Minority Stress, Self-Awareness, and Coping Strategies during the COVID-19 Pandemic among Italian Transgender Young Adults
Abstract
:1. Introduction
2. Materials and Methods
3. Results
3.1. Lockdown-Related Advantages and Disadvantages for Transgender People
3.1.1. “I Discovered This Aspect of My Identity”: Exploring and Expressing Gender
I have had positive repercussions. Because I had the time to take those spaces to understand who I was and what I wanted. So definitely on the positive side and definitely if [the pandemic] hadn’t been I wouldn’t be at this point [in the gender affirmation path].Nicola, 19, intersex, transgender man
3.1.2. “My Doctors Have Disappeared”: When Pandemic Set Transition on Hold
3.2. Minority Stress, Social Stigma, and Discrimination during the Pandemic
3.2.1. “So Much Nastiness in Certain Groups”: New Minority Stress Contexts
Unfortunately, I had with the various offices not very pleasant situations. (…) sometimes someone thought that I had stolen them [documents] or in short that they belonged to another person. (…) You are in that situation where you have to, in some way, give credence to what you say, however, you don’t want to expose yourself and it’s definitely a stressful situation.Pietro, 22, AFAB, transgender man
3.2.2. “No One Was Looking at Me”: Feeling Safe under the Mask
I always have anxiety when I don’t have the mask on. I kind of experience these situations related not to the lockdown, but to the transition and the fact that I lived everything in lockdown, that is, even just discovering myself. I get hallucinating anxiety walking down the street without having the mask protecting me.Francesca, 33, AMAB, transgender woman
I started the medicalized transition at the end of 2019, so I started to see the changes right around the time I had to put the mask on; therefore, I couldn’t see nor could I show, I didn’t feel free to say ‘okay now this is me, because now I want others to see me’. There was this need and instead I couldn’t do it, and that really brought me a discomfort.Luca, 23, AFAB, transgender man
4. Discussion
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
References
- Italian Government. Ulteriori Disposizioni Attuative del Decreto-Legge 23 Febbraio 2020, n. 6, Recante Misure Urgenti in Materia di Contenimento e Gestione Dell’emergenza Epidemiologica da COVID-19 (Dpcm 8 Marzo 2020 n. 59.). In Gazzetta Ufficiale Della Repubblica; 2020. Available online: https://www.gazzettaufficiale.it/eli/id/2020/03/08/20A01522/sg (accessed on 29 December 2023).
- Italian Government. Disposizioni Urgenti per il Superamento Delle Misure di Contrasto alla Diffusione Dell’epidemia da COVID-19, in Conseguenza Della Cessazione Dello Stato di Emergenza (Ddl 24 Marzo 2022 n. 24). In Gazzetta Ufficiale Della Repubblica; 2022. Available online: https://www.gazzettaufficiale.it/eli/id/2022/04/02/22A02188/SG (accessed on 29 December 2023).
- Bochicchio, V.; Winsler, A.; Pagliaro, S.; Pacilli, M.G.; Dolce, P.; Scandurra, C. Negative affectivity, authoritarianism, and anxiety of infection explain early maladjusted behavior during the COVID-19 outbreak. Front. Psychol. 2021, 12, 583883. [Google Scholar] [CrossRef] [PubMed]
- Fiorillo, A.; Sampogna, G.; Giallonardo, V.; Del Vecchio, V.; Luciano, M.; Albert, U.; Carmassi, C.; Carrà, G.; Cirulli, F.; Dell’Osso, B.; et al. Effects of the lockdown on the mental health of the general population during the COVID-19 pandemic in Italy: Results from the COMET collaborative network. Eur. Psychiatry 2020, 63, e87. [Google Scholar] [CrossRef] [PubMed]
- Mazza, C.; Ricci, E.; Biondi, S.; Colasanti, M.; Ferracuti, S.; Napoli, C.; Roma, P. A nationwide survey of psychological distress among Italian people during the COVID-19 pandemic: Immediate psychological responses and associated factors. Int. J. Environ. Res. Public Health 2020, 17, 3165. [Google Scholar] [CrossRef] [PubMed]
- National Institute of Statistics (Istat). Occupati E Disoccupati. 2020. Available online: https://www.istat.it/it/archivio/occupati+e+disoccupati (accessed on 29 December 2023).
- Amerio, A.; Lugo, A.; Stival, C.; Fanucchi, T.; Gorini, G.; Pacifici, R.; Odone, A.; Serafini, G.; Gallus, S. COVID-19 lockdown impact on mental health in a large representative sample of Italian adults. J. Affect. Disord. 2021, 292, 398–404. [Google Scholar] [CrossRef] [PubMed]
- Castellini, G.; Rossi, E.; Cassioli, E.; Sanfilippo, G.; Innocenti, M.; Gironi, V.; Silvestri, C.; Voller, F.; Ricca, V. A longitudinal observation of general psychopathology before the COVID-19 outbreak and during lockdown in Italy. J. Psychosom. Res. 2021, 141, 110328. [Google Scholar] [CrossRef] [PubMed]
- Rossi, R.; Socci, V.; Talevi, D.; Mensi, S.; Niolu, C.; Pacitti, F.; Di Marco, A.; Rossi, A.; Siracusano, A.; Di Lorenzo, G. COVID-19 pandemic and lockdown measures impact on mental health among the general population in Italy. Front. Psychiatry 2020, 11, 790. [Google Scholar] [CrossRef] [PubMed]
- Bockting, W.O.; Miner, M.H.; Swinburne Romine, R.E.; Hamilton, A.; Coleman, E. Stigma, mental health, and resilience in an online sample of the US transgender population. Am. J. Public Health 2013, 103, 943–951. [Google Scholar] [CrossRef]
- Hendricks, M.L.; Testa, R.J. A conceptual framework for clinical work with transgender and gender nonconforming clients: An adaptation of the minority stress model. Prof. Psychol. Res. Pract. 2012, 43, 460–467. [Google Scholar] [CrossRef]
- Mezzalira, S.; Scandurra, C.; Mezza, F.; Miscioscia, M.; Innamorati, M.; Bochicchio, V. Gender felt pressure, affective domains, and mental health outcomes among transgender and gender diverse (TGD) children and adolescents: A systematic review with developmental and clinical implications. Int. J. Environ. Res. Public Health 2023, 20, 785. [Google Scholar] [CrossRef]
- Meyer, I.H. Prejudice, social stress, and mental health in lesbian, gay, and bisexual populations: Conceptual issues and research evidence. Psychol. Bull. 2003, 129, 674. [Google Scholar] [CrossRef]
- Meyer, I.H. Prejudice and discrimination as social stressors. In The Health of Sexual Minorities: Public Health Perspectives on Lesbian, Gay, Bisexual, and Transgender Populations; Meyer, I.H., Northridge, M.E., Eds.; Springer Science + Business Media: Berlin/Heidelberg, Germany, 2007; pp. 242–267. [Google Scholar] [CrossRef]
- Meyer, I.H. Resilience in the study of minority stress and health of sexual and gender minorities. Psychol. Sex. Orientat. Gend. Divers. 2015, 2, 209. [Google Scholar] [CrossRef]
- Testa, R.J.; Habarth, J.; Peta, J.; Balsam, K.; Bockting, W. Development of the gender minority stress and resilience measure. Psychol. Sex. Orientat. Gend. Divers. 2015, 2, 65. [Google Scholar] [CrossRef]
- Gava, G.; Fisher, A.D.; Alvisi, S.; Mancini, I.; Franceschelli, A.; Seracchioli, R.; Meriggiola, M.C. Mental health and endocrine telemedicine consultations in transgender subjects during the COVID-19 outbreak in Italy: A cross-sectional web-based survey. J. Sex. Med. 2021, 18, 900–907. [Google Scholar] [CrossRef] [PubMed]
- Mirabella, M.; Senofonte, G.; Giovanardi, G.; Lingiardi, V.; Fortunato, A.; Lombardo, F.; Speranza, A.M. Psychological Well-Being of Trans* People in Italy During the COVID-19 Pandemic: Critical Issues and Personal Experiences. Sex. Res. Soc. Policy 2022, 19, 1808–1818. [Google Scholar] [CrossRef] [PubMed]
- Hawke, L.D.; Hayes, E.; Darnay, K.; Henderson, J. Mental health among transgender and gender diverse youth: An exploration of effects during the COVID-19 pandemic. Psychol. Sex. Orientat. Gend. Divers. 2021, 8, 180–187. [Google Scholar] [CrossRef]
- Jarrett, B.A.; Peitzmeier, S.M.; Restar, A.; Adamson, T.; Howell, S.; Baral, S.; Beckham, S.W. Gender-affirming care, mental health, and economic stability in the time of COVID-19: A global cross-sectional study of transgender and non-binary people. PLoS ONE 2021, 16, e0254215. [Google Scholar] [CrossRef]
- Kidd, J.D.; Jackman, K.B.; Barucco, R.; Dworkin, J.D.; Dolezal, C.; Navalta, T.V.; Belloir, J.; Bockting, W.O. Understanding the impact of the COVID-19 pandemic on the mental health of transgender and gender nonbinary individuals engaged in a longitudinal cohort study. J. Homosex. 2021, 68, 592–611. [Google Scholar] [CrossRef]
- Miscioscia, M.; Poli, M.; Gubello, A.; Simonelli, A.; Gatta, M.; Gato, J.; Rigo, P. Influence of the COVID-19 pandemic on Italian LGBT+ young adults’ mental health: The role of neuroticism and family climate. Int. J. Environ. Res. Public Health 2022, 19, 15795. [Google Scholar] [CrossRef]
- Malmquist, A.; Bredenberg, C.; Melin, J.; Wurm, M.; Tasker, F.; Gato, J. Queers in quarantine: Young LGBTQ+ people’s experiences during the COVID-19 pandemic in Sweden. Scand. J. Psychol. 2022, 64, 150–159. [Google Scholar] [CrossRef]
- Malmquist, A.; Miscioscia, M.; Leal, D.; Tasker, F.; Bredenberg, C.; Gubello, A.; Gato, J.; Houghton, M.; Wurm, M. “Under House Arrest”: Mental Health and Minority Stress Experiences of LGBTQ+ Young Adults During the COVID-19 Pandemic in Europe. Sex. Res. Soc. Policy 2023. [Google Scholar] [CrossRef]
- Malterud, K.; Siersma, V.K.; Guassora, A.D. Sample size in qualitative interview studies: Guided by information power. Qual. Health Res. 2016, 26, 1753–1760. [Google Scholar] [CrossRef] [PubMed]
- Braun, V.; Clarke, V. Using thematic analysis in psychology. Qual. Res. Psychol. 2006, 3, 77–101. [Google Scholar] [CrossRef]
- Braun, V.; Clarke, V. Toward good practice in thematic analysis: Avoiding common problems and be(com)ing a knowing researcher. Int. J. Transgender Health 2023, 24, 1–6. [Google Scholar] [CrossRef] [PubMed]
- Coleman, E.; Radix, A.E.; Bouman, W.P.; Brown, G.R.; de Vries, A.L.C.; Deutsch, M.B.; Ettner, R.; Fraser, L.; Goodman, M.; Green, J.; et al. Standards of care for the health of transgender and gender diverse people, Version 8. Int. J. Transgender Health 2022, 23 (Suppl. 1), S1–S259. [Google Scholar] [CrossRef] [PubMed]
- Brennan, J.M.; Dunham, K.J.; Bowlen, M.; Davis, K.; Ji, G.; Cochran, B.N. Inconcealable: A cognitive–behavioral model of concealment of gender and sexual identity and associations with physical and mental health. Psychol. Sex. Orientat. Gend. Divers. 2021, 8, 80–93. [Google Scholar] [CrossRef]
- Pellicane, M.J.; Ciesla, J.A. Associations between minority stress, depression, and suicidal ideation and attempts in transgender and gender diverse (TGD) individuals: Systematic review and meta-analysis. Clin. Psychol. Rev. 2022, 91, 102113. [Google Scholar] [CrossRef] [PubMed]
- Koehler, A.; Motmans, J.; Alvarez, L.M.; Azul, D.; Badalyan, K.; Basar, K.; Dhejne, C.; Duišin, D.; Grabski, B.; Dufrasne, A.; et al. How the COVID-19 pandemic affects transgender health care—A cross-sectional online survey in 63 upper-middle-income and high-income countries. Int. J. Transgender Health 2023, 24, 346–359. [Google Scholar] [CrossRef] [PubMed]
- Scandurra, C.; Amodeo, A.L.; Valerio, P.; Bochicchio, V.; Frost, D.M. Minority stress, resilience, and mental health: A study of Italian transgender people: Minority stress, resilience, and mental health. J. Soc. Issues 2017, 73, 563–585. [Google Scholar] [CrossRef]
- Scandurra, C.; Vitelli, R.; Maldonato, N.M.; Valerio, P.; Bochicchio, V. A qualitative study on minority stress subjectively experienced by transgender and gender nonconforming people in Italy. Sexologies 2019, 28, e61–e71. [Google Scholar] [CrossRef]
- Calvo, V.; Cusinato, M.; Meneghet, N.; Miscioscia, M. Perceived Social Support Mediates the Negative Impact of Insecure Attachment Orientations on Internalized Homophobia in Gay Men. J. Homosex. 2021, 68, 2266–2284. [Google Scholar] [CrossRef]
- Smith, S.K. Transgender and gender nonbinary persons’ health and well-being: Reducing minority stress to improve well-being. Creat. Nurs. 2020, 26, 88–95. [Google Scholar] [CrossRef] [PubMed]
Variables | Sample (n = 12) n (%) |
---|---|
Age (mean) | 26.41 (SD = 10.50) |
Assigned gender at birth | |
Male | 9 (75%) |
Female | 2 (16.7%) |
Intersex | 1 (8.3%) |
Gender identity | |
Transgender man | 10 (83.3%) |
Transgender woman | 2 (16.7%) |
Sexual orientation | |
Heterosexual | 5 (41.3%) |
Homosexual | 1 (8.3%) |
Asexual | 1 (8.3%) |
Queer | 2 (16.7%) |
Questioning | 2 (16.7%) |
No sexual orientation | 1 (8.3%) |
Occupational status | |
Student | 4 (33.3%) |
Working student | 3 (17.1%) |
Employed | 4 (38%) |
Unemployed | 1 (8.3%) |
Highest level of education | |
Second grade | 9 (75%) |
Bachelor degree | 2 (16.7%) |
University Master | 1 (8.3%) |
Current relationship status | |
Partnered | 6 (50%) |
Single | 6 (50%) |
Disclaimer/Publisher’s Note: The statements, opinions and data contained in all publications are solely those of the individual author(s) and contributor(s) and not of MDPI and/or the editor(s). MDPI and/or the editor(s) disclaim responsibility for any injury to people or property resulting from any ideas, methods, instructions or products referred to in the content. |
© 2024 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
Share and Cite
Della Casa, V.; Gubello, A.; Malmquist, A.; Mezzalira, S.; Bonato, M.; Simonelli, A.; Gatta, M.; Miscioscia, M. Minority Stress, Self-Awareness, and Coping Strategies during the COVID-19 Pandemic among Italian Transgender Young Adults. Healthcare 2024, 12, 132. https://doi.org/10.3390/healthcare12020132
Della Casa V, Gubello A, Malmquist A, Mezzalira S, Bonato M, Simonelli A, Gatta M, Miscioscia M. Minority Stress, Self-Awareness, and Coping Strategies during the COVID-19 Pandemic among Italian Transgender Young Adults. Healthcare. 2024; 12(2):132. https://doi.org/10.3390/healthcare12020132
Chicago/Turabian StyleDella Casa, Veronica, Alessio Gubello, Anna Malmquist, Selene Mezzalira, Marina Bonato, Alessandra Simonelli, Michela Gatta, and Marina Miscioscia. 2024. "Minority Stress, Self-Awareness, and Coping Strategies during the COVID-19 Pandemic among Italian Transgender Young Adults" Healthcare 12, no. 2: 132. https://doi.org/10.3390/healthcare12020132
APA StyleDella Casa, V., Gubello, A., Malmquist, A., Mezzalira, S., Bonato, M., Simonelli, A., Gatta, M., & Miscioscia, M. (2024). Minority Stress, Self-Awareness, and Coping Strategies during the COVID-19 Pandemic among Italian Transgender Young Adults. Healthcare, 12(2), 132. https://doi.org/10.3390/healthcare12020132