Perceptions of Gender Nonconformity, Internalized Stigma, and Embodiment in a Sample of Self-Identified Transgender Individuals

Abstract

This study examines how societal heteronormative norms influence interactions involving transgender individuals, offering insights into identity formation and mental health. Understanding how societal heteronormative norms shape interactions involving transgender individuals is crucial to the attainment of public health goals related to addressing societal barriers, such as stigma, and promoting mental health. Interviews were conducted at a university in the Southwest United States with 11 self-identified transgender individuals, focusing on three main questions: How do you feel when you interact with someone who does not conform to heteronormative gender roles? When you meet somebody who doesn’t conform to heteronormative gender roles does that cause you to question your own gender identity. Does your body have to match your gender identity? Directed content analysis revealed a divided phenomenon. While some participants experienced discomfort due to societal scrutiny, safety issues concerns, and heightened visibility, others found empowerment and validation in these interactions, affirming their identities and fostering a sense of belonging. Yet another finding pointed to the role of embodiment and lived experiences, highlighting contrasting views on body harmony congruence: some participants prioritized physical alignment for societal acceptance, while others valued internal authenticity over external validation. This underscores the tension between personal agency and societal expectations in shaping gender identity. The study contributes to transidentity-theoretical literature by addressing the diverse outcomes resulting from the copresence of discomfort versus empowerment, internalized stigma, and the interplay of self-perception with societal norms. Clinical implications point to the need for inclusive spaces, supportive interventions, and mental health resources to assist trans individuals in navigating these challenges.

1. Introduction

For many trans individuals, bodily expressions of gender conformity vs. nonconformity are evolving and ever salient, both in terms of affirming one’s internal identity (including embodiment) and affirming one’s social identity (with friends, family, peers, etc.) (Lindley et al. 2020; Kalb et al. 2022; Nagoshi et al. 2013). Tensions relating to attempting to conform to heteronormative binary expressions of gender by passing can increase mental health risks, increase isolation, and result in internalized stigma (Bockting et al. 2020a). On the other hand, the ability to foster public identities of gender expression within safe contexts and have interactions with other individuals who are also empowered by non-heteronormative gender expressions can foster feelings of alliances and unity (Chattopadhyay 2017; Kalb et al. 2022; Nagoshi et al. 2013; Singh et al. 2011).

This paper focuses on three main questions: how do you feel when you interact with someone who does not conform to heteronormative gender roles, when you meet somebody who does not conform to heteronormative gender roles does that cause you to question your own gender identity, and does your body have to match your gender identity? This paper builds upon participant responses by exploring trans individuals’ interactions with those who diverge from traditional gender norms, focusing on their reported discomfort and potential internalized stigma versus serving as a source of empowerment, affirming one’s trans identity and fostering community inclusion. These interactions can cause individuals to question their own gender identity with possibly a need to “pass” in certain social settings, while on the other hand, a sense of belonging can reinforce feelings of embodiment and increased mental health.

1.1. Feminist, Queer, and Transgender Theories

Feminist theory proposes that, to maintain traditional ideas of essentialist, binary gender norms and male superiority, society is required to consolidate and reinforce traditional ideas of masculine behaviors, appearance, and heterosexual sexual orientation, thus reinforcing homophobic/transphobic prejudicial beliefs and discriminatory actions based on these societal heteronormative values and beliefs (Cramwinckel et al. 2018; Van der Toorn et al. 2020). Transphobia has been shown to be tied to strong essentialist cisgender societal beliefs about the binary nature of gender identity (Ansara and Hegarty 2014; Herek 1986; Nagoshi et al. 2008, 2019), where the individual is supposedly born as a certain male or female biological sex (Rubin 1993; Warner 1991) while ignoring the existence of intersex and is thus predetermined to then behave in the mannerisms, (i.e., gender roles and gender expressions) that are consistent with that biological sex (Bornstein 1994; Green 2020). This is consistent with a heteronormative ideology that reinforces a system of valuing heterosexuality as both natural and normative (Kitzinger 2005; Schilt and Westbrook 2009; Vivienne 2020), therefore devaluing all other expressions of sexuality and gender (Warner 1991; Zentner and von Aufsess 2022). Critical feminisms examined the contributions and experiences of trans, non-binary, and queer people to reimagine what it means to be a feminist in a world of free expression (Draper and Chapple 2023, p. 585). Critical feminism is thus an “intersection political philosophy committed to the dismantling of heteronormative, capitalist, racist patriarchy” and “a tool for coalitional work around overlapping and interconnected political realities” (Cifor and Wood 2017, p. 2).

Queer theory was a development from feminist and deconstructivist theories that proposed that gender roles, gender identity, and sexual orientation were all social constructs, whether “normative” or “deviant” (Jagose 2009), and was initially aimed at unifying the LGBTQ+ community in response to the backlash against sexual minority rights in the latter half of the 20th century (Li 2024, p. 210). In spite of queer theory’s advances in conceptualizing gender, many transgender individuals expressed dissatisfaction with the purely social constructivist assumptions about gender identity inherent in this theory. Queer theory thus may still promote gender role stereotyping by seeming to accept gender categories, even as it attempts to queer, i.e., destabilize them. In addition, queer theory established a collective identity, but at the expense of an understanding and deconstruction of the individual lived experience (Sullivan 2003). “Worse still, it veils over the difference between, for example, lesbianism and gayness, between ‘women,’ between transsexualism and cross-dressing, and ignored differences of class, race, age, and so on, once again positing sexuality as a unified and unifying factor” (Sullivan 2003, p. 44).

Transgender theory developed from ideas that transgenderism included more than just an “either/or” conceptualization but rather a “both/neither” conceptualization of gender identity outside the male/female binary (Roen 2002). Transgenderism is seen not only as transgressing the gender binary, but also emphasizing a “fluid embodiment” (Salamon 2010; Stryker 2008; Williams et al. 2013). This approach recognizes the essential continuity between the body and the mind, where everything consists of “shades of grey” in moving between more physical compared to more mental aspects of gender (Ekins and King 2006; Seamont 2018). Such an approach still allows for recognizing the variations in gender identity and gender-related behaviors and sexuality, while also acknowledging the range of experiences, from physical or essentialist to wholly socially constructed, that are associated with gender. A critique of trans theory though is the “ambivalence over how to best embody one’s sense of gender and highlights the confrontation within the limitations of the body in light of an individual’s more dynamic experiences of gender… where gender identity appears to shift based on the everyday activities the individual was engaged in and where one may notice that the body hasn’t shifted with how they feel in the moment” (Taylor et al. 2025, p. 10).

1.2. Transidentity Theory: Where Transgender Theory Meets Intersectionality

The lived experiences of transgender and nonbinary (TNB) individuals are shaped by the intersection of gender identity and various social categories, such as race, class, and sexuality. Such intersections produce a social landscape shaped by marginalization, resilience, and community belonging. Although intersectionality theories have attempted to account for variations in gender identity, these identities are often characterized by patterns of visibility, surveillance, and regulation. It is thus important to understand that there is no absolute definitive description on how an individual embodies or expresses their trans and nonbinary identities (e.g., Burstall et al. 2024; Lindley et al. 2025). Taylor et al. (2025) note that there are a variety of inhabited and desired bodies with a prevalent belief that “there’s no correct way to look or be nonbinary” (p. 12).

Drawing on Alcoff’s (2005) theorization of visible identities, gender identity becomes consequential in social spaces through embodied presentation. Gender non-conforming individuals express their identities through mannerisms, behaviors, dress, voice, and bodily movements. Societal controls mold and constrain gender expression through constant surveillance, and others pick up on cues associated with gender identity, regardless of how individuals self-identify. These visible cues trigger social responses before individuals have safe opportunities to articulate their own sense of identity. The body thus becomes a contested site where self-understanding meets socially suggestive feedback, with significant implications for safety, belonging, and well-being. The enforcement of visibility manifests differently than other identity dimensions. While race is often immediately visible, sexual orientation may remain invisible unless disclosed. Gender identity occupies an ambiguous space where presentation and perception interact in complex ways. Furthermore, multiple forms of oppression, resilience, and community-building emerge from the intersection of these identities (Cho et al. 2013).

Transidentity theory suggests that transgender experiences should be understood as intertwined with gender identity while simultaneously connected to other social categories. This approach examines how TNB identities interact with multiple dimensions—such as race, sexuality, class, and culture—to shape distinct lived experiences (e.g., Nagoshi et al. 2013; Zhou et al. 2023). These intersections are not merely additive (Shields 2008); they produce qualitatively distinct experiences that demand critical theoretical attention. For example, a Black gay trans woman navigates anti-Black racism, homophobia, transphobia, and misogyny simultaneously, encountering particular forms of discomfort and danger in public spaces that differ markedly from those faced by white trans women or Black cisgender gay men.

This paper, therefore, reaffirms transidentity theory as a framework that bridges transgender studies and intersectionality by exploring how gender non-conformity structures social interactions and community formation. In addition, it presents transidentity theory as a framework that bridges transgender studies and intersectionality theory by exploring how visible gender non-conformity shapes social interactions and community formation. Multiple marginalized identities generate both intensified vulnerability and opportunities for coalition and solidarity. Individuals may face compounded discrimination when their gender variance intersects with other stigmatized identities, yet they may also access multiple communities of support and devise sophisticated strategies for navigating hostility (Zaharin and Pallotta-Chiarolli 2022). The concept of comadre—kinship and solidarity among those who share struggles—illustrates how marginalized communities build strength through connection. Understanding these dynamics requires attention to both structural forces that constrain and the agentic practices through which individuals and communities resist and transform them. Intersectionality thus demands examining not only how identities intensify vulnerability, but also how they open possibilities for resistance, allyship, and collective liberation.

1.3. Internalized Stigma and Transphobia

Studies indicate that TNB individuals experience discrimination, prejudice, and bias at disproportionate levels compared to the general population (e.g., DeSon and Andover 2024; Drabish and Theeke 2022; Worthen 2021) and research has shown that compared to gay/lesbian individuals, trans individuals may also be at higher risk for mental health problems (Medley et al. 2016; Wanta et al. 2019). For example, Gerhardstein and Anderson (2010) found that heterosexual individuals’ evaluations of trans individuals were more negative when these latter individuals’ physical appearance did not conform to expected gender norms. Trans individuals may experience both harassment and discrimination as a result of deviating from these expected societal gender norms, i.e., male and female roles, behaviors and preferences, such as clothing, use of body, language, and mannerisms (i.e., “buying in” to gendered activities) (Bradford et al. 2013; Hill and Willoughby 2005; James et al. 2016; Namaste 2000) that are socially constructed rather than a function of biology and are consistent with the gender norms of the culture, society, or group (Cislaghi and Heise 2020).

The social stigma and violence experienced by many trans individuals, including lack of acceptance by family, friends, and peers and reduced interpersonal relationship quality (Beals and Peplau 2006; Bockting et al. 2020a; Dewaele et al. 2011) and multilevel stigma (individual, interpersonal, and structural) can increase the risk of self-stigmatization through the internalizing of these negative attitudes about being transgender (Fabbre and Gaveras 2020; Huynh et al. 2025; Lindley et al. 2020). For example, Scandurra et al.’s (2018) study found that shame and alienation, both indicators of internalized transphobia, mediate the relationship between transgender discrimination and depression. In addition, Rosati et al.’s (2025) research showed that control, intrusiveness, non-affirmations, and social invalidation were extensive in the daily experiences of nonbinary individuals, contributing to the internalization of negative emotions and ineffective coping strategies, including shame, discomfort, lower levels of self-esteem, and a sense of social inadequacy, along with depressive symptoms, suicidal ideation, suicide attempts, and substance abuse (Drabish and Theeke 2022; Lee et al. 2020).

Nonbinary individuals may prioritize the comfort of others in social interactions, negotiating the disclosure of their identity to prevent others from feeling uneasy in their presence (Rosati et al. 2025). Reflecting on gender non-binary experiences, Taylor et al. (2025) discuss how nonbinary individuals can express feelings of “subjucation and betrayel of their own bodies where it can ‘result in an alienating feeling, where I feel like I’m living in someone else’s body, detached and foreign and decidedly not my own’ where their body is an unfamiliar space that isn’t entirely their own with an internal sense of estrangement within their own skin” (p. 8). Prejudice and discrimination toward trans individuals may lead some trans individuals to directly conceal their trans identity, where being able to “pass” becomes an issue not just of self-identity, but also of personal safety (Edelman 2020; Levitt and Ippolito 2014). Passing for some trans individuals may be indicative of internalized transphobia, highlighting how trans individuals with internalized transphobia may project their feelings of guilt and self-hatred onto other trans individuals that they encounter (Bockting et al. 2006). Beauchamp (2019) argues that being able to and/or choosing to conceal one’s transgender identity is not just about protection from a gender-prejudiced society vs. identity self-affirmation, but has larger political/societal implications of questioning the system of privilege that regulates everyone’s behaviors. Beauchamp (2019) argues that mechanisms for monitoring and regulating behaviors in society rely on assumptions of behavioral normativity derived from these privileged classes. Therefore, this larger understanding of the negotiation of gender nonconformity in social spaces has important implications from both an empowerment perspective and from an oppression, stigmatization perspective.

1.4. Trans Empowerment, Social Identity, and Coalition Building

Social identity research highlights the power of the group and connecting with similar peers, in order to access psychological resources and bring about change. Social identity is both the degree to which one’s self-concept is derived from membership in that social group, along with the emotional value tied to being a part of that group (Tajfel 1978). Kalb et al. (2022) note that greater 2SLGBTQIA+identity integration, such as engaging in 2SLGBTQIA+-related social activities, working through homophobic negative attitudes, feeling more comfortable with other individuals knowing about one’s 2SLGBTQIA+ identity, and disclosing that identity to others, was associated with less depressive and anxious symptomology among gender non-heteronormative individuals (Rosario et al. 2011). For example, Beemyn (2015) conducted interviews with over 200 gender-nonconforming students (including nonbinary gender and nonbinary sexual identities) and uncovered sources of strength and strategies of resilience, finding that online communities, such as Tumblr, provided a unique source of support and information (p. 117). Building on Social Identity theory, The Multidimensional Framework of TNB Resilience (Puckett et al. 2024) utilizes a socioecological framework to highlight five dimensions of resilience (i.e., individual, interpersonal, community, societal, and intersectional). Lindley et al. (2020) illustrate this ecodevelopmental model framework from their research on trans individuals’ perceptions of the dynamic interactions between their gender and sexual identity development through the transition process: (1) the microlevel influences of embodiment, (2) mesolevel conflicts between embodiment and romantic partner expectations, and (3) macrolevel influences of societal gender expectations, thus connecting intersecting identities and multilevel social identity developmental layers together.

When building community among individuals of intersectional identities and expressions, Feinberg (2013) and Stryker (2008) propose that multiple minority groups unite and work together to create political and economic justice under shared experiences of oppression. This reinforces what rights and privileges mean to the individuals/group, which in turn reinforces the mission at hand and allows individuals to apply their own personal narratives as to why they want that end goal for themselves and with their families and/or loved ones, thus reinforcing intrinsic motivation. According to Shields (2008), one’s identity is not just about his or her own self-identification, but is also about the intersecting larger social structures and the power differentials that are associated with belonging to a certain group or groups. When we approach creating change from this place of healthy unity with others we reduce the conflict between “our” identity and “their” expectations of our gender performance, here begins to arise an opportunity to live an embodied, empowered and self-determined life (Chattopadhyay 2017; Nagoshi and Brzuzy 2010; Nagoshi et al. 2013; Singh et al. 2011).

1.5. Present Study

The current study examines the reported experiences of trans individuals when encountering other individuals who do not conform to the traditional heteronormative gender roles. Three questions were analyzed using directed content analysis to explore participant responses. For the first question, how do you feel when you interact with someone who does not conform to heteronormative gender roles, two themes emerged from the participants’ responses focusing on the discomfort in the social context vs. the validation and empowerment trans participants felt when encountering other individuals who do not conform to the traditional heteronormative gender binary. The second interview question focused on, when you meet somebody who doesn’t conform to heteronormative gender roles, does that cause you to question your own gender identity? Directed content analysis focused on the nature of how this encounter did or did not affect the participants’ own understanding of their gender identity. Lastly, the participants were asked, does your body have to match your gender identity? Directed content analysis focused on whether trans participants felt that their body needed to match their gender identity and how an expressed need for such a match was consistent with internalized stigma and feelings of internalized transphobia. Building on transgender/trans-identity theory (Nagoshi and Brzuzy 2010; Nagoshi et al. 2013), the second question was meant to explore the socially- vs. self-constructed nature of participants’ developing transgender identity, while the third question considered the role of embodiment, particularly in terms of visible presentations of gender non-conformity.

2. Method

2.1. Participants and Recruitment

In order to understand the diverse and fluid nature of gender identity, gender roles, and sexual orientation, interviews were conducted with open ended questions in an attempt to capture the individuals’ lived experiences and give the individual the platform to have their voices heard and stories told. Of the eleven self-identified transgender participants, six were recruited through snowball sampling with community contacts at a University in the Southwest, United States, who asked prospective participants if they were willing to be contacted by the principal investigator for a possible interview about the nature of gender identity, gender roles, and sexual orientation. The other five participants were recruited through a posting on the Ubiquity LGBT online community bulletin board for LGBTQ students and staff at the university. This posting for LGBTQ participants described the interview as an exploration of the nature of gender identity, gender roles, and sexual orientation and left a phone number and email address of the first author. Prospective participants were contacted via phone. They were briefly explained about the nature of the interview, and we set up a time for a meeting at the participant’s place of residence, on campus, or at a public location. All interviews were conducted by the first author.

2.2. Demographics

The trans participants sample included 11 self-identified trans individuals, 6 stating on the demographic forms that they were “born female,” 4 “born male,” and 1 “born intersex” (

Table 1. Participant demographics.

Initials	Self-Identification	Age Range	Race-Ethnicity	Occupation
TAF	FTM transgender	25–34	White	College staff/employee
TBL	MTF transsexual	35–44	White	College staff/employee
TCP	Intersex, transgender	25–34	White	College staff/employee
TDN	MTF transsexual	35–44	White	College student
TEV	FTM transgender	25–34	White	College staff/employee
TFD	MTF transgender	18–24	White	College student
TGR	FTM transgender	18–24	Hispanic	College staff/employee
THW	FTM transgender	18–24	White	College staff/employee
TJT	FTM transsexual	45–54	White	College staff/employee
TKS	FTM transsexual	35–44	White	College staff/employee
TLK	MTF transgender	18–24	White	College student

). Six of the participants identified as transgender, four participants distinguished themselves as transsexual and one participant distinguished themselves as intersex. None of the participants identified as “gender nonbinary” or “other.” Participants ranged in age from 19 to 43 years. Among the participants, 5 indicated having had postgraduate education or having earned a postgraduate degree, while the remaining participant indicated having had some college education. All trans participants were White, except for one self-identified Hispanic.

2.3. Use of Terminology

The authors used the term gender nonconforming in the context of any individual who does not conform to the gender norms or gender expressions that are expected of them based on their biological sex, where society assumes that such biological sex is either male or female and thus ignores the existence of intersex individuals. It should be noted that this is not meant to conflate an individual person as a label, i.e., we are not referring to any particular individual as a gender-nonconforming person, but rather a person who engages in non-heteronormative expressions of gender norms (Veldhuis et al. 2024). When we designed the original question “How do you feel when you interact with someone who does not conform to heteronormative gender roles?“, we were attempting to cover both gender norms and gender expressions. The authors recognize the limitations of gendered terms (the demographics form for the study included a number of terms, such as transgender, FTM/MTF transsexual, nonbinary, queer, and “other,” as available labels for our participants) in allowing individuals to fully describe and affirm their gender (Ansara and Hegarty 2014), including the use of he/she/ze or us/they within a feminist framework. We also understand that the terms transgender and male/female as a dichotomy reinforce this gender binary view of male and female as the default gender and does not necessarily reflect all the spaces that fall outside of the oppressive binary context of male/female as one’s choice of gender identity labels (Roen 2002). We use the term “transgender” here due to the self-identification of participants and defined transgender as individuals who have a gender identity that is not fully aligned with their sex assigned at birth (American Psychological Association 2015) and gender identity as a description of someone’s internal self-concept of their gender (Veldhuis et al. 2024).

2.4. Data Collection

At the beginning of the interview session, the nature of the interview questions was briefly described to the participant, who then read and signed an informed consent form. This consent form assured participants that no data obtained for the research would have any identifying information attached and that participants were free to withdraw from participation in the research at any time without penalty. Interviews were recorded on a microcassette audio recorder and took between 40 and 60 min to complete. The interview questions, discussed below, were set up to include prompts in places to encourage participants to stay on the relevant topic, and the interviewer was free to deviate from the scripted questions to pose follow-up questions to participant responses. The Institutional Review Board approved the study and procedures, including the protections of participant data confidentiality and contingencies for working with participant distress.

2.5. Interview Questions

The overall intent of the project was to capture the variations in trans, gay, and heterosexual participants’ unique perspectives and lived experiences of gender identity, gender roles, and sexual orientation and to then try to link the interviews to transgender, queer, and feminist theories. The initial resulting interview questions focused on questions of maleness-femaleness and masculinity-femininity as they related to biological sex and gender roles, sexual orientation, physical appearance and embodiment, social norms and privileges, as well as experiences of discrimination and internalized transphobia. Centering on the trans participants experiences, the present report focuses on the responses toward the end of the interview to the following questions: (1) How do you feel when you interact with someone who does not conform to heteronormative gender roles? (2) When you meet somebody who doesn’t conform to heteronormative gender roles, does that cause you to question your own gender identity? (3) Does your body have to match your gender identity? The first two questions were meant to elicit responses indicative of acceptance or rejection of public expressions of gender nonconformity. For the trans participants, however, rejection of such public expressions of gender non-conformity might be indicative of internalized transphobia. While the term “heteronormative” is undoubtedly unfamiliar to much of the general public, the trans participants in the present sample were all part of or connected to university organizations supportive of the LGBTQ community and thus were familiar with the term heteronormative. The third question on the need for one’s body to match their gender identity was meant to get at the importance of embodiment and feelings of internalized stigma versus empowerment.

2.6. Analyses

Directed content analysis provides a suitable analytical framework for addressing the goals of this study. The method’s theory driven approach complements well with the study’s basis on transgender, queer and feminist theories (Velez et al. 2021). This compatibility between theories underpinning this study, and directed content analysis as a methodology facilitates the use of pre-determined codes (Assarroudi et al. 2018) while enabling the incorporation of unexpected themes and experiences specific to respondents lived experiences. This is crucial to this study which attempts to comprehend unique perspectives of transgender individuals within the broad theoretical underpinnings. Since the method is useful for validating and broadening theoretical concepts, it is also well aligned with the goals of this study. By systematically examining participants lived experiences (Ayton et al. 2023) with the extant gender theories guiding this study, the method offers valuable opportunities for pushing conceptual boundaries. The complex and multifaceted nature of the research questions associated with physical appearance (White and Jenkins 2017) and gender identity, experiences of discrimination, and internalized transphobia, offers a rich and well-suited ground for utilizing and exploring the utility of directed content analysis (Moradi et al. 2016). In sum, directed content analysis provides a comprehensive analytical tool for this study, permitting a structured approach to data analysis grounded in theory (Son 2017) and broad enough to accommodate new insights.

For this study, our research team built upon a hybrid DCA five step approach to analysis, starting deductively with pre-existing feminist, queer and transgender theories within the lens and focus of internalized transphobia to create initial codes, then adding inductive codes as new patterns emerged from the data for a richer, more flexible analysis that balances the theory with emergent insights. Then the research team applied these predefined codes to the text/data, highlighting relevant patterns. Patterns were then examined by counting similar codes to validate themes and interpret findings in relation to the original theory. Both the first, second and third authors independently went through the process of coding utilizing Nvivo 10 and then cross-checking as a research team thorough triangulation to check cohesiveness of themes and subsequent coding. As a guide, themes that provided the most insightful and direct answers to the study’s research questions were prioritized. In the case of disagreements, the coders met and revisited the data to cross check the coding and whether the coding was driven by both theory and inductive themes. Upon consensus, revisions to the codebook were made in an effort to foster deeper conceptual clarity and ensuring multiple perspectives were valued.

2.7. Researcher Positionality

All interviews were conducted by the first author who is cisgender, bisexual and who currently is a co-leader and co-mentor of a university research laboratory that works with a vibrant and diverse community of self-identified 2SLGBTQIA+ researchers. At the time of participant interviewing, the second author was a graduate student of social work and women and gender studies, under the mentorship and supervision of a self-identified trans professor, 2SLGBTQIA+researcher, and trans activist. The third author is an Asian professor of psychology and a co-mentor of our university research laboratory, whose research focuses on trans prejudice and discrimination. The fourth author is an Asian international human rights scholar and demographer in social work whose research focuses on women’s reproductive health, and the fifth author is White and currently a Director of Undergraduate Programs in Psychology whose research focuses on human sexuality and sexual health. It should be noted that while the research team brings a plethora of unique lived experiences and an expertise in LGBT+ research and sexual health, the research team notes the importance of trans-driven community-based research. There can be inherent bias in the creation and design of the research questions due to not having a transgender nonbinary lens. We also now better understand the unique opportunities that would have been presented in our research study if we would have centered our research questions around the importance of intersecting identities.

3. Results

In the present study, three questions were analyzed using directed content analysis to explore participant responses. For question one, how do you feel when you interact with someone who does not conform to heteronormative gender roles, two categories emerged from the participants responses focusing on the discomfort vs. the empowerment trans participants felt when encountering other gender-nonconforming individuals who do not conform to the traditional heteronormative gender binary. The second interview question focused on when you meet somebody who doesn’t conform to heteronormative gender roles, does that cause you to question your own gender identity? Directed content analysis focused on the nature of how this encounter did or did not affect the participants’ own understanding of their gender identity. Lastly, the participants were asked, does your body have to match your gender identity? Directed content analysis focused on whether trans participants felt that their body needed to match their gender identity and how an expressed need for such a match was consistent with internalized stigma and feelings of internalized transphobia.

While most of the participants expressed no discomfort, or even empowerment, when encountering other gender non-conforming individuals, nuanced reasons were given for those 5 participants who did express discomfort with such encounters. The two over-arching themes that thus emerged were that encounters with other gender non-conforming people were perceived as validating and even empowering versus the theme that discomfort with such encounters was derived from apprehensions about social consequences for the participant. These themes were further explored with the responses from the gender identity and body matching questions. None of the participants indicated that encounters with gender non-conforming individuals had any adverse effects on their developing gender identities, while the negative effects of socially presented bodies not matching the participants’ gender identities were similarly in terms of the social consequences for the participants.

3.1. Interactions with Gender Noncomforming Individuals: Sources of Empowerment

When asked, “How do you feel when you interact with someone who does not conform to heteronormative gender roles,” most participants either expressed no discomfort with such experienced interactions, with some even regarding these encounters as a source of empowerment and alliance building. Four participants reflected these feelings of empowerment, responding with emotions of happiness and acceptance for individuals who do not conform to the heteronormative societal norms in regard to gender.

Participant TEV [FTM, Transgender, 25–34] shared their thoughts by stating, “It makes me happy. I feel like, Thank God, why aren’t there more of you. One, I don’t feel alone. Two, I feel like I’m able to somehow own a piece of masculinity. Somehow able to own a piece of this, and feel comfortable enough to be this way.” Two participants took it a step further from just expressing happiness to an assertion of loving interactions with individuals who do not conform to gender norms. TAF [FTM, Transgender, 25–34] shared their thoughts on gender non-conformity by stating, “I love it. I’m like, oh yay, you’re one of me…yeah. I feel like it all comes in degrees, and not-as-conforming could be a straight guy crying, and I feel really happy that person is able to do that. And I feel really validated that I’m a real person, that my existence is real. So for me, I just get really excited when I see gender non-conformity.”

THW [FTM, Transgender, 18–24] echoed this feeling and stated,

“the way that you looked when you were born doesn’t have to deal with who you act or who you are. I like it when people can see that they don’t have to be … they’re a girl or be that they are a guy or whatever. People know that they can break down these gender roles and stereotypes and be who you are instead of what you were born as.”

TDN [MTF, Transsexual, 35–44] took it a step further and revealed that seeing someone who does not conform to these norms made them feel right at home, providing a sense of comfort and acceptance. They felt that diversity should be celebrated and not looked down upon: “Right at home. People who deviate from the norm in ways that make them more functional, generally, I tend to respect.” The participant continued with, “I celebrate diversity, I don’t freak about it.”

Building on participants’ feelings of discomfort and internalized stigma versus empowerment when interacting with gender non-conforming individuals, there were moments of validation through encountering others’ gender non-conformity which appear to offer a sense of empowerment and belonging. Social identity was of the upmost importance to several participants and highlighted a need to celebrate and promote diversity. Some participants found joy and comfort in witnessing others break traditional gender stereotypes, which highlights the affirming potential of shared experiences.

3.2. Questioning One’s Gender Identity

The second interview question focused on when you meet somebody who doesn’t conform to heteronormative gender roles, does that cause you to question your own gender identity? Many participants discussed the importance of embodiment and identity formation versus performativity and passing in social contexts. In addition, many narratives developed through the participants’ past stories of their personal identity and the process they experienced while forming and embodying their identity. It is notable that all participants regarded these encounters with gender non-conforming individuals as important and positive experiences for validating and empowering their developing gender identities.

Four participants expressed how their past experiences shaped their viewpoints on questioning their own gender identity after seeing someone who does not conform to heteronormative gender roles. TAF [FTM, Transgender, 25–34] shared,

“When I was younger, not so much, but now I see that it just validates more that there are numerous ways to express your gender. I kept that with me…validation that maybe there are more people out there like me who don’t fit into their box, the nice and neat box that people expect us to fit into…there’s definitely quite a few people who don’t fit into that box, so what does this mean? And then trying to figure that out and then questioning my own gender, do I need to change to be more like myself, do I need to be more like them?”

TDN [MTF, Transsexual, 35–44] also shared a similar viewpoint when they questioned their gender identity. The participant recalled, “So there was a window of time in which I did question my gender identity in a context. Because I really didn’t understand why they weren’t like me.” TDN further revealed, “but then I realized they’re not like me because they feel fine having a female body, that’s the big difference. And so…and then after that I didn’t question my gender identity…. And now I know, now if I meet people who are kind of all over the gender expression map, that’s fine, I think there were times when, before I decided to transition, that I was trying to figure it out.”

THW [FTM, Transgender, 18–24] went on to note how their gender was not questioned until after interacting with transgender individuals:

“Before I started hanging out with transgender people my gender was clear. I was like okay I am a boyish female, I was born that way and I am kind of a tomboy. But afterwards I realized that just because I was born female doesn’t have to mean I am female. Well yeah actually, but just because I was born female but don’t fit female roles doesn’t make me male. So it definitely changed my views on it.”

These past experiences acknowledged for the participants that there were other individuals who also did not conform to traditional gender norms, which can validate and bring feelings of self-acceptance and acceptance of other gender-nonconforming individuals.

While some participants made it clear that interacting with gender nonconforming individuals made them question their own gender identity, other participants felt that they knew a core sense of themselves so, therefore, interactions with gender-nonconforming individuals did not negatively affect their awareness of their own fluid gender identity. Two participants adamantly proclaimed that they knew who they were. TBL [MTF, Transsexual, 35–44] reflected,

“No, because I know who I am. So if I see someone who’s very feminine or very masculine, okay, that’s their business, it’s not my business to get involved in their life. “TCP also had a similar response of self-awareness stating, “I know who I am. I’ve been who I am for a long time. There have been different genders who shaped myself and who I am, but they’ve never made me one or the other. Because that’s just part of you, who are you, really. And being honest with yourself.”

Other participants noted how their own ongoing internal process of questioning their gender identity over time superseded questioning their gender identity due to social interactions.

TEV [FTM, Transgender, 25–34] stated, “I don’t think it’s possible for anything to make me question my gender identity more than I already do.” TFD [MTF, Transgender, 18–24] expressed a similar response by stating, “No, I did that already. I outted my identity before I met other transgender people.”

Through these responses, it is evident that some individuals had self-assurance and awareness of their identity and were not challenged on questioning their gender when interacting with someone who did not fit into societal gender expectations. This shows a sense of empowerment for the individuals feeling confident about their identity. The process of questioning and reaffirming one’s gender identity is closely related to moments of validation and discomfort. For some, encountering diverse gender expressions prompted reflection and growth, revealing the fluidity and adaptability of gender roles. For others, a strong sense of self prevailed, shaped by internal reflection rather than external interactions. This balance between questioning and self-assurance reflects the deeply personal yet relational nature of gender identity. Participants noted how these interactions with gender non-conforming individuals had minimal to large impacts on how they viewed their gender identity.

3.3. Interactions with Gender-Nonconforming Individuals: Sources of Discomfort

For those participants who expressed discomfort in their responses to the first interview question, “How do you feel when you interact with someone who does not conform to heteronormative gender roles,” this discomfort was explained in terms of negative social consequences for the participant. These negative consequences, in turn, were often in the context of social factors, such as physical setting, safety, and language use.

Two participants revealed their experiences interacting with individuals who do not conform to gender norms depended on different situations that influence the interaction. TLK [MTF, Transgender, 18–24] noted, “depends on the situation where we are… I mean if we are in a big mass of just normal people it is probably not a totally good thing because then they all will look at you weirdly, I know I just got to look at you first and not worry about what box you are supposed to fit into but this is not the case. You cannot say there are not behaviors that make others uncomfortable and therefore me uncomfortable…”

TCP [Intersex, Transgender, 25–34] discussed how they didn’t want to interact with individuals depending on how they portrayed their gender. TCP noted,

“I really don’t see people as traditional male or female, I see them as a mixture of both, but there are people out there that I, even myself, being in a community for a very, very long time I’m unconformable with…maybe I’m a little more close-minded, although I don’t think I am, but it’s very possible…there are some people that I don’t want to interact with, because of the way they express their gender…it’s not because of the gender that they choose, but just the way my trans friends portray that gender.”

One participant talked about interacting with an individual based on whether or not the individual could pass in a social setting, noting that individuals who are not able to pass compromises the safety of the individual in contact with them. Even though TAF [FTM, Transgender, 25–34], above, had expressed positive feelings about meeting gender non-conforming individuals, they nevertheless also noted concerns about safety in some circumstances: “I don’t like being seen with cross-dressers and things like that. Just because if they don’t pass, then I feel like there’s more scrutiny on me. But it’s not about being uncomfortable around them, it’s about being uncomfortable being seen with them because of my own safety.”

When TDN [MTF, Transsexual, 35–44], who also, above, had expressed positive feelings about meeting other gender non-conforming individuals, was asked to elaborate about why they also felt uncomfortable in this context, the participant attempted to push back by being pro diversity and stated,

“but I celebrate diversity, I don’t freak about it. What I don’t celebrate are people who go so far in their presentation as to make it absurd, make it a caricature. People who feel they need to be…. Like, you’re a gay man and you’re a queen, fine. But if you’re a transgendered woman and you’re a queen, a diva, you’re giving us a bad name. Just relax. Being a woman is just about being. It’s about just relax, just enjoy it. It’s not…don’t worry about it all the time. Those people who are always onstage, they still have issues.”

Another participant discussed their discomfort, when confronted with the issue of language and the lack of gender-neutral language that inhibits stronger communication within the LGBTQ community. TJT [FTM, Transsexual, 44–54] noted,

“the only discomfort, of course, is language. We don’t really have any gender-neutral language in this country. So when you come across a gender variant person who wants to be known as thee, zee or hir or pronouns that have been created it is really hard to talk that way, it doesn’t flow off very easily so if you want to make reference to someone with a pronoun who is in between it is really hard to know how to do that.”

These participants noted the complexity of the social interaction and how context was of utmost importance in terms of communication, passing, and physical setting. A discomfort with certain forms of gender expression within the community, demonstrates the internal conflicts that arise even in spaces meant to foster diversity. This discomfort is rooted in concerns about societal scrutiny, safety, and perceptions of authenticity. Similarly, challenges in adopting gender-neutral language, underscore the barriers to inclusivity and the difficulties of navigating a society not fully prepared to accommodate diverse identities.

3.4. Body Matching Gender Identity

The issue of embodiment, in the context of the present study, is that a socially perceived mismatch between one’s gender identity and one’s physical appearance is a visible social marker of gender non-conformity. When asked, does your body have to match your gender identity, some participants responded that it allowed them to function easier in society, stating that it would bring them a sense of relief, would reduce the risk of being outted, and would alleviate confusion for themselves and others around them. These reasons parallel the gender conformity and safety concerns expressed by participants who felt discomfort with encountering other gender non-conforming individuals.

TBL [MTF, Transsexual, 35–44] described their thoughts and feelings of relief, when one’s body matches their gender identity by noting how it makes life much easier and there is less likelihood of being outted:

“If you wanted to date a guy, as a transsexual prior to surgery, you are now considered a ‘fetish,’ and as a fetish, you’re dealing with a whole different group of partner possibilities than you would if you were to be ‘anatomically correct,’ so to speak. Then looking for a normal partner and going, ‘Oh, okay, I’m here for the person, not because they’ve got something different between their legs.’ It’s a bit of a relief, in the sense that there’s a lot less worry of being found out.”

TCP [Intersex, Transgender, 25–34] noted a similar response to the benefits of one’s body needing to match their gender identity through the process of Sex Reassignment Surgery (SRS), in order for society to be accepting of the individual as passing. “I’ve never had SRS, and I would like to have it, eventually, because it would be much easier for me. Well…for you to be happy, I believe that your body should match, at least up to your point of acceptance.”

The above quotes provide a lens of the importance of the one’s body matching their gender due to societal constructs and expectations set by a heteronormative culture. TJT [FTM, Transsexual, 45–54] also discussed sex reassignment surgery, adding,

“If I could wave a magic wand and have my body male I would do it. I don’t have the money to have all of those surgeries right now, I have had top surgery, it is more important than bottom because that is something that people can see. I would like to have some lower surgery one day when I have money. And in our case no amount of money will get you exactly the same as the biological example. Whereas, with SRS, they can. But if I could have the normative male body I would.”

Another participant discussed how one’s body not matching their own gender identity can be confusing to the individual and to the larger society. TFD [MTF Transgender, 18–24] noted,

“Well, if you look in the mirror and it doesn’t match, number one, it’s confusing as hell, um, that’s not a good thing. Like right now, everything pretty much matches, you know what I mean; but uh…but I mean, I think it’s pretty important it matches just because of how other people perceive you. Like right now it’s just so hard to be in a relationship with someone because most of the people who do want to go out with you, you’re a novelty, and the other people who think you’re attractive they find out that you’re not “post-op”, because if you tell anyone that you’re not “post-op” they go ballistic.”

While some participants expressed the importance of their body matching their gender in order to be accepted and function in today’s society, other participants expressed how they did not care what others thought of them. Three participants strongly expressed their viewpoints on why your body does not need to match your gender identity. TFD [MTF Transgender, 18–24] noted, “No, definitely not, I identify as female because it was what I was born as but I really don’t care which one you think I am. But I definitely don’t look female stereotype.” TFD further spoke about how it is important for an individual to feel comfortable and happy with their identity by stating,

“No, because it is whatever the person is comfortable with. So for somebody, for example in my case, someone like me who was born into a female looking body, but felt male, but doesn’t hate the body the way it is and to let it live as a masculine sort of woman or if they are able to look male to other people and they are happy with that, not have to do any surgery, then that is fine for them.”

This response supports how an individual should not have to conform to societal norms and undergo a life changing transformation through transitioning, if they feel comfortable with their identity and gender. To support this notion, TEV [FTM, Transgender, 25–34] reflected on the importance of self-perception and one’s confidence in their personal identity. TEV discussed their ideals on body matching one’s gender,

“I think your body is your gender identity. But I think that your body is yours. The social construction of what your body is, the social construction of what your gender is, I don’t think that should match because I don’t think the social construction should be there in the first place. You know, it’s all about self-perception. And how your self-perception of your body impacts your self-perception of your gender.”

Circling back to the question of responses to encountering other gender non-conforming individuals, it is notable that TEV’s body positivity corresponds to their similar positivity, quoted above, with such encounters. In contrast, while TJT’s expressed a need to have a male body to correspond to societal expectations, they were also quoted above as being uncomfortable with the awkwardnesses of pronouns in social interactions with other gender non-conforming individuals. While some participants, viewed physical alignment with their gender identity as essential for acceptance and comfort, others resisted these norms, prioritizing self-perception and personal happiness over societal validation. These divergent perspectives highlight the ongoing struggle between individual agency, societal constructs, and possible generational differences in the perceptions of having to have sex reassignment surgery based on the historical medicalization of trans bodies versus a more fluid, transcendent view of lived bodily experiences today. It can be seen how the issue of one’s body matching one’s gender identity parallels the conflict between expressed gender nonconformity as identity affirmation vs. as a source of internal conflict within a society that enforces heteronormativity.

4. Discussion

Given that transgender individuals navigate a complex social landscape, this study adopts a trans-identity theoretical multi-framework approach combining postfeminist critique, queer theory, critical race theory, and intersectionality to analyze the complexity of transgender experiences. Postfeminist scholarship both illuminates and decolonizes how neoliberal and cultural discourses of choice and empowerment simultaneously liberate and constrain trans experiences, especially as they intersect with consumerism, medicalization, cultural artifacts, and normative beauty standards. This theoretical pluralism resists reductionist analyses that privilege one framework over others, instead recognizing that lived experience emerges from the confluence of multiple theoretical insights (Cho et al. 2013; Shields 2008). By bringing these frameworks into conversation, transidentity theory provides tools for understanding both individual experiences and broader social dynamics.

The present findings are unique in asking trans individuals about their responses to interacting with other gender-nonconforming individuals. Consistent with recent theoretical scholarship (Beauchamp 2019; Dias et al. 2021; Edelman 2020), many participants’ responses revolved around issues of trying to conform to heteronormative forms of gender expression to avoid discrimination versus having feelings of affirmation and empowerment of their gender identities. Similar to the findings from Raj’s (2014) work, some participants reported feelings of embarrassment when encountering individuals who presented themselves as gender nonconforming, with some participants asserting that these individuals give the transgender community a “bad name.” Some participants disclosed that they did not want to associate with anyone who did not fully transition into one side or the other of the gender binary. For these individuals, expressing discomfort with meeting someone who is deviating from the traditional gender binary was linked with safety concerns and feeling a need to pass.

As Bockting et al. (2006) notes, this concern about passing may be indicative of internalized transphobia, with some trans individuals projecting their feelings of internal shame, guilt and self-hatred onto other trans and gender-nonconforming individuals that they encounter. Beauchamp (2019) argues that this “surveillance of gender non-conforming individuals” may not be about their self-identification as being transgender, but rather may be on the perceived “deception” underlying transgressive gender presentation. This may isolate individuals from seeking social support from openly out members of the trans and gender non-conformity community, increasing mental health risks and isolation. This is consistent with explaining how social oppression could cause the internalization of negative emotions about one’s transgender identity that could lead to internalized stigma and internalized transphobia (Bockting et al. 2013; Hendricks and Testa 2012; Meyer 2003). Beauchamp (2019) and Edelman (2020) also have considered passing not just in terms of safety, but also in terms of deliberate gender nonconformity as a form of self-identity affirmation. Consistent with our participants’ responses, encountering other gender-nonconforming individuals was seen as an empowering experience, affirming one’s identity, fostering empowerment and creating spaces for authentic self-expression (Breslow et al. 2015; Rood et al. 2017; McConnell et al. 2018; Singh et al. 2011).

On the other hand, participant responses reflected a tension between validation and empowerment derived from seeing similar individuals in a public space versus an apprehension about negative social reactions from the larger gender-conforming society. Ironically, none of the participants thought that such encounters negatively affected their own gender identity. Several participants though explicitly described a developmental process leading to a strong acceptance of their embodied transgender identity with participants noting how such encounters would have caused necessary questioning of the participants’ gender identity early in their transition process. Consistent with transgender/trans-identity theory (Nagoshi and Brzuzy 2010; Nagoshi et al. 2013), these findings highlight how socially constructed gender expression sparks and then empowers the self-construction of transgender identity both for the individual and others.

Developmental theories and research on transgender identity reflect the tensions trans individuals experience before, during, and after the transitioning process (Devor 2004; Levitt and Ippolito 2014). This transition process involves trying to establish and integrate a self-identity and sense of embodiment in the context of pervasive social pressures to conform to the heteronormative gender and sexual binary constructs while having little social support and role models (Lindley et al. 2020). Green (2020) notes the discrimination and power dynamics felt within the trans community on whether the individual is pre vs. post-surgery, or whether the person has had top surgery or bottom surgery, with the ideal as being fully transitioned and living the life of the opposite sex. Spade (2006) highlights how both medical and law practices reinforce the heteronormative status quo, rather than challenging it, thus reinforcing the western ideologies of trans medicalization versus the importance of resisting traditional cultural values by questioning identification with contemporary western medical discourses on trans bodies and being educated about medicalized understandings of gender that may be deemed culturally inappropriate (Roen 2001).

In terms of embodiment, the present research also highlights the importance of socially presented physical appearance for transgender identity development. Paralleling the tension between experiencing encounters with other individuals physically expressing gender non-conformity in public spaces as validating and empowering vs. as threatening, due to the risk of opprobrium from those enforcing gender conformity in these spaces, participants’ thoughts on the need for their bodies to match their gender identities contrasted acceptances of transgender bodies as empowering bases for transgender identity vs. the perceived need to fit bodies to traditional gender norms in social spaces. Transgender/trans-identity theory (Nagoshi and Brzuzy 2010; Nagoshi et al. 2013) already emphasizes how bodily experiences are an aspect of transgender identity development, not typically associated with gay/lesbian identity development, but the present findings also show how embodiment and its presentation in society interacts with the social and self-construction of transgender identity.

While the current research centers on gender identity and gender non-conformity as primary analytical categories, it acknowledges that focusing on these dimensions alone risks obscuring how other factors shape gender variance. Understanding how gender non-conformity functions as a visible identity requires distinguishing transphobia from homophobia, as they operate through distinct mechanisms in social interaction. Transphobia is often triggered by gender presentation cues, such as voice, clothing, body shape, and movement, while homophobia responds to displays such as same-sex affection or references to same-sex partners, signaling non-heterosexual orientation. This distinction reveals that different aspects of identity become targets in different contexts, shaping individuals’ lived experiences of discrimination and informing their strategies for navigating hostile environments.

Participants carry racial identities, sexual orientations, class positions, religious and cultural affiliations, and other dimensions that profoundly shape their lived experiences. Several questions arise from this understanding: Does the color of one’s skin compound discrimination? Does sexual orientation influence how gender non-conformity is interpreted? Do medical transition choices affect social legibility and safety? Does religious identity create additional tensions or offer sources of support? These questions highlight that, despite this study’s focus on gender variance, participants’ experiences are inevitably shaped by the constellation of their intersecting identities.

Given the range of participant ages between 19 to 43 years old, it is important to highlight both historical and birth cohort effects that have occurred in the last few decades. The historical oppressive coupling of trans experiences as a medicalized DSM diagnosis with limited options outside of sex reassignment surgery greatly affected trans individuals mental health (Wolf-Gould et al. 2025). Many were only given the medicalized option to fully transition and were told that they needed to “pass” and/or have surgery in order to function completely in society. Therefore, trans interactions with gender non-conforming mannerisms and behaviors could lead to psychological mental health triggers and trauma for trans individuals who felt like they had to “pass” for their own safety. Even though the DSM diagnosis of Gender Identity Disorder (GID) was eliminated in 2013 and replaced with “gender dysphoria,” this change subsequently focused the diagnosis on the gender identity-related distress that some transgender people experience (and for which they may seek psychiatric, medical, and surgical treatments), rather than on transgender individuals or identities themselves” (American Psychiatric Association 2017).

For older cohorts who had traumatic experiences, such as having to pass or needing medicalization to “equal” their identity, this removal of the GID DSM diagnosis in 2013 shaped their hopes for a future where trans individuals would not be forced into the medicalized binary boxes of transitioning as part of their identity. For newer generations, the shift away from the forced medicalization of the gender binary and GID as anon-identity diagnosis has created spaces of “gender renegotiation,” where individuals do not have to conform to traditional binary gender roles or need to have transition surgery. This sets the stage developmentally for new “trans teenagers” who are on the brink of modern gender renegotiations, with a new sense of public gender fluidity and gender expression, including a new political activism.

While over the past decade there have been many important steps toward trans equality and trans activism, the evolving political climate for trans individuals has become more and more hostile over time creating renewed challenges (e.g., Bockting et al. 2020b; Pew Research Center 2022, 2025) and forcing trans communities back into spaces of invisibility and passing. This leads to the retraumatizing of trans communities and reinforces both patriarchy and the pathologization of trans individuals. The current political climate has once again shifted toward an either/or gender mentality, where you are either a biological male or female and that is how society is forced to define you, through visible public identities, versus how you define yourself through embodiment and your own private identities in a both/neither gender world (Roen 2002).

5. Conclusions

Clinical interventions for transgender individuals must emphasize creating inclusive spaces, providing supportive resources, and fostering mental health services that address the multifaceted challenges this community faces. A critical consideration is generational differences, particularly how historical trauma shapes experiences of identity and the mental health implications of “passing” within societal norms. Counseling approaches should be sensitive to these generational nuances, recognizing that the lived experiences of older transgender individuals may differ significantly from younger cohorts due to changing societal attitudes and legal protections.

It is also essential to distinguish between behaviors and mannerisms versus the individual’s intersecting identities when designing clinical interventions. Effective counseling should target specific behaviors that contribute to discomfort or distress rather than pathologizing or attempting to alter a person’s identity. This hinges on designing interventions that differentiate between behaviors and mannerisms versus intersecting identities. Such an approach respects the complexity of multiple salient identities and promotes authenticity and self-acceptance.

Furthermore, clinicians should actively advocate for LGBTQ+ inclusion in broader societal contexts. Encouraging the development of safe spaces such as in schools, workplaces, and community settings can significantly enhance mental health well-being by reducing stigma and fostering acceptance. These spaces also offer opportunities to normalize exposure to diverse gender expressions and behaviors and to understand the psychological burden that binary spaces have on non-binary people and the potential negative effects on mental health (Rosati et al. 2025), thus helping to dismantle societal biases and promoting broader acceptance of gender nonconformity and fluid gender expressions. Overall, clinical practices must balance individualized care with systemic advocacy, aiming to empower transgender individuals while challenging the structural barriers that perpetuate stigma and exclusion. Also, specific targeted interventions can help reduce mental health symptoms such as depression/anxiety and reduce exposure to minority stressors, while helping to build coping strategies and increase overall mental health (Goldbach et al. 2021a, 2021b).

Limitations and Future Research

A few limitations—such as the relatively small sample composed of predominantly white, university-based participants—limit the extent to which our findings can be generalized to the broader transgender community. In addition, the specific geographical and institutional context of this research may not fully incorporate the diversity of experiences across different regions, socioeconomic backgrounds, and cultural contexts. Future research should focus on recruiting more diverse samples that include transgender individuals from various racial and ethnic backgrounds, educational levels, rural and urban settings, and age groups to better understand the full spectrum of experiences within this community.

In addition, generational nuances add a critical temporal dimension to transidentity theory. This involves recognizing that older transgender individuals often lacked terminology to describe their experiences. The younger generation acquired a much expanded vocabulary. Generational differences in several aspects such as medical transition access and gatekeeping practices, may directly influence how gender variance is expressed and negotiated within trans communities. Despite these limitations, our findings offer important preliminary insights into the experiences and needs of transgender individuals within the specific context studied. Clinicians and researchers should view our recommendations as a foundation for further inquiry and practice development.

Lastly, future research should consider the positionality of the research team and possible researcher bias in the creation and design of the research questions. For instance, the first two questions were meant to elicit a response indicative of acceptance or rejection of public expressions of gender nonconformity. While this worked and all of the participants were able to highlight their experiences within this binary researcher-driven outcome, our research team now notes both the limiting and restrictive aspects of this type of researcher-biased question. For example, this research has brought to light the complexities of how we define gender non-conformity within the context of self and social identifications, especially through a researcher-biased lens.