Examining the Psychometric Properties of the Transgender Identity Survey in Residents of Puerto Rico: A Preliminary Analysis
Keywords:
internalized transphobia, attitudes, transgender, stigmaAbstract
The transgender (trans) community in Puerto Rico has historically been addressed according to the gender binary. Trans people pursuing these binary paradigms could experience internalized transphobia. The objectives of the study are: (1) to examine the psychometric properties of the Transgender Identity Survey (TIS) translated into Spanish and, (2) to evaluate the factorial structure of the instrument. The sample consisted of 58 trans and gender non-conforming adult individuals. A discrimination analysis was carried out using point-biserial correlation. Cronbach's Alpha was obtained for the TIS (α=.88). A confirmatory factor analysis was performed to evaluate the original structure of the TIS. The results did not show a good fit, so an alternate three-factor model with a better fit of the model is proposed χ2 = 132.9, RMSEA = .175, SRMR = .0908, CFI = .89 y TLI = .91. Finally, the preliminary findings, limitations and contributions of the research are presented.
References
Acolatse, N. (2020). Health Disparities among Lesbian, Gay, Bisexual, and Transgender Population in Ghana. Texila International Journal of Nursing, 6(1), 84–96. doi:10.21522/tijnr.2015.06.01.art009
Anzani, A., Biella, M., Scandurra, C., & Prunas, A. (2022). Desire for Genital Surgery in Trans Masculine Individuals: The Role of Internalized Transphobia, Transnormativity and Trans Positive Identity. International journal of environmental research and public health, 19(15), 8916. https://doi.org/10.3390/ijerph19158916
Auerbach, J. D., Moran, L., Watson, C., Weber, S., Keatley, J., & Sevelius, J. (2020). We Are All Women: Barriers and Facilitators to Inclusion of Transgender Women in HIV Treatment and Support Services Designed for Cisgender Women. AIDS patient care and STDs, 34(9), 392–398. https://doi.org/10.1089/apc.2020.0056
Bandini, E., & Maggi, M. (2014). Transphobia. Emotional, Physical and Sexual Abuse: Impact in Children and Social Minorities, 9783319067, 49–59. https://doi.org/10.1007/978-3-319-06787-2_4
Bockting, W. O., Miner, M. H., Swinburne Romine, R. E., Dolezal, C., Robinson, B. B. E., Rosser, B. R. S., & Coleman, E. (2020). The Transgender Identity Survey: A Measure of Internalized Transphobia. LGBT Health, 7(1), 15–27. https://doi.org/10.1089/lgbt.2018.0265
Bockting, W. O., Miner, M. H., Swinburne Romine, R. E., Robinson, B. E.,
Rosser, B. R. S., & Coleman, E. (2014). The Transgender Identity Survey: A measure of internalized transphobia. Manuscript submitted for publication.
Brislin, R. W. (1970). Back-translation for cross-cultural research. Journal of Cross-Cultural Psychology, 1(3), 185–216. https://doi.org/10.1177/135910457000100301
Campo-Arias, A., & Oviedo, H. C. (2008). Propiedades Psicométricas de una Escala: la Consistencia Interna. Revista de Salud Pública, 10(5), pp. 831-839. https://doi:10.1590/s0124 00642008000500015
Cárdenas Castro, M., Saiz Vidallet, J. L., Barrientos Delgado, J., Espinoza Tapia, R., Linker San Juan, D., Gómez Ojeda, F., … Saavedra Lovera, L. (2021). Recomendaciones para la investigación psicológica con personas transgénero: Una aproximación desde una experiencia en Chile. Interdisciplinaria. Revista de Psicología y Ciencias Afines, 38(1). doi:10.16888/interd.2021.38.1.14
Chakrapani, V., Newman, P. A., Shunmugam, M., Logie, C. H., & Samuel, M. (2015). Syndemics of depression, alcohol use, and victimisation, and their association with HIV-related sexual risk among men who have sex with men and transgender women in India. Global Public Health, 12(2), 250–265. https://doi.org/10.1080/17441692.2015.1091024
Chakrapani, V., Vijin, P. P., Logie, C. H., Newman, P. A., Shunmugam, M., Sivasubramanian, M., & Samuel, M. (2017). Assessment of a “Transgender Identity Stigma” scale among trans women in India: Findings from exploratory and confirmatory factor analyses. International Journal of Transgenderism, 18(3), 271–281. doi:10.1080/15532739.2017.1303417
Champion, D. (1981). Basic statistics for social research. New York: McMillan
Cohen, J. (1988). Statistical Power Analysis for the Behavioral Sciences (2nd ed.). Routledge. https://doi.org/10.4324/9780203771587
de Vries, E., Kathard, H., & Müller, A. (2020). Debate: Why should gender-affirming health care be included in health science curricula?. BMC medical education, 20(1), 51. https://doi.org/10.1186/s12909-020-1963-6
Ebel, R. L., & Frisbie, D. A. (1991). Essentials of educational measurement. In Journal of School Psychology (5th ed.). Englewoods Cliffs. https://doi.org/10.1016/0022-4405(73)90057-5
Fabbre, V. D., & Gaveras, E. (2020). The manifestation of multilevel stigma in the lived experiences of transgender and gender nonconforming older adults. The American journal of orthopsychiatry, 90(3), 350–360. https://doi.org/10.1037/ort0000440
Field, A. (2018). Discovering statistics using IBM SPSS Statistics (5th ed.). SAGE Publications.
Figueroa, W. S., Zoccola, P. M., Manigault, A. W., Hamilton, K. R., Scanlin, M. C., & Johnson, R. C. (2021). Daily stressors and diurnal cortisol among sexual and gender minority young adults. Health Psychology, 40(2), 145–154. https://doi.org/10.1037/hea0001054
Flentje, A., Clark, K. D., Cicero, E., Capriotti, M. R., Lubensky, M. E., Sauceda, J., Neilands, T. B., Lunn, M. R., & Obedin-Maliver, J. (2022). Minority Stress, Structural Stigma, and Physical Health Among Sexual and Gender Minority Individuals: Examining the Relative Strength of the Relationships. Annals of behavioral medicine : a publication of the Society of Behavioral Medicine, 56(6), 573–591. https://doi.org/10.1093/abm/kaab051
Gamarel, K. E., Reisner, S. L., Laurenceau, J. P., Nemoto, T., & Operario, D. (2014). Gender minority stress, mental health, and relationship quality: a dyadic investigation of transgender women and their cisgender male partners. Journal of family psychology : JFP : journal of the Division of Family Psychology of the American Psychological Association (Division 43), 28(4), 437–447. https://doi.org/10.1037/a0037171
Giffort, D. M., & Underman, K. (2016). The relationship between medical education and trans health disparities: a call to research. Sociology Compass, 10(11), 999–1013. doi:10.1111/soc4.12432
Grant J. M., Mottet L, Tanis J. E., Harrison J, Herman J, K. M. (2011). Injustice at Every Turn: A Report of the National Transgender Discrimination Survey. National Center for Transgender Equality and National Gay and Lesbian Task Force. https://doi.org/10.1016/S0016-7878(90)80026-2
Hu, L., & Bentler, P. M. (1999). Cutoff criteria for fit indexes in covariance structure analysis: conventional criteria versus new alternatives. Structural Equation Modeling: A Multidisciplinary Journal, 6(1), 1–55.
Kessler, R., Barker, P., Colpe, L., Epstein, J., Gfroerer, J., Hiripi, E. et al. (2003). Screening for serious mental illness in the general population. Archives of General Psychiatry, 60(2), 184-189. https://doi.org/10.1001/archpsyc.60.2.184
Lacombe-Duncan, A., Kia, H., Logie, C. H., Todd, K. P., Persad, Y., Leblanc, G., Nation, K., Scheim, A. I., Lyons, T., Horemans, C., & Loutfy, M. (2021). A qualitative exploration of barriers to HIV prevention, treatment and support: Perspectives of transgender women and service providers. Health & social care in the community, 29(5), e33–e46. https://doi.org/10.1111/hsc.13234
Lefevor, G. T., Boyd-Rogers, C. C., Sprague, B. M., & Janis, R. A. (2019). Health disparities between genderqueer, transgender, and cisgender individuals: An extension of minority stress theory. Journal of counseling psychology, 66(4), 385–395. https://doi.org/10.1037/cou0000339
Lelutiu-Weinberger, C., Wilton, L., Koblin, B. A., Hoover, D. R., Hirshfield, S., Chiasson, M. A., Nandi, V., Usher, D., & Frye, V. (2020). The Role of Social Support in HIV Testing and PrEP Awareness among Young Black Men and Transgender Women Who Have Sex with Men or Transgender Women. Journal of urban health : bulletin of the New York Academy of Medicine, 97(5), 715–727. https://doi.org/10.1007/s11524-019-00396-8
Lin, Y., Xie, H., Huang, Z., Zhang, Q., Wilson, A., Hou, J., Zhao, X., Wang, Y., Pan, B., Liu, Y., Han, M., & Chen, R. (2021). The mental health of transgender and gender non-conforming people in China: a systematic review. The Lancet. Public health, 6(12), e954–e969. https://doi.org/10.1016/S2468-2667(21)00236-X
Madera, S. L., Díaz, N. V., Padilla, M., Pibernus, X. R., Neilands, T. B., Segarra, E. R., Velázquez, C. M., & Bockting, W. (2019). "Just Like Any Other Patient": Transgender Stigma among Physicians in Puerto Rico. Journal of health care for the poor and underserved, 30(4), 1518–1542. https://doi.org/10.1353/hpu.2019.0089
Martínez-Vélez, J. J., Melin, K., & Rodriguez-Diaz, C. E. (2019). A Preliminary Assessment of Selected Social Determinants of Health in a Sample of Transgender and Gender Nonconforming Individuals in Puerto Rico. Transgender Health, 4(1), 9–17. https://doi.org/10.1089/trgh.2018.0045
Meyer, I. H. (2003). Prejudice, Social Stress, and Mental Health in Lesbian, Gay, and Bisexual Populations: Conceptual Issues and Research Evidence. Psychological Bulletin, 129(5), 674–697. https://doi.org/10.1037/0033-2909.129.5.674
Newman, P. A., Reid, L., Tepjan, S., & Akkakanjanasupar, P. (2021). LGBT+ inclusion and human rights in Thailand: a scoping review of the literature. BMC public health, 21(1), 1816. https://doi.org/10.1186/s12889-021-11798-2
Otero-Cordero, C. T., Pérez-Pedrogo, C., & Rosario-Rodríguez, A. (2020). Efecto Mediador de la Angustia Psicológica y la Satisfacción Sexual en Puertorriqueños con Cáncer de Próstata. Revista Caribeña de Psicología, 4(3), 191–203. https://doi.org/10.37226/rcp.v4i3.4953
Reisner, S. L., Poteat, T., Keatley, J., Cabral, M., Mothopeng, T., Dunham, E., Holland, C. E., Max, R., & Baral, S. D. (2016). Global health burden and needs of transgender populations: a review. Lancet (London, England), 388(10042), 412–436. https://doi.org/10.1016/S0140-6736(16)00684-X
Rodríguez-Madera, S., Ramos-Pibernus, A., & Varas Díaz, N. (2015). Radiografía de las comunidades trans en PR. Radiografiía de Las Comunidades Trans En Puerto Rico: Visibilizando Femineidasdes y Masculinidades Anternas, March, 1–35. https://www.researchgate.net/publication/296706120
Sánchez, N. F., Sánchez, J. P., & Danoff, A. (2009). Health Care Utilization, Barriers to Care, and Hormone Usage Among Male-to-Female Transgender Persons in New York City. American Journal of Public Health, 99(4), 713–719. doi:10.2105/ajph.2007.132035
Scandurra, C., Bochicchio, V., Amodeo, A. L., Esposito, C., Valerio, P., Maldonato, N. M., Bacchini, D., & Vitelli, R. (2018). Internalized transphobia, resilience, and mental health: Applying the psychological mediation framework to Italian transgender individuals. International Journal of Environmental Research and Public Health, 15(3). https://doi.org/10.3390/ijerph15030508
Shannon, K., Crago, A. L., Baral, S. D., Bekker, L. G., Kerrigan, D., Decker, M. R., Poteat, T., Wirtz, A. L., Weir, B., Boily, M. C., Butler, J., Strathdee, S. A., & Beyrer, C. (2018). The global response and unmet actions for HIV and sex workers. Lancet (London, England), 392(10148), 698–710. https://doi.org/10.1016/S0140-6736(18)31439-9
Shaw, S. Y., Lorway, R. R., Deering, K. N., Avery, L., Mohan, H. L., Bhattacharjee, P., Reza-Paul, S., Isac, S., Ramesh, B. M., Washington, R., Moses, S., & Blanchard, J. F. (2012). Factors Associated with Sexual Violence against Men Who Have Sex with Men and Transgendered Individuals in Karnataka, India. PLoS ONE, 7(3), e31705. https://doi.org/10.1371/journal.pone.0031705
Su, D., Irwin, J. A., Fisher, C., Ramos, A., Kelley, M., Mendoza, D. A. R., & Coleman, J. D. (2016). Mental Health Disparities Within the LGBT Population: A Comparison Between Transgender and Nontransgender Individuals. Transgender Health, 1(1), 12–20. doi:10.1089/trgh.2015.0001
Testa, R. J., Habarth, J., Peta, J., Balsam, K., & Bockting, W. (2015). Development of the Gender Minority Stress and Resilience Measure. Psychology of Sexual Orientation and Gender Diversity, 2(1), 65–77. https://doi.org/10.1037/sgd0000081
Valentine, S. E., & Shipherd, J. C. (2018). A systematic review of social stress and mental health among transgender and gender non-conforming people in the United States. Clinical psychology review, 66, 24–38. https://doi.org/10.1016/j.cpr.2018.03.003
Vázquez-Rivera, M., Martínez-Taboas, A., Francia Martínez, M., & Toro-Alfonso, J. (2016). LGBT 101: Una mirada introductoria al colectivo.
Vélez-Ríos, B., Martínez-Taboas, A., & Pérez-Pedrogo, C. (2021). Efecto del manejo de identidad LGBTT+ en el bienestar psicológico. Revista Caribeña de Psicología, 5, e5455. https://doi.org/10.37226/rcp.v5i1.5455
Williams-Colón, G., Alicea-Cruz, A. J., & Pérez-Pedrogo, C. (2021). Propiedadespsicometricas de la Escala de Actitudes Negativas hacia Personas Trans en proveedores de salud en Puerto Rico. Ciencias de la Conducta, 36(1), 80-91.
Winter, S., Diamond, M., Green, J., Karasic, D., Reed, T., Whittle, S., & Wylie, K. (2016). Transgender people: health at the margins of society. The Lancet, 388(10042), 390–400. doi:10.1016/s0140-6736(16)00683-8