Mentalizing stigma: Reflective functioning as a protective factor against depression and anxiety in transgender and gender-nonconforming people

J Clin Psychol. 2020 Sep;76(9):1613-1630. doi: 10.1002/jclp.22951. Epub 2020 Mar 28.

Abstract

Objective: The current study examined the role of internalized transphobia (IT) as a mediator between gender-related rejection and mental health, and reflective functioning (or mentalization) as a resilience factor moderating the relationship between both rejection and IT with mental health.

Method: This online study included 203 Italian transgender and gender-nonconforming (TGNC) individuals ranged in age from 18 to 66 years old (M = 30.70; standard deviation = 10.79). Moderated-mediation analysis was performed using a structural equation modeling approach.

Results: Both rejection and IT were positively associated with mental health, and IT mediated the relationship between rejection and mental health. Mentalization moderated the relationship between rejection and IT with mental health. The indirect effect of rejection on mental health through IT was moderated by mentalization.

Conclusions: Findings highlight psychological paths that may inform individual- and group-level mentalization-based interventions to reduce minority stress in TGNC individuals.

Keywords: mental health; mentalization; minority stress; stigma; transgender.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Anxiety / prevention & control*
  • Anxiety / psychology
  • Depression / prevention & control*
  • Depression / psychology
  • Female
  • Humans
  • Italy
  • Male
  • Mentalization*
  • Middle Aged
  • Protective Factors
  • Psychological Distance
  • Sexual and Gender Minorities / psychology*
  • Sexual and Gender Minorities / statistics & numerical data
  • Social Stigma*
  • Stress, Psychological / prevention & control*
  • Stress, Psychological / psychology
  • Transgender Persons / psychology*
  • Transgender Persons / statistics & numerical data
  • Young Adult