The impact of psychological flexibility in the relationship between discrimination and internalized transnegativity among transgender and gender expansive adults

Transgender and gender expansive (TGE) individuals are at heightened risk for mental health issues including depression, anxiety, and suicidality due to their distinctive experiences of alienation, marginalization, and discrimination. Despite the disproportionate mental health risks TGE individuals experience, few studies have examined protective factors for this population. The current study investigated the protective impact of psychological flexibility in the relationship between discrimination and internalized transnegativity among TGE individuals. A total of 180 TGE individuals in the U.S. over 18 years old completed an online survey. Results from a multiple regression analysis found a significant interaction between discrimination and psychological flexibility on internalized transnegativity controlling for age, such that increased discrimination predicted increased internalized transnegativity only among individuals with high psychological flexibility, F (4,165) = 9.23, p < .001, R-2 = 0.183. A follow-up analysis found a significant difference in internalized transnegativity between individuals with high psychological flexibility (M = 3.70, SD = 1.23) and low psychological flexibility (M = 4.30, SD = 1.07), t (178) = 3.49, p = .001, indicating that individuals with low psychological flexibility had higher internalized transnegativity. The results suggest that increasing psychological flexibility through Acceptance and Commitment Therapy (ACT) may reduce internalized transnegativity; however, additional evaluation of ACT interventions that target psychological flexibility and assessment of macro-level interventions to fight discrimination are needed.