Does Structural Transphobia Exacerbate the Relationship Between Interpersonal Trauma and Mental Health in Transgender Adolescents?

Background: Relative to cisgender adolescents, transgender adolescents experience greater interpersonal trauma, depression, and suicidality. Structural transphobia (societal conditions constraining transgender people’s rights/wellbeing) may exacerbate associations between trauma and poor mental health for this group. Indeed, a recent study found more severe suicidality in trauma-exposed transgender adults from states with more transphobic policies. To date, this line of research has rarely examined transgender adolescents nor considered structural anti-transgender attitudes.Method: We used national survey data (5,188 transgender adolescents; 22 states) to explore the interaction of trauma and state-level transphobia (explicit anti-transgender attitudes) on mental health. Factor analysis was used to create a state-level transphobia measure. Latent class analysis identified transgender adolescents exposed to low (0-2; mostly bullying; 70%) vs. high (>2; mostly physical assault; 30%) numbers of traumas. To explore interaction effects, we created categories representing trauma class and low vs. high transphobia representing 4 groups: 31% low trauma/low transphobia, 16% low trauma/high transphobia, 37% high trauma/low transphobia, and 16% high trauma/high transphobia. Regressions examined associations between group membership and depression and suicidality.Results/Discussion: Relative to the low trauma/low transphobia group, transgender adolescents in high trauma groups were more likely to consider (ORs=2.8 & 2.4) or plan (ORs=2.9 & 3.4) suicide (ps<.001), and those in all other groups were more likely to report depression (ORs=1.3-2.8, ps<.001). The highest odds for depression and suicidality were found in the high trauma/high transphobia group. Results suggest that structural transphobia confers additional risk for trauma-exposed transgender adolescents, who may benefit from multilevel interventions addressing both interpersonal and structural stigma.

A method to determine a personalized set of online exercises for improving the positive mental health of a caregiver of a chronically ill patient

Background Taking care of chronic or long-term patients at home is an arduous task. Non-professional caregivers suffer the consequences of doing so, especially in terms of their mental health. Performing some simple activities through a mobile phone app may improve their mindset and consequently increase their positivity. However, each caregiver may need support in different aspects of positive mental health. In this paper, a method is defined to calculate the utility of a set of activities for a particular caregiver in order to personalize the intervention plan proposed in the app. Methods Based on the caregivers’ answers to a questionnaire, a modular averaging method is used to calculate the personal level of competence in each positive mental health factor. A reward-penalty scoring procedure then assigns an overall impact value to each activity. Finally, the app ranks the activities using this impact value. Results The results of this new personalization method are provided based on a pilot test conducted on 111 caregivers. The results indicate that a conjunctive average is appropriate at the first stage and that reward should be greater than penalty in the second stage. Conclusions The method presented is able to personalize the intervention plan by determining the best order of carrying out the activities for each caregiver, with the aim of avoiding a high level of deterioration in any factor.