Utrecht Gender Dysphoria Scale - Gender Spectrum in a Chinese population: scale validation and associations with mental health, self-harm and suicidality

Runsen Chen; Yi Feng; Di Su; Amanda Wilson; Meng Han; Yuanyuan Wang

doi:10.1192/bjo.2022.617

Utrecht Gender Dysphoria Scale - Gender Spectrum in a Chinese population: scale validation and associations with mental health, self-harm and suicidality

BJPsych Open. 2023 Jan 18;9(1):e17. doi: 10.1192/bjo.2022.617.

Authors

Runsen Chen¹, Yi Feng², Di Su³, Amanda Wilson⁴, Meng Han⁵, Yuanyuan Wang⁶

Affiliations

¹ Vanke School of Public Health, Tsinghua University, China; and Institute for Healthy China, Tsinghua University, China.
² Mental Health Center, Central University of Finance and Economics, China; and Faculty of Psychology, Beijing Normal University, China.
³ Department of Psychology, Tsinghua University, Beijing, China; and Mental Health Center, Ningxia University, China.
⁴ Division of Psychology, Faculty of Health and Life Sciences, De Montfort University, UK.
⁵ Vanke School of Public Health, Tsinghua University, China.
⁶ Key Laboratory of Brain, Cognition and Education Sciences, Ministry of Education, China; School of Psychology, South China Normal University, China; Center for Studies of Psychological Application, South China Normal University, China; and Guangdong Key Laboratory of Mental Health and Cognitive Science, South China Normal University, China.

Abstract

Background: Individuals with gender dysphoria display an incongruence between birth-assigned gender and gender expression. However, there is no existing Chinese measure for gender dysphoria.

Aims: This study aims to validate the Utrecht Gender Dysphoria Scale - Gender Spectrum (UGDS-GS) in a Chinese population, and compare the psychometric properties of the UGDS-GS with one frequently used scale for gender dysphoria measurement, the Gender Identity/Gender Dysphoria Questionnaire for Adolescents and Adults (GIDYQ-AA).

Method: A total of 2646 Chinese participants were recruited. The following information was collected: sociodemographic variables, gender identity, sexual orientation, gender dysphoria measured by the UGDS-GS and the GIDYQ-AA, anxiety, depression and suicide assessment. Principal component analyses and confirmatory factor analysis (CFA) were conducted to test the fitness of the model. Discriminant validity was tested with one-way analysis of variance.

Results: The UGDS-GS showed good psychometric properties, with the GIDYQ-AA demonstrating slightly better psychometric properties than the UGDS-GS. UGDS-GS also showed strong internal consistency (Cronbach's α = 0.89), and good convergent validity and criterion validity. Exploratory factor analysis showed a one-factor structure (Kaiser-Meyer-Olkin test, 0.93; χ² = 13 342.50; d.f. = 153; P < 0.001). The UGDS-GS was positively associated with anxiety symptoms, depressive symptoms, suicidal ideation, attempted suicide and self-harm. We also found the results were robust in different samples.

Conclusions: The validated UGDS-GS can significantly stimulate and promote gender dysphoria assessment in Chinese populations, allowing for assessment in a more diverse subset of gender minorities.

Keywords: Depression; anxiety; gender dysphoria; psychological psychometrics; suicide.