Perceived Effect of Race/Ethnicity, Place, and Religion on Gender Identity: Findings from a Nationwide Sample of Transgender, Nonbinary, and Gender Diverse Young Adults in the U.S.

Transgender, nonbinary, and gender diverse young adults (TGD-YA) experience mental health inequities. Negative experiences coming out (disclosing gender identity) and/or understanding gender identity can adversely affect mental health. This formative study explored the perceived effect of race/ethnicity, place, and religion on TGD-YA experiences of coming out/understanding gender. In August 2022, a U.S. nationwide sample of TGD-YA ages 18–25 years (n = 104) completed a cross-sectional survey including sociodemographics and coming out/understanding gender experiences. Three questions asked about the extent to which race/ethnicity, place, and religion made it harder to come out/understand gender. Descriptive and bivariate analyses assessed prevalence of each of these and associations of race/ethnicity, place, and family religion. Firth’s penalized logistic regression models were fit for individual-level TGD-YA characteristics; a random-intercept multilevel model was used for contextual-level anti-transgender legislative state policy. Mean age was 21.8 years; 46% were people of color (POC); 66% were nonbinary; 33% resided in the South and 19% Midwest; 34% lived in a state with anti-transgender legislation; 53% reported Christian family religion. TGD-YA who were POC, lived in a state with anti-transgender legislation, and had a Christian family religion had the highest odds of reporting that race/ethnicity, place, and religion, respectively, made it “harder” to come out/understand gender (p < 0.05). Experiences coming out/understanding gender for TGD-YA were affected by race/ethnicity, geographic context, and family religion. Findings suggest the need for supportive interventions that address intersectional stigma, including supportive gender-related state policies given the association of state-level anti-transgender legislation with difficulties coming out/understanding gender.