. R., & Jones, K. T. (2016). Mental health and medical health disparities in 5135 transgender veterans receiving healthcare in the Veterans Health Administration: A case–control study. LGBT health, 3(2), 122-131.
Goldblum, P., Testa, R. J., Pflum, S., Hendricks, M. L., Bradford, J., & Bongar, B. (2012). The relationship between gender-based victimization and suicide attempts in transgender people. Professional Psychology: Research and Practice43(5), 468.
Livingston, N.A., Berke, D.S., Ruben, M.A., Matza, A.R., & Shipherd, J.C. (2019). Experiences of trauma, discrimination, microaggressions, and minority stress among trauma-exposed LGBT veterans: Unexpected findings and unresolved service gaps. Psychological Trauma: Theory, Research, Practice, and Policy, 11(7), 695-703doi: http://dx.doi.org/10.1037/tra0000464 
Sloan, C. A., Berke, D. S., & Shipherd, J. C. (2017). Utilizing a dialectical framework to inform conceptualization and treatment of clinical distress in transgender individuals. Professional Psychology: Research and Practice48(5), 301.
Tankersley, A.P., Grafsky, E.L., Dike, J. & Jones, R. T. (2021). Risk and Resilience Factors for Mental Health among Transgender and Gender Nonconforming (TGNC) Youth: A Systematic Review. Clinical Child and Family Psychological Review, 24, 183–206. https://doi.org/10.1007/s10567-021-00344-6