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ORIGINAL RESEARCH article

Front. Psychol.
Sec. Health Psychology
Volume 15 - 2024 | doi: 10.3389/fpsyg.2024.1448706
This article is part of the Research Topic Breaking Barriers in LGBT+ Health: Innovations and Insights View all articles

Development and Validation of the Transgender Adolescent Stress Survey-Dysphoria (TASS-D)

Provisionally accepted
Sheree M. Schrager Sheree M. Schrager 1*Jeremy T. Goldbach Jeremy T. Goldbach 2*Jules K. Wood Jules K. Wood 2Rory P. O'brien Rory P. O'brien 3Shannon L. Dunlap Shannon L. Dunlap 4Harmony Rhoades Harmony Rhoades 2
  • 1 California State University, Dominguez Hills, Carson, California, United States
  • 2 Washington University in St. Louis, St. Louis, United States
  • 3 University of Michigan, Ann Arbor, Michigan, United States
  • 4 University of California, Los Angeles, Los Angeles, California, United States

The final, formatted version of the article will be published soon.

    Objective: Transgender and nonbinary adolescents (TNBA) may experience gender dysphoria arising from incongruities between their body and their gender. Prior dysphoria measures have largely focused on clinical diagnosis with little regard to comparability of forms for people assigned male or female at birth, overall psychometric performance, or applicability to nonbinary populations. This study develops and validates the Transgender Adolescent Stress Survey -Dysphoria (TASS-D), intended to address these gaps.Methods: The current study recruited a U.S. national sample of TNBA (N=444, aged 12-17; 65.5% White, 9.5% Black, 9.5% Latine, 15.5% other ethnicity; 34.7% transmasculine, 17.3% transfeminine, 38.3% nonbinary, 9.5% agender). The item pool was developed from life history calendars, a modified Delphi process, and cognitive interviews with TNBA. Scale development included factor analysis, item response theory modeling, measurement invariance testing, and reliability analyses. Associations were examined between the TASS-D and existing measures of gender dysphoria (convergent validity), gender minority stress (divergent validity), and behavioral health outcomes (criterion validity).Results: TASS-D and its subscales (body distress and gender expression burden) were significantly and strongly associated with gender dysphoria; significantly but weakly associated with gender minority stress; and significantly associated with most indicators of psychological distress including depressive, anxiety, and posttraumatic stress symptoms, suicidal behaviors and nonsuicidal selfinjury. Conclusions: The TASS-D is a reliable and valid measure of gender dysphoria for TNBA, offering notable benefits over existing measures: It is psychometrically sound, inclusive of all gender identities, and does not assume that respondents identify binarily or desire medical transition as a terminal goal.

    Keywords: transgender1, nonbinary2, adolescents3, gender4, dysphoria5, behavioral health

    Received: 13 Jun 2024; Accepted: 12 Aug 2024.

    Copyright: © 2024 Schrager, Goldbach, Wood, O'brien, Dunlap and Rhoades. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence:
    Sheree M. Schrager, California State University, Dominguez Hills, Carson, 90747, California, United States
    Jeremy T. Goldbach, Washington University in St. Louis, St. Louis, United States

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