META-ANALYZING THE RELATIONSHIPS BETWEEN SOCIAL SUPPORT, MINORITY STRESS, AND MENTAL HEALTH AMONG TRANSGENDER AND GENDER DIVERSE INDIVIDUALS

Abstract

Transgender and Gender Diverse (TGD) individuals report disproportionate rates of mental health disparities in comparison to their cisgender peers (Wittgens et al., 2022). These disparities are due to social stress TGD individuals experience based on stigma against their gender minority identities- otherwise known as minority stress (Brooks, 1981; Meyer, 2003; 2013; Frost & Meyer, 2023). A large body of literature is dedicated to understanding the numerous factors that protect against the relationship between minority stress and adverse mental health outcomes. One protective factor that has garnered ample research is social support (e.g., support from peers, family, and other salient people and groups). Despite the large body of literature dedicated to empirically testing the relationship between minority stress and mental health, as well as the protective effects of social support on these relationships, no study to date has conducted a meta-analysis to synthesize these well-established effects. Thus, the current study evaluated social support as a protective factor for TGD individuals by (a) meta-analyzing the associations between social support, minority stress, and mental health; and (b) testing the moderating effects of the type of social support on the relationship between social support and the variables minority stress and mental health. A systematic search of the literature yielded 15,442 results, which after de-duplication, a title/abstract screening, and full text screening, resulted in 44 studies that met full eligibility criteria. Multilevel meta-analyses revealed that minority stress was significantly and positively associated with adverse mental health outcomes (r=.28, 95% CI [.24, .33]). Social support was significantly and negatively associated with minority stress (r=-.18, 95% CI [-.24, -.13]), and social support was significantly and negatively associated with adverse mental health (r=-.22, 95% CI [-.25, -.18]). Moderation analyses revealed that the type of social support (i.e., general versus gender-specific support) did not significantly moderate the relationships between social support and minority stress (QM(1) = 0.31, p = .58) or social support and mental health (QM(1) = 0.81, p = .37). However, the source of social support did significantly moderate the relationships between social support and minority stress (QM (5) = 25.59, p < .001), such that in comparison to family support, support from significant others and support from LGBTQ community did not demonstrate as strong of a negative relationship with minority stress. Similarly, the source of social support significantly moderated the relationship between social support and mental health (QM (6) = 37.28, p < .001). This moderation demonstrated that support from significant others, LGBTQ community, and work/school demonstrated a significantly weaker relationship with adverse mental health outcomes in comparison to family support, and this moderation demonstrated that in comparison to family support, support from multiple sources (i.e., total support) demonstrated a significantly stronger relationship. Taken together, findings show that social support is an important protective factor for the deleterious effects of minority stress on mental health outcomes. These findings present particular salience during a time when transgender and gender diverse people find themselves the unwilling object of intense political scrutiny and immense psychological harm. This meta-analysis may offer implications for policy considerations at state and national levels by synthesizing research on how social support bolsters mental health in the TGD community, potentially supporting increased funding for TGD social support groups, family support interventions, and research on protective factors.