Health Care and Social Predictors of Gender Positivity and Gender Distress Among Transgender and Nonbinary People in Canada
Bibliographic record
Abstract
Background: Transgender (trans) health care is focused on gender dysphoria and overlooks the diverse gender experiences of trans and nonbinary (TNB) individuals, especially gender positivity (also known as gender euphoria), a crucial aspect and resilience factor of trans well-being. Existing research on gender positivity is primarily qualitative, lacking quantitative assessment tools. This thesis provides quantitative insights by utilizing new assessment scales to evaluate gender positivity (GP) and gender distress (GD).\nMethods: Data (n = 2316) were from Trans PULSE Canada, a 2019 cross-sectional community-based survey of TNB people aged 14+ in Canada. Social and bodily dimensions of gender well-being were measured with the Trans Youth CAN! Gender Positivity Scale and Gender Distress Scale, originally developed using a clinical sample of TNB youth in Canada. This thesis applied confirmatory factor analysis to validate psychometric properties of the two scales, and structural equation modelling to examine health care and social predictors associated with GP and GD.\nResults: Correlation analysis demonstrated that GP and GD have a complex relationship instead of being simple opposites. Confirmatory factor analysis supported two-factor (social and body) models for GP and GD, confirming that GP and GD are multi-faceted distinct constructs. Structural equation modelling revealed that gender-affirming medical care was associated with higher GP and lower GD across social and bodily dimensions. However, when barriers impeded accessing ongoing care, these benefits were diminished compared to unobstructed ongoing care or completion of needed care. Possessing government identification with the preferred gender marker was linked to overall gender well-being. The frequency of misgendering emerged as a prominent risk factor, detrimentally impacting both GP and GD across social and body dimensions. Strong parental support was significantly associated with greater GP and less social GD, a link not observed with other familial or romantic partner support.\nConclusion: This study enhances our understanding of TNB gender experiences, underscoring the need for a more balanced and holistic healthcare perspective that promotes gender positivity. The findings suggest that TNB healthcare practices could benefit from incorporating strength- and resilience-based approaches, cultivating gender positivity as a protective factor for the health and well-being of the TNB population.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.003 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.001 |
| Bibliometrics | 0.001 | 0.003 |
| Science and technology studies | 0.005 | 0.001 |
| Scholarly communication | 0.002 | 0.001 |
| Open science | 0.001 | 0.002 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.003 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".