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Transgender (or trans) is an umbrella term for individuals who experience their gender differently from what is associated with the sex they were assigned at birth. Individuals who are nonbinary experience their gender outside binary conceptions of gender. Although research has predominantly focused on negative mental health outcomes for transgender and non-binary (TNB) individuals, an emergent literature has begun to explore protective and health-promoting factors and dimensions of psychological well-being. In this Review, we discuss the sociocultural context for TNB people, beginning with a brief history of TNB identity before highlighting frameworks for understanding the higher prevalence of certain mental health concerns among TNB individuals. Next, we summarize the predictive factors associated with higher rates of depression, anxiety, suicidality, trauma-related concerns, disordered eating behaviours and substance use. We also review TNB coping, resilience and resistance to anti-trans stigma, as well as psychological well-being, flourishing and gender euphoria. Tying these topics together, we discuss affirming interventions for reducing mental health disparities and promoting psychological health in TNB individuals and communities. We conclude by discussing future research directions.

Extant research on sexual identity development among sexual minority individuals has been predominantly conducted in Western contexts and focused on factors that hinder identity development processes. Using thematic analysis, this qualitative study sought to explore the experiences of sexual identity development among Chinese sexual minority men as well as the facilitative factors in China that positively influence this developmental process. The sample comprised 24 participants who self-identified as Chinese sexual minority men. The analysis yielded five overarching themes: awareness of one's attraction and corresponding reactions, identity exploration, moving toward identity acceptance and commitment, acceptance and support from others, and environmental support. The first three themes described the processes of sexual identity development among Chinese sexual minority men, whereas the latter two themes centered on the related facilitative factors in the context of China. The results highlight the importance of understanding the identity development process within Chinese minority men's unique sociocultural contexts. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Research on the interaction between gender and emotions has largely been constrained by the gender binary. This article seeks to advance theory of constructed emotions as relates to marginalized id...

A trans person is murdered every 3 days in the world, with the majority of these murders occurring in Latin America. This violence is a motivating factor for Latinx trans immigrants to immigrate to the United States. Regardless of whether individuals may be able to remain in the U.S., trans immigrants and asylum seekers are often held in detention facilities until immigration courts decide their cases. Although there are several standards of care and guidelines produced for trans and nonbinary (TNB) people who are held in detention, various reports have indicated that Immigration and Customs Enforcement (ICE) has not or inappropriately implemented these guidelines, thereby incurring and increasing risk of harm upon TNB immigrants.This qualitative study used thematic analysis to provide an understanding of the psychological impact that the systemic power of US detention proceedings had on the lives of Latinx, trans immigrants.The semi-structured interview protocol and implementation of this study was developed in collaboration with two national Latinx, LGBTQ immigrant advocacy organizations. The sample included 30 trans participants, between the ages of 18 and 52 (Participants reported being subject to debilitating and torturous conditions in "La Hielera", torture and abusive treatment by detention authorities, being denied access to basic human needs and medical care, and held in solitary confinement as punishment. This dehumanization, abuse, and transphobia in detention incurred psychological sequelae on participants including trauma, anxiety and depression, suicidal ideation, and a preference to self-deport.Implications include calls to abolish immigration detention, recommendations for mental health providers, and an overall restructuring of policies and services for humane asylum seeking processes for trans, Latinx immigrants.

Psychotherapie mit transmaskulinen Personen kann ein wichtiges Hilfsmittel sein, um sie bei einer Vielzahl von Anliegen zu unterstützen. Dabei liegen Themen wie Identitätsentwicklung, geschlechtsspezifische traumatisierende Erlebnisse und verinnerlichte Transnegativität (Stigma) im Fokus sowie die Bewältigung belastender Emotionen und Hilfestellungen bei einer Geschlechtsumwandlung.

Increased scientific understanding explains why transgender and gender nonconforming (TGNC) youth report more mental health concerns than their cisgender peers. However, the emotional processes of TGNC youth have not been assessed beyond mental health diagnoses. Our aim in this study was to investigate how TGNC youth understand, experience, and label their emotional experiences. We conduced a two-tiered qualitative analysis of 20 predominantly White TGNC youths, ages 7–18 years, resulting in the creation of the appraisal, valence, arousal theory of emotions. Within the theory, emotions are categorized in four quadrants: Reflective/Unpleasant, Anticipatory/Unpleasant, Reflective/Pleasant, and Anticipatory/Pleasant. Results indicated that the majority of TGNC youths’ emotions were located in the Reflective/Unpleasant and Reflective/Pleasant quadrants. The current study highlights TGNC youths’ appraisal of emotions and the potential impact on youths’ cognitive and emotional processes. Interventions should attend to pleasant and unpleasant aspects of emotions while also focusing on youths’ understanding of the context of their emotions.

BACKGROUND: Transgender, nonbinary, and gender nonconforming (TNG) young people are a diverse group, including young people with gender identities beyond the gender binary. While nonbinary youth experience disparities in victimization and mental health, school belonging, support, and resources have not been well described. METHODS: We conducted an online survey of TNG young people (ages 12–22) in Wisconsin to assess school belonging, safety, support, and resources. We compared responses among participants with nonbinary versus binary identities using mulvariate analysis of variance, multivariate analysis of covariance, chi-square and logistic regression analysis. RESULTS: A total of 287 TNG young people met inclusion criteria (average age 18.2 ± 2.5 years). More than 40 percent of participants identified as nonbinary. Nonbinary participants were less likely to be out to teachers, but more likely to utilize supportive staff as a resource compared to binary-identified TNG peers. There were no significant differences in school safety and belonging. CONCLUSIONS: Most school experiences do not vary significantly between TNG young people with binary versus nonbinary gender identities, though nonbinary young people are less likely to be out at school. Future research should examine factors that impact whether nonbinary young people share their gender identity and access school support services.

Given the rise in the visibility of the trans community, increasing attention has been paid to mental health disparities in trans populations. Specifically, research findings conclude that suicide is considered 1 of the major health disparities in trans populations. Across several studies it has been found that 40% or more of trans people have attempted suicide at least once in their lifetime. There are a multitude of reasons why trans people experience suicidal ideation and attempt suicide, with minority stress being theorized as a primary cause. To address minority stress-focused suicide, a psychologically adapted public health model is proposed. This model includes the following steps for preventing suicidal thoughts and behaviors: (a) defining the issue, (b) identifying causes and risk factors, (c) developing and testing psychological interventions, and (d) implementing psychological interventions. Key components discussed include the evidence and practice for supporting trans people through their social and medical transition processes, which have been demonstrated to improve mental and physical health outcomes. The implications of the prevention model indicate that psychologists play a key role in supporting trans people, regardless of the clinical concerns that bring them to therapy. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

This introductory article to the special issue on psychotherapy and HIV provides an overview of the state of HIV intervention research, recommendations for future psychotherapy practice, and an emphasis on how psychotherapy researchers focusing on HIV should move away from the typical public health model. We provide information about how historical bias impacts HIV clinical decision-making now. In addition, we include an analysis of how public health definitions of intervention research have limited psychotherapy research-specifically the importance of common factors and process-oriented components in psychotherapy. In this introductory article, we highlight the 13 articles that comprise the 5 following sections included in the special issue: (a) General Guidelines for Psychotherapy Practice for People With HIV, (b) HIV Stigma in Psychotherapy Process and Techniques, (c) Sexual Functioning and Romantic Relationships for People with HIV, (d) A Focus on Specific Disorders (Chronic Pain and Trauma) Comorbid With HIV, and (e) A Focus on Specific Populations (Adolescents and South African Populations). We conclude by offering recommendations to researchers to focus on the sociocultural context for clients with HIV and for psychotherapists to use an intersectional approach in their work with clients with HIV. (PsycINFO Database Record (c) 2020 APA, all rights reserved).

Trans and nonbinary individuals experience high rates of identity-based stigma and stress (minority stress) in U.S. society. Despite research empirically linking minority stress with adverse mental health outcomes, the extent to which minority stress experiences are discussed in psychotherapy and how therapists respond is unknown. The primary aim of the present study was to develop and test an observational coding scheme, the Minority Stress Experiences and Interactions (MSEI) scheme. With this scheme, observational data from psychotherapy sessions with 19 transgender and nonbinary adult psychotherapy client participants were coded to provide pilot data for the initial development of the MSEI coding scheme. A total of 19 clients' entire 50-min psychotherapy sessions were coded over 3 phases of psychotherapy: beginning (Session 1), middle (Session 2), and end (Session 10/11). Results indicate that the MSEI scheme was reliable for most codes. Codes revealed that all (N = 19; 100%) clients in the study reported at least 1 minority stress event (MSE) over the course of the 3 sessions, with the mean number of MSEs being 7 per client. The most frequent proximal stressor reported by clients was related to internalized stigma and the most frequent distal stressor reported by clients was prejudice. A total of 2 clients' clinical exchanges with their therapists centered on MSEs are highlighted to demonstrate the nuance of how MSEs are discussed in session, specifically regarding multiple minority identities. Implications for the current study include the need for therapist training regarding minority stress interventions and attention to power and oppression within sessions. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

We hypothesized that transgender and nonbinary (TNB) individuals who reported a longer period of time from realizing they were TNB to beginning their transition will have a longer history of nonsuicidal self-injury (NSSI) and that participants who report higher levels of body investment, fewer years from realization of TNB identity to transition, and more years since NSSI will report lower levels of current anxiety, stress, and depression. We conducted a secondary data analysis of a dataset collected online, which included 217 participants. We conducted multiple regressions to explore the hypotheses. Results revealed that TNB people who had a longer time between realizing their gender identity and beginning a transition had a longer history of NSSI. Exploratory analyses were also conducted to help understand the relationship between NSSI, transition, and body investment on mental health outcomes. Providers are cautioned that the presence of NSSI should not necessarily be a contraindication to transition.

Family support and acceptance are protective for transgender and gender diverse (TGD) youths' mental health and identity development. Although some studies have examined the role of supportive family relationships for TGD youth, prior research has not fully explored how TGD youth and their caregivers understand or characterize these relationships within the family system. In this qualitative study, we explored perspectives of TGD youth and their caregivers regarding youth-caregiver and caregiver-caregiver relationships within the family system. We recruited a community-based sample of 20 families (20 TGD youth, ages 7 to 18 years, and 34 caregivers) from 3 U.S. geographic regions. TGD youth represented multiple gender identities; caregivers included mothers (n = 21), fathers (n = 12), and 1 grandmother. Each family member completed an individual semistructured interview that included questions about family relationships. Interviews were transcribed verbatim and transcripts were analyzed using a thematic analysis approach. Analyses revealed complex bidirectional family relationships, highlighting 5 contextual factors influencing these relationships: school, community, workplace, religion, and extended family. TGD youths' identity development was inextricably linked to how caregivers respond to, adjust to, and learn from their children, and how caregivers interact with one another. Findings illustrate how caregiver acceptance and family cohesion may be linked and how youth and caregivers identified shared contextual factors impacting the family system. This research highlights the importance of situating TGD youth and caregivers as equal partners in family level approaches to affirm and support TGD identity development. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Minority stress has been determined to contribute to some mental health concerns for transgender, nonbinary, and gender nonconforming individuals, yet little is known regarding interventions to decrease the effects of minority stress. The purpose of this pilot study was to assess the feasibility and relative effectiveness of two interventions developed for work with transgender clients. Transgender individuals (N = 20) were recruited to participate in a randomized controlled trial comparing two psychotherapy interventions for transgender adults seeking psychotherapy for a variety of concerns: (a) transgender affirmative psychotherapy (TA) and (b) Building Awareness of Minority Stressors + Transgender Affirmative psychotherapy. Gender-related stress and resilience were assessed before, immediately after, and 6 months following the intervention; psychological distress and working alliance were assessed at these three time points as well as weekly during the intervention. Feasibility and acceptability of the study and psychotherapy interventions were supported. Exploratory analyses indicate improvement in both groups based on general outcome measures; targeted outcome measures indicate a trend of improvement for internalized stigma and nonaffirmation experiences. Results from this study support further evaluation of both treatment arms in a larger randomized controlled trial. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Objective: Sexual satisfaction has implications for well-being and may be related to gender norms. This study was conducted to understand the relationship between U.S. sexual minority (SM) individu...

An increasing number of young adults identify with nonbinary gender identities. Yet health providers and therapists often lack understanding of such identities. In this mixed-methods study of 506 transgender undergraduate and graduate students, most of whom (75%) had nonbinary gender identities, we aimed to understand participants’ mental health and health care experiences, and factors related to misgendering and less affirming treatment by providers. Eighty-five percent of participants reported mental health challenges, and named fear of violence and nonsupport as distal stressors. Experiences with therapists and health providers were mixed. Salient features of negative interactions were invalidation, avoidance, or overemphasis in regard to participants’ nonbinary identities. Participants viewed counseling services as more affirming than health services. Nonbinary students reported more misgendering by therapists and health providers, and less trans-affirming care by health service providers, compared to binary students. Undergraduate students reported more misgendering by therapists and health providers than graduate students.

The clinical need for lesbian, gay, bisexual, and queer (LGBQ+) affirmative psychotherapies has been widely recognized; however, empirical research on the outcomes of such psychotherapies is limited. Moreover, key questions about whom such psychotherapies are for and what they comprise require critical consideration. We begin by offering definitions to answer these questions and delineate four key themes of LGBQ+ affirmative psychotherapies. We conceptualize LGBQ+ affirmative psychotherapies not as sexual orientation group-specific, but rather as considerations and practices that can be applied with all clients. We then summarize our own search for studies to attempt a meta-analysis and we discuss limitations and directions for research based on our literature review. We end by delineating diversity considerations and recommending therapeutic practices for advancing LGBQ+ affirmative psychotherapy with clients of all sexual orientations.

This study reviews the research evidence on the effectiveness of attending to clients' gender identity and gender as a system of power in psychotherapy. We begin with definitions and measures of gender identity and provide clinical examples. Next, we summarize our search for studies to conduct two meta-analyses on: (a) randomized controlled trials (RCTs) of psychotherapy conducted with transgender clients, and (b) RCTs of the outcomes of psychotherapies that attend explicitly to gender as a system of power compared with another bona-fide psychotherapy. Our search did not yield studies that fit either search criteria; thus, meta-analyses were not conducted. Instead, we conducted a content analysis of the 10 qualitative and quantitative studies on psychotherapy with transgender individuals. We conclude by highlighting the limitations of the research base, describing diversity considerations, and recommending therapeutic practices that attend to gender, gendered systems of power, oppression, and privilege.

Despite an upward trend in research focused on trans youth, how trans youth cope with their gender identity remains relatively unknown. We aimed to gather in-depth information about how trans youth described the developmental process of coping with factors that arise when youth are exploring their gender identity, coming out to others, and navigating institutions and society. We interviewed 20 trans youth, ages 7–18, from the Northeastern, Southern, and Midwestern regions of the United States. Six coping themes, with 23 higher order categories, emerged from the grounded theory analysis: Negotiating Gender, Avoidance, Emotional Relief, Personal Solace, Support, and Active Engagement. Findings underscore the importance of understanding the nuances of coping processes, such that the same coping strategy could be either useful or harmful, depending on the purpose, timing, and context. Results indicate that youth report both subtle and explicit observations of their family members’ coping processes, especially when comparing how family members cope differently on similar issues related to gender identity. Implications for this study include the importance of researching interventions that focus on minority stress for trans youth, as well as future research directions to understand family coping processes.

Background: Transgender people in the United States often lack access to high-quality health care.Methods: A group of researchers and transgender people came together in a community-based participatory research process to survey transgender Wisconsinites about their health care experiences. A multiple regression analysis of survey data was used to evaluate the association between barriers to health care, gender identity, and quality of medical and mental health care provider.Results: Seventy-seven respondents were included in this analysis. Transmasculine respondents were more likely than transfeminine respondents to report barriers to high-quality health care, but having a high-quality medical or mental health care provider was associated with reporting fewer barriers to care across the entire sample.Discussion: This community-based study suggests that health care providers play a key role in facilitating access to care for transgender Wisconsinites in the USA.

The goal of this paper is to give current understanding of non-binary/genderqueer identities, non-binary mental health trends and identity development, unique experiences of non-binary individuals, and recommendations for clinicians and researchers. About one third of individuals who identify as transgender primarily identify as non-binary. Recent studies found that non-binary people are at higher risk for suicide, experience more psychological distress, and experience higher levels of depression and anxiety. New studies on identity development of non-binary individuals provide explicit and fluid understandings of gender identity development outside of male/female, man/woman, and boy/girl. Overall, little research is focused on non-binary individuals even though non-binary people make up a significant portion of the transgender community and experience even greater negative mental health risks. Non-binary people face several challenges in a society that is structured around binary gender identities. We encourage psychologists to challenge the dominant binary assumption about gender and create environments that include and affirm non-binary individuals.

Background: A growing body of research has examined transgender identity development, but no studies have investigated developmental pathways as a transactional process between youth and caregivers, incorporating perspectives from multiple family members. The aim of this study was to conceptualize pathways of transgender identity development using narratives from both transgender and gender-nonconforming (TGN) youth and their cisgender (nontransgender) caregivers.Methods: The sample included 16 families, with 16 TGN youth, ages 7 to 18 years, and 29 cisgender caregivers (N = 45 family members). TGN youth represented multiple gender identities, including trans boy (n = 9), trans girl (n = 5), gender-fluid boy (n = 1), and girlish boy (n = 1). Caregivers included mothers (n = 17), fathers (n = 11), and one grandmother. Participants were recruited from LGBTQ community organizations and support networks for families with transgender youth in the Midwest, Northeast, and South regions of the United Stat...

This article addresses the challenges that clinicians face in writing letters of support for transgender and gender-diverse clients. It addresses common but challenging clinical representations to help the reader understand the nuances associated with writing letters. Three cases are presented. The first addresses systemic challenges, the second addresses management of care, and the third addresses co-occurring mental health concerns. Recommendations for practice are provided based on the experiences included within the 3 case examples.

Much has been written in recent years regarding the integration of social justice values with psychology and psychotherapy; however, the discourse surrounding social justice perspectives related to conducting psychotherapy research is scant. Psychotherapy researchers are beholden to various professional ethical standards, laws, and policies; however, adhering to these rules and guidelines may make research ethical, but not necessarily socially or politically just. In this article, the authors build on previous work from community, feminist, positive, and multicultural psychology perspectives as well as their own experiences as psychotherapy researchers, to propose a framework for approaching psychotherapy research from an ethical and socially just position. Examples from the authors' experiences conducting psychotherapy research with incarcerated individuals, community- and school-based research with youth, and research with sexual/gender minorities are provided to illustrate theoretical principles and provide practical recommendations. Barriers to implementing such a framework to psychotherapy research, as well as strategies to manage these challenges are also discussed. In addition, the authors propose a model that can be used to develop and evaluate the social justice process and content dimensions of a research study. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

The clinical need for lesbian, gay, bisexual, and queer (LGBQ+) affirmative psychotherapies has been widely recognized; however, empirical research on the outcomes of such psychotherapies is limited. This chapter begins by offering definitions and delineating four key themes of LGBQ+ affirmative psychotherapies. The authors conceptualize LGBQ+ affirmative psychotherapies not as sexual orientation group specific but rather as considerations and practices that can be applied with all clients. The chapter then summarizes a search for studies to attempt a meta-analysis and discusses limitations and directions for research based on this search. The chapter ends by delineating diversity considerations and recommending therapeutic practices for advancing affirmative psychotherapy with clients of all sexual orientations.

This chapter reviews the research evidence on the effectiveness of attending to clients’ gender identity in psychotherapy. It begins with definitions and measures of gender identity and provides clinical examples. A literature search did not yield studies that fit the authors’ search criteria; thus meta-analyses were not conducted. Instead, the authors conducted a content analysis of the 10 qualitative and quantitative studies on psychotherapy with transgender individuals. The chapter concludes by highlighting the limitations of the research base, describing diversity considerations, and recommending therapeutic practices that attend to gender, gendered systems of power, oppression, and privilege.

Purpose: An emerging body of research analyzes the scope, ethics, and inequalities of web-based crowdfunding to raise money for medical expenses related to illness or injury. To date, little research has investigated how transgender communities utilize crowdfunding expenses related to gender affirming medical care. Methods: Using GoFundMe.com, we created a data set of 391 crowdfunding campaigns for gender-affirming care created from 2012 to 2016. In addition to descriptive statistics of recipient demographics and campaign financials, we conducted hierarchical multiple regression analyses to determine the factors associated with financial outcomes of fundraising for medical expenses. Results: Findings indicate that the majority of campaigns were used to fund chest surgeries among young, white, binary-identified trans men in the United States. Few campaigns met their fundraising goal. Being a trans man whose Facebook community shares the crowdfunding campaign is predictive of meeting a higher percentage of the fundraising goal, whereas being a trans woman whose Facebook community shares the campaign is predictive of raising more money. Conclusion: The use of crowdfunding for gender affirming highlights the difficulties that transgender persons face with using private and public health care programs to fund medically necessary care. Health care providers should exercise caution in recommending crowdfunding as a viable strategy to raise money for out-of-pocket costs.

Rationale Men who have sex with men (MSM) in China are disproportionately affected by HIV and mental health issues. Although predominately western-based research suggests a minority stress perspective to explain health disparities, how Chinese MSM experience stress related to being a sexual minority and how such experiences affect their health have not been carefully examined. Objective: This study was a qualitative investigation of how stress related to sexuality (e.g., stigma, discrimination, and oppression) are experienced among MSM in China and how these experiences affect their psychological and behavioral health. Method In-depth, semi-structured interviews were conducted with 24 MSM in China. Grounded theory was employed to guide data analysis. Results Six categories emerged, which included: A Family-Oriented, Heteronormative Culture, Interpersonal Rejections and Marginalization, Internalization of Stigma, the Psychological Impact of Minority Stress, Impact on HIV-related Behavioral Health, and Coping. A conceptual model was developed, which illustrated relationships among categories and described sources, processes, and impact of minority stress among MSM in China. Cultural, social, and internalized sources of minority stress were shown to have detrimental effects on participants' psychological health and HIV-related behavioral health. Various coping strategies shared the purpose of navigating well-being in one's direct environment and in the larger culture. Conclusions Findings demonstrate the relevance of minority stress in behavioral health among Chinese MSM as well as the need to conceptualize minority stress within MSM's sociocultural context. HIV prevention efforts may benefit from a contextualized understanding of minority stress and addressing minority stress in a culturally congruent, community-centered fashion.

Future perspectives of transgender youth and their caregivers may be shaped by knowledge of discrimination and adverse mental health among transgender adults. Qualitative data from the Trans Youth Family Study were analyzed to examine how transgender and gender nonconforming (TGN) youth and their caregivers imagine the youth's future. A community-based sample of 16 families (16 TGN youth, ages 7-18 years, and 29 caregivers) was recruited from 2 regions in the United States. Participants completed in-person qualitative interviews and surveys. Interview transcripts were analyzed using grounded theory methodology for coding procedures. Analyses yielded 104 higher order themes across 45 interviews, with 8 prominent themes: comparing experiences with others, gender affirming hormones, gender affirming surgery, gender norms, questioning whether the youth is really transgender, expectations for romantic relationships, uncertainty about the future, and worries about physical and emotional safety. A conceptual model of future perspectives in TGN youth and caregivers is presented and clinical implications are discussed. (PsycINFO Database Record

Purpose: Research has demonstrated associations between discrimination and mental health in lesbian, gay, bisexual, and transgender populations. However, little is known about the influence of geographic location on psychological distress in these populations, particularly among transgender people. Methods: This secondary analysis conducted on a national sample of transgender individuals (N=414) offers a preliminary understanding of the effects of geographic location on psychological distress (i.e., anxiety and depression). A univariate analysis of variance was calculated to determine this relationship. Results: The West South Central division (i.e., Arkansas, Louisiana, Oklahoma, and Texas) revealed highest psychological distress. Conclusion: Results suggest an urgent need for transgender-competent healthcare in this division.

The present study examined patterns in trans individuals’ multiple identities and mental health outcomes. Cluster 1 (socioeconomic and racial privilege; n = 239) was characterized by individuals who identified as trans women or cross-dressers, lesbian, bisexual, or questioning; had associates degrees; reported household incomes of $60,000 or more a year; and were non-Latino White. Cluster 2 (educational privilege; n = 191) was characterized by individuals who identified as trans men or genderqueer, gay, or queer; had a bachelor’s degree; reported household incomes of $10,000 or less a year; and were people of color. There was a pattern of individuals in Cluster 1 who identified with two privileged identities (identifying as White and having higher household incomes), whereas individuals in Cluster 2 identified only formal education as a privilege. Individuals in Cluster 2 reported statistically significant levels of anxiety. Implications of these results for future research and clinical practice are examined.

In this article, we aim to provide readers with tools to critically consider decisions related to conducting research with trans populations. We first present the historical and contemporary contexts that shaped our approach to writing this article, and drawing from various social justice frameworks, we set forward our own critical framework to guide the discussion of research considerations with trans populations. We then move into discussing considerations for participant recruitment and sampling strategies, such as effective use of language in recruitment and study materials, consideration of research venues, and recruitment of diverse samples. We also provide a number of considerations related to research methods, study design, and dissemination of study results. Therefore, this article seeks to not only raise a number of important considerations for research with trans populations but also to provide readers with critical tools for adapting decision making when planning and conducting research with trans populations.

This study provides a content analysis of more than a decade (2002–2012) of academic scholarship about trans people and issues. A total of 960 trans-focused publications were coded; there was a close balance of nonempirical (54%) and empirical (46%) publications. The analyses revealed that the literature on trans people and issues is growing, although many publications include trans people and issues nominally without substantive attention. The analyses also pointed to underutilized research designs and methodologies, the need for more clear assessment and more consistent reporting of demographic characteristics, and topics that warrant further attention. Specifically, literature on trans people and issues continues to be needed on the topics of focus thus far, such as psychological and identity-related distress. Scholarship is also needed to address important topics that have been understudied, including self-harm and suicide, positive functioning and mental health promoting factors, developmental issues across the life span, school and workplace experiences, and the training and competencies of health care providers to ensure affirmative and effective services for trans people.

The current study examined how dimensions of masculinity and femininity were expressed for sexual minorities. Cluster analysis was used to determine the number of latent classes for conformity to masculine and feminine norms for sexual minorities. A four-class solution was the best fit to the data. Cluster 1 (labeled Relating to others through equality and caring, n = 41) was characterized by low dominance and power over women and high involvement with kids and have nice relationships norms. Cluster 2 (labeled Relating to others through avoidance and misogyny, n = 38) was characterized by low risk-taking and have nice relationships and high power over women and disdain for homosexuality. Cluster 3 (labeled Relating to others through power, n = 34) was characterized by high winning, pursuit of status, and appearance and low modesty. Cluster 4 (labeled Relating to others through sex, n = 27) was characterized by low involvement in romantic relationships and sexual fidelity while endorsing high playboy attit...

Scholarship about lesbian, gay, bisexual, and transgender (LGBT) people and issues has been growing. However, trans issues are often overlooked or addressed only nominally in this literature, leading to calls for further focused attention to trans people and issues. In a series of articles, this Major Contribution addresses such calls by (a) providing a content analysis of scholarship about trans people and issues, (b) discussing methodological considerations and strategies for conducting research with trans populations, and (c) presenting an empirical study that addresses how intersecting identities (e.g., ethnicity/race, sexual orientation, socioeconomic status) combine in relation to trans people’s mental health. This article provides a context for the Major Contribution and offers an overview of each of the component articles.

Alliance, empathy, and genuineness are each integral parts of the therapeutic relationship. No previous meta-analysis has explored the extent to which therapist empathy and genuineness contribute to the therapeutic alliance.In this meta-analysis, a multifaceted search strategy yielded 53 studies. Forty studies reported alliance/empathy relationships, eight studies reported alliance/genuineness relationships, and five studies reported both.Random effects meta-analyses revealed that therapeutic alliance was significantly related to perceptions of therapist empathy with a mean r = 0.50 (95% CI = 0.42, 0.57). Therapeutic alliance was also significantly related to perceptions of therapist genuineness with a mean r = 0.59 (95% CI = 0.45, 0.71). Tests of publication bias indicated a low likelihood of publication bias affecting the strength and direction of the results. Potential moderating variables were explored, including rater perspective, measure of therapeutic relationship variables, and client race/ethnicity.Therapeutic alliance has a moderate relationship with perceptions of therapist empathy and genuineness. Of note, there may be reason to believe that when rated by the same person, these constructs have significant overlap and lack discreteness. Future directions for study of the therapeutic relationship are discussed. Implications for practice are provided.

In this article, we introduce a special section focused on the application of advanced methodologies to specific research questions in counseling psychology. The articles include applications of natural language processing, dynamic systems, mediation analyses in single studies and meta-analysis, and synthesis of qualitative research. We provide a brief overview of each article. (PsycINFO Database Record