The impact of transgender minority stress and emotion regulation on suicidality and self-harm

Transgender and gender diverse (TGD) individuals experience high levels of minority stress, as well as a high prevalence of suicidality and self-harm. The current study investigates if emotion regulation mediates the relationships of minority stressors with self-harm and suicidality. TGD adult primary care patients (N = 115) completed a survey including measures of minority stressors, emotion dysregulation, self-harm, and suicidality. Emotion regulation mediated the relationship between victimisation and suicidality. Emotion regulation did not mediate the relationship between victimisation and self-harm. TGD individuals' suicide risk may be increased when they experience victimisation through increased emotion dysregulation.

Community Diversity Climate Impact on the Well-Being of Asian Americans Amid Anti-Asian Sentiment During the COVID-19 Pandemic: The Role of Two-Way Symmetrical Communication by Local Governments

Integrating the literature from public relations, community psychology, and minority stress theory, this study proposes and tests a model that describes the mechanism by which local governments' two-way symmetrical communication practices may affect local Asian Americans' experiences amid anti-Asian sentiment during the COVID-19 pandemic. The results of an online survey of 400 Asian Americans living in the United States indicated that local governments' two-way symmetrical communication practices with respect to diversity acceptance helped establish a community diversity climate. Such a perception lowered the target group's perceived stigma consciousness and fear of discrimination, which are the two main proximal stressors affecting minority members' emotions and wellbeing. Theoretical and practical implications on public relations and governmental communication are discussed.

Effects of the COVID-19 Pandemic on the Wellbeing of LGBTQ+ Individuals in Moldova: A Mixed Methods Analysis.

Research on the effects of the COVID-19 pandemic for LGBTQ+ people is limited, particularly in eastern Europe. This mixed methods study explored the direct and indirect effects of the pandemic on the mental and physical wellbeing of LGBTQ+ individuals in Moldova. From June to the end of July 2022, 86 surveys and 12 interviews were completed by self-identified LGBTQ+ adults in Moldova. Survey data were analyzed with descriptive statistics and interviews were coded and analyzed using the grounded theory methodology. The two data sets were interpreted concurrently to identify emergent themes. Overall, data suggest LGBTQ+ people experienced both negative and positive effects on their mental wellbeing due to the pandemic. Participants expressed feelings of anxiety, loneliness, and depression, and an inability to be their authentic selves. Conversely, participants had more capacity to explore their identities and they demonstrated social support within the LGBTQ+ community. Regarding physical impacts, there were interruptions to transgender medical care and concerns about housing affordability. Findings highlight the unique impacts of the pandemic on LGBTQ+ people and stress the importance of further research in this area and policies and plans to address the needs of LGBTQ+ people in response to the pandemic and future health crises.

A pilot study of gender minority stress, allostatic load, and sleep in transgender and gender expansive adolescents and young adults

Transgender and gender expansive adolescents and young adults (AYA) experience a high burden of mental and physical health sequelae, which is linked to gender minority stress. Few reports have examined gender minority AYA sleep health, which may lie at a unique intersection of developmental and social risk. Little is known about the role of gender minority stress or protective factors on sleep health. A sample of 40 transgender and gender expansive AYA, ages 12-24 years old, engaged in gender-affirming medical care at an urban medical center completed study surveys, which captured information on multiple dimensions of sleep health and behaviors, gender minority stress, parental support, and other demographic information. Health data was also extracted from participant's EMR. Gender minority stress (gender victimization and nonaffirmation), parental support, and allostatic load (AL), as measures by retrospective EMR-reported biomarkers, were examined as predictors of sleep health domains. Exploratory analyses testing the relationship between sleep, AL, and gender minority stress were also performed. Contrary to extant literature, the majority of participants reported good sleep quality. Results showed that other areas of participants' sleep health were comparable to population rates reported in the literature. Findings should be considered within the context of national changes in sleep patterns and behaviors that occurred during the first year of the COVID-19 pandemic, which overlapped with study enrollment. Parental support and gender victimization was not associated with sleep health. Gender nonaffirmation was found to be associated with sleep quality, however this relationship was attenuated when controlling for depressive symptoms and age. Weekday sleep latency was also associated with AL. Exploratory analyses examining the contribution of gender minority stress and AL yielded mixed results. Despite mixed findings, this report extends the current body of knowledge on sleep health among gender minority AYA. This is the first investigation of gender minority stress and protective factors as well as AL in relation to sleep health among gender minority AYA. Findings contribute to biocultural research efforts aimed at promoting health equity among transgender and gender expansive youth as well as highlight areas of future investigation. (PsycInfo Database Record (c) 2023 APA, all rights reserved)

Mental health among LGBTQ+ communities in the context of COVID-19

Rates of anxiety, depression, and suicidality have long been known to be elevated among LGBTQ+ communities and it was expected that the COVID-19 pandemic would deepen systemic injustices and inequities in mental health outcomes. However, it remains difficult to document inequities as surveillance systems do not typically capture LGBTQ+-inclusive data necessary to study the impact of COVID-19 on LGBTQ+ population health. This chapter reports on two studies designed to address this gap. The COVID-19 Impacts Study (CIS) documented the early mental health and social impacts of COVID-19 among sexual and gender minority adults, as well as adults with HIV, during the first round of shut-downs and initial economic disruptions. Subsequently, the Youth and Young Adults COVID-19 Study (YYA) measured the impacts of COVID-19 on the mental health outcomes, testing/vaccination behaviors, and stigmatization experiences of LGBTQ+ and BIPOC (Black, Indigenous, People of Color) young people. Several recommendations are discussed-including mandated collection of data on sexual orientation and gender identity in all surveillance systems, policy solutions to better address access and cost barriers, and deep and meaningful engagement that empowers communities. © 2023 The authors.

COVID-racism on social media and its impact on young Asians in Australia

COVID-19 has fueled discrimination against people of Asian descent across the world, and anti-Asian sentiment has become pervasive across social media platforms. However, little research has been conducted to understand Asians' experiences of COVID-related racism outside the USA. Drawing insights from cultivation theory and minority stress theory, this study examines how young Asians' use of social media in Australia affects their experiences of individual and vicarious racial discrimination on social media, and how racial discrimination experienced on social media is associated with their concerns about real-world racism and well-being. A survey of 413 social media users aged 16–30 who self-identified as Asians or Asian Australians shows that active use of social media relating to COVID-19 increases their likelihood of experiencing both individual and vicarious racial discrimination on social media. Racism experienced on social media contributes to their concerns about real-world racism, which leads to negative emotions and low life satisfaction. © AMIC/WKWSCI-NTU 2023.

Impact of the COVID-19 pandemic on the mental health of transgender persons in India: Findings from an exploratory qualitative study.

Introduction: Transgender persons in India, who are one of the most vulnerable groups, were particularly impacted by the COVID-19 pandemic. Increased risk of COVID-19, challenges with continuing livelihood, uncertainty, and anxiety around the pandemic over pre-existing social discrimination and exclusion pose risk of a mental health impact as well. To investigate this further, this component of a larger study on experiences in healthcare of transgender persons in India during COVID-19 and looks into the question "How did the COVID-19 pandemic impact the mental health of transgender persons in India". Methods: 22 In-depth interviews (IDI) and 6 focus group discussions (FGD) were conducted virtually and in-person with persons self-identifying as transgender or belonging to ethnocultural transgender communities from different parts of India. Community based participatory research approach was used by ensuring representation from the community in the research team and through a series of consultative workshops. Purposive sampling with snowballing was used. The IDIs and FGDs were recorded, transcribed verbatim and analyzed using an inductive thematic analysis. Results: Mental health of transgender persons were affected in the following ways. Firstly, COVID-19, its associated fear and suffering combined with pre-existing inaccessibility of healthcare and reduced access to mental health care affected their mental health. Secondly, unique social support needs of transgender persons were disrupted by pandemic linked restrictions. Thirdly, pre-existing vulnerabilities such as precarious employment and underlying stigma were exacerbated. Finally, gender dysphoria was a key mediating factor in the impact of COVID-19 on mental health with a negative and positive impact. Conclusions: The study reiterates the need to make systemic changes to make mental healthcare and general healthcare services trans-inclusive while also recognizing the essential nature of gender affirmative services and the need to continue them even during emergencies and disaster situations. While this brings out how public health emergencies can exacerbate vulnerabilities, it also shows how the lived mental health experience of transgender person is intricately linked to the way work, travel and housing is structured in our society and therefore points to the structural nature of the linkage between mental health and gender.

I Am Not A Virus: Status-Based Rejection Sensitivity and Sleep Among East Asian People in the United States During COVID-19.

As COVID-19 spread in the United States, anti-East Asian bias increased. This article aimed to (1) show that thinking about COVID-19 heightened East Asian individuals' anxious expectations of discrimination and (2) explore these expectations' health correlates. Specifically, the paper focused on COVID-19-triggered race-based rejection sensitivity, defined as (1) East Asian individuals' expectations of rejection due to the stereotype that they spread the virus and (2) high levels of anxiety about this possibility. Study 1 (N = 412) showed that reminders of COVID-19 increased COVID-19-triggered race-based rejection sensitivity among Chinese citizens living in the United States and East Asian Americans, but not Americans of other races. Study 2 (N = 473) demonstrated that East Asian people who habitually focused on COVID-19 experienced greater COVID-19-triggered race-based rejection sensitivity and, in turn, greater sleep difficulties. Thus, societal-level shifts that target minoritized groups may increase minoritized group members' concerns about discrimination in ways that undermine their health.

Blurred border or safe harbor? Emotional well-being among sexual and gender minority adults working from home during COVID-19.

During the COVID-19 pandemic, lesbian, gay, bisexual, transgender, and queer (LGBTQ) adults have experienced pronounced declines in well-being. However, less is known about how changes to daily routines and settings, such as the shift to remote work within many occupations, may be playing a role in well-being outcomes. Drawing on a unique time diary data source (N = 3515 respondents and 7650 episodes) collected between April 2020-July 2021 through online crowdsourcing platforms, we conducted random effects analyses to examine how working from home has been associated with experienced well-being among LGBTQ and cisgender heterosexual workers in the United States during the pandemic. Findings indicate LGBTQ adults felt significantly less stressed and tired while doing paid work at home than while working at a workplace. In addition, working at a workplace, rather than working from home, appeared to be more detrimental to LGBTQ adults' well-being compared to their non-LGBTQ counterparts. Adjusting for work characteristics explained some of the difference, whereas adjusting for family characteristics had little impact on the results. It is possible that for LGBTQ employees, working from home mitigates some of the minority stressors experienced during paid work.

Religion and sexual identities.

Religion and sexuality have a complex, deep-rooted relationship. Religions often teach how aspects of sexuality should be conducted, typically promoting heterosexuality. Such discourse is at odds with a growing population using sexual minority identities. The tension between one's homonegative faith or religious environment and their sexual minority orientation can lead to poor health outcomes like psychological distress and suicidal ideation. Attempts to change sexual orientation to match religious expectations are futile and frequently harmful. However, sexual minority individuals can find health benefits if they are able to reconcile their religious and sexual identities or find accepting religious/spiritual communities. The COVID-19 pandemic and religious influence on US politics have also shaped the safety of environments for disclosing a sexual minority identity.

Queers in quarantine: Young LGBTQ+ people's experiences during the COVID-19 pandemic in Sweden.

The COVID-19 pandemic led to major restrictions of everyday life activities. This worsened the social situation of many people, and marginalized groups have been especially affected. This article explores how LGBTQ+ young adults in Sweden have been affected by the COVID-19 pandemic and the subsequent recommendations and restrictions. Fifteen participants between 20-29 years, who self-identified as lesbian, gay, bisexual, transgender, and queer (LGBTQ+), were interviewed about their experiences. A thematic analysis of the data showed that the participants perceived their psychological wellbeing to have been greatly affected by the pandemic. Several reported symptoms of clinical depression, as well as anxiety, worry, rumination, and a heightened sensitivity to stress. Stressors included fear of the disease itself, and fear of spreading the virus, as well as the negative consequences of adhering to the recommendations of social distancing, which constantly interplayed with the marginalized position of being a young LGBTQ+ person. Most participants experienced a decrease in minority stress in face-to-face interaction with social distancing measures in place, but an increase in minority stress online. Those who faced minority stress at home experienced the isolation as particularly stressful. Limited access to the LGBTQ+ community was a common stressor. For transgender participants, the effects on transgender healthcare, such as prolonged waiting times for gender dysphoria assessment and hormone treatment, were a major challenge. Our results have added valuable knowledge to research indicating how vulnerable young adults were highly affected by the COVID-19 pandemic restrictions.

Loneliness and depressive symptoms differ by sexual orientation and gender identity during physical distancing measures in response to COVID-19 pandemic in Germany.

During the COVID-19 pandemic, physical distancing measures to prevent transmission of the virus have been implemented. The effect of physical distancing measures on loneliness especially for vulnerable groups remained unclear. Thus, we aimed to investigate loneliness in relation with depressive symptoms among lesbian, gay, bisexual, trans, inter, asexual, and queer (LGBT) persons compared with cis-heterosexual persons during the pandemic. We conducted an online survey during the first two waves of the COVID-19 pandemic in Germany. The survey contained self-categorizations regarding sexual orientation and gender identity, questions on loneliness, social contacts, depressive symptoms, and healthcare. Descriptive and regression analysis and propensity score matching across cohorts was conducted using R; 2641 participants took part in first wave of the survey and 4143 participants in the second wave. The proportion of lonely people was higher in the second wave compared with the first wave. LGBT persons were more lonely than cis-heterosexual persons. In both waves, being LGBT was associated with depressive symptoms, but loneliness mediated the effect, even when adjusting for social contacts. Psychologists and other practitioners should be aware that LGBT clients might have an increased risk for loneliness and depressive symptoms and of the potential burden of the pandemic measures.

Psychological distress and everyday discrimination among Chinese international students one year into COVID-19: a preregistered comparative study.

BACKGROUND AND OBJECTIVES: During the COVID-19 pandemic, Chinese international students (CISs) experienced distress associated with both unique and universal stressors, among which everyday discrimination may be especially harmful. DESIGN: Cross-sectional design. METHODS: We compared distress between CISs (N = 381) and Chinese students in Chinese colleges (CSCCs; N = 305) and examined correlates of distress including the association between everyday discrimination and distress as well as moderators on this link. RESULTS: Compared to CSCCs, CISs reported greater depression and anxiety. Sensitivity analyses - multiple regressions controlling for covariates and coarsened exact matched (CEM) comparisons - replicated the results. 28.6% CISs reported suicidal ideation (PHQ-9 item 9) at least several days during the past two weeks. Within CISs, depression was associated with being older, female, non-heterosexual, increased everyday discrimination, decreased self-esteem, coping flexibility, perceived social support, and satisfaction with online learning. Anxiety was associated with being in undergraduate years, female, increased discrimination, decreased self-esteem, coping flexibility, and satisfaction with online learning. High perceived social support and being heterosexual weakened the association between discrimination and anxiety and depression, while high self-esteem strengthened the association between discrimination and anxiety. CONCLUSIONS: Our study underscored the distress experienced by CISs and highlighted risk/protective factors that may warrant attention.

An Identity-Affirming Web Application to Help Sexual and Gender Minority Youth Cope With Minority Stress: Pilot Randomized Controlled Trial.

BACKGROUND: Efficacious mental health interventions for sexual and gender minority youth have had limited reach, given their delivery as time-intensive, in-person sessions. Internet-based interventions may facilitate reach to sexual and gender minority youth; however, there is little research examining their efficacy. OBJECTIVE: This study aims to describe the results of a pilot randomized controlled trial of imi, a web application designed to improve mental health by supporting lesbian, gay, bisexual, transgender, queer, and other sexual and gender minority identity affirmation, coping self-efficacy, and coping skill practice. METHODS: Sexual and gender minority youth (N=270) aged 13 to 19 (mean 16.5, SD 1.5) years and living in the United States were recruited through Instagram advertisements. Approximately 78% (210/270) of the sample identified as racial or ethnic minorities. Participants were randomized in a 1:1 fashion to the full imi intervention web application (treatment; 135/270, 50%) or a resource page-only version of the imi site (control; 135/270, 50%). The imi application covered four topical areas: gender identity; lesbian, gay, bisexual, transgender, queer, and other sexual and gender minority identity; stress and coping; and internalized homophobia and transphobia. Participants explored these areas by engaging with informational resources, exercises, and peer stories at a self-guided pace. Both arms were assessed via web-based surveys at baseline and 4-week follow-up for intervention satisfaction, stress appraisals (ie, challenge, threat, and resource), coping skills (ie, instrumental support, positive reframing, and planning), and mental health symptoms among other outcomes. Main intent-to-treat analyses compared the arms at week 4, controlling for baseline values on each outcome. RESULTS: Survey retention was 90.4% (244/270) at week 4. Participants in the treatment arm reported greater satisfaction with the intervention than participants in the control arm (t241=-2.98; P=.003). The treatment arm showed significantly greater improvement in challenge appraisals (ie, belief in one's coping abilities) than the control (Cohen d=0.26; P=.008). There were no differences between the arms for threat (d=0.10; P=.37) or resource (d=0.15; P=.14) appraisals. The treatment arm showed greater increases in coping skills than the control arm (instrumental support: d=0.24, P=.005; positive reframing: d=0.27, P=.02; planning: d=0.26, P=.02). Mental health symptoms improved across both the treatment and control arms; however, there were no differences between arms. Within the treatment arm, higher engagement with imi (≥5 sessions, >10 minutes, or >10 pages) predicted greater improvement in stress appraisals (all P values <.05). CONCLUSIONS: The results provide initial evidence that asynchronous psychosocial interventions delivered via a web application to sexual and gender minority youth can support their ability to cope with minority stress. Further research is needed to examine the long-term effects of the imi application. TRIAL REGISTRATION: ClinicalTrials.gov NCT05061966; https://clinicaltrials.gov/ct2/show/NCT05061966.

Mental well-being, social support, and the unique experiences of transgender and nonbinary people during the COVID-19 pandemic

The COVID-19 pandemic introduced a myriad of novel stressors, and early research suggests the mental well-being of many has suffered as a result. Transgender and nonbinary (TN) people in particular may have experienced additional stressors related to their gender identity, and may not have had access to minority coping resources that could normally buffer against experiencing negative mental health outcomes. In May 2020, 1160 cisgender heterosexual, 369 cisgender lesbian, gay, bisexual, and queer (LGBQ), and 195 TN people completed a survey on their mental well-being and experiences during the first wave of the COVID-19 pandemic. We also asked TN participants about how their lesbian, gay, bisexual, transgender, and/or queer (LGBTQ+) identity intersected with their experience of the COVID-19 pandemic. We found that TN participants experienced more psychological distress and less social support than cisgender heterosexual participants during the COVID-19 pandemic. We also found that social support was associated with less psychological distress among TN participants during the pandemic;however, LGBQ+ and TN community connectedness were not related to distress. Using inductive thematic analysis, we summarize TN participants' descriptions of the ways that their LGBTQ+ identities intersected with the pandemic to change their access to gender-affirming services and behaviours, their home and public life, and their experiences of affirming social support and/or LGBTQ+ community connectedness. Together, our findings provide valuable insights into the experiences of TN people during the pandemic and highlight the ways in which our "normal" society is difficult for TN people to inhabit.

Family Conflict, Physical Symptoms, and Post Traumatic Stress among Sexual Minorities during the COVID Pandemic: A Moderated Mediation Model.

Sexual minorities experience health disparities compared to heterosexuals due to their stigmatized identies. The COVID- 19 pandemic has further exacerbated these disparities. Sexual minorities were surveyed about their experiences during the pandemic and asked about family conflict and minority stress as predictors of Post Traumatic Stress Symptoms (PTSS) and physical health symptoms, as well as psychological symptoms as a mediator of these relationships. We surveyed 435 sexual minorities who were recruited from Mechanical MTurk. Participants completed questionnaires that included demographics, PTSS in response to the pandemic, family conflict, minority stress, psychological symptoms, and physical health outcomes. Our findings support a moderated mediational model, explaining the relationships between family conflict, minority stress, PTSS and physical symptoms. Specifically, those participants who are high in minority stress are vulnerable to family conflict resulting in increased PTSS and physical symptoms. Psychological symptoms mediated these relationships.

LGBTQ Identity-Related Victimization During COVID-19 Is Associated with Moderate to Severe Psychological Distress Among Young Adults.

Purpose: Existing evidence indicates significant threats against the mental health of sexual and gender minority (SGM) young adults as a result of the COVID-19 pandemic, including elevated rates of substance use, anxiety, depression, and traumatic stress. Therefore, it is imperative to understand the mechanistic identity-related factors that may influence the mental health needs of SGM young adults in the time of COVID-19. This study aims to examine the impact of increases in lesbian, gay, bisexual, transgender, and queer or questioning (LGBTQ) identity-related victimization since the start of COVID-19 on psychological distress among SGM college students. Methods: A nonprobability, cross-sectional online survey was conducted between May and August 2020 to explore the psychological impacts of COVID-19 on U.S. SGM college students (N = 565). Previously validated scales were used to measure LGBTQ identity-related victimization and psychological distress. Chi-square tests of independence, independent samples T-tests, and adjusted logistic regression were used to examine the study aim. Results: Adjusted logistic regression findings revealed that reporting past year+more frequent LGBTQ identity-related victimization since the start of COVID-19 (compared to no report) was associated with over four times greater odds of experiencing moderate to severe psychological distress. Conclusion: Findings highlight the importance of research, practice, and policy stakeholders toward addressing the unique identity-related mental health needs and victimization experiences of SGM college students. Mental health, social service, and higher education practitioners have an important opportunity and responsibility toward identifying and intervening on SGM college students and young adults facing identity-related victimization amid the ongoing COVID-19 pandemic.

Understanding self-harm urges and behavior amongst non-binary young adults: A grounded theory study

Introduction: This study aims to gain a greater understanding of self-harm amongst non-binary young adults and what helps to manage these urges. Method: Data was collected from 11 participant interviews and analyzed in line with grounded theory principles. Results: Findings highlighted how factors associated with growing up feeling outside of the binary, family discord, and the pain of living in a cisnormative society were associated with self-harm. Results describe what helps to manage selfharm and the impact of COVID-19. Conclusion: Findings extend existing research and offer clinical implications and highlight a need for increased understanding and acceptance of non-binary identities.

Associations between living arrangement and sexual and gender minority stressors among university students since the start of the COVID-19 pandemic.

OBJECTIVE: To examine the associations between COVID-19-related living arrangements and sexual and gender minority (SGM)-related stressors (ie, identity concealment and familial rejection). PARTICIPANTS: N = 478 SGM university students (Mage = 22 years, SD = 4.00). METHODS: SGM university students were surveyed cross-sectionally between May and August 2020 regarding SGM-related stressors and living arrangements since the start of COVID-19. RESULTS: Approximately half (48.7%) of the sample reported a living rearrangement to their parents' home due to COVID-19. Living rearrangement to parents' homes was associated with an increased degree of identity concealment (ß [95% C.I.] = 0.62 [0.10, 1.15]; p = .020) and familial rejection (ß [95% C.I.] = 1.56 [0.72, 2.41]; p < .001) since the start of COVID-19 compared to stably living without parents (34.3%). Stably living with parents (17.0%) was not associated with increased degree of SGM-related stressors compared to experiencing a living rearrangement. CONCLUSIONS: Stakeholders must consider the unique identity-related vulnerabilities of SGM students living with parents and who experience living rearrangements due to COVID-19.

Minority stress, pandemic stress, and mental health among gender diverse young adults: Gender dysphoria and emotion dysregulation as mediators

Gender diverse people in the United States are uniquely vulnerable to deleterious health outcomes because of long-enshrined systems of oppression and marginalization in American society. Trans young adults are especially vulnerable to these deleterious outcomes owing to their unique position in the life course. However, more research is needed on the mechanisms through which this marginalization contributes to mental health disparities in trans populations. Using a minority stress framework and online cross-sectional survey design, the current study examines potential mediators of the relationship between transgender identity-related distal stress and psychological distress from late May to early July 2020 in a sample of transgender young adults (N = 239;ages 18-29). More than half the sample scored above the K6 cutoff for severe psychological distress. Distal stress had a significant direct (beta = .17, SE = .04, t = 2.76, p = .006) and indirect effect on psychological distress. Distal stress was indirectly associated with psychological distress through gender dysphoria (beta = .04;95% CI [.001, .10]) and emotion dysregulation (beta = .16;95% CI [.09, .23]). COVID-19 pandemic stressors were also positively associated with psychological distress (beta = .36, SE = .12, t = 5.95, p < .001). Results highlight the significant mental health burden facing the trans community especially in the COVID-19 context, support a conceptualization of gender dysphoria as connected to experiences of oppression, and affirm the relevance of emotion dysregulation within minority stress frameworks. Mental health resources cognizant of the specific challenges experienced by trans young adults as well as policy changes that seek to address underlying structural transphobia in American culture and institutions are urgently needed. (PsycInfo Database Record (c) 2022 APA, all rights reserved) Impact Statement This study surveying young adults with minority gender identities found (a) high rates of psychological distress during COVID-19, (b) that pandemic stress was associated with greater psychological distress, and (c) transphobic discrimination was associated with greater gender dysphoria and emotion dysregulation, which were both associated with greater psychological distress. This highlights the mechanisms underlying trans health disparities and the importance of recognizing transphobic/cisnormative experiences and systems of oppression when conducting research, creating policies, and/or providing services to support the transgender community. (PsycInfo Database Record (c) 2022 APA, all rights reserved)