Stigma, Health, and Psychosocial Functioning Among Transgender Active Duty Service Members in the U.S. Military

Transgender persons face frequent instances of stigma that may make them vulnerable to adverse mental and physical health outcomes. To date, however, few studies have assessed gender identity–related stigma and its psychosocial correlates among active duty transgender military personnel. To assess the associations of stigma with psychosocial functioning and health, U.S. military personnel self-identifying as transgender completed anonymous online measures of stigmatizing situations within the military, health, psychosocial functioning, eating pathology, risk behaviors, and coping strategies. Participants also described their worst experience of gender identity–related stigma within the military. In total, 174 service members (28.8 ± 6.3 years, 50.6% transmale, 71.3% non-Hispanic White, 7.8 ± 5.5 years in service) completed the survey. The majority (93%) reported at least 1 instance of gender identity–related stigma in the military, including bullying and barriers to obtaining gender-affirming services. Although service members reported generally good health and psychosocial functioning, stigma in the military was significantly associated with poorer overall mental health and greater depression, anxiety, and stress, after adjusting for age, gender identity, race, and service rank. Stigma was unrelated to self-reported physical health. Of 14 different coping behaviors assessed, only positive reframing was associated with better mental health. The current study indicates that stigma within the military is reported by the majority of service members self-identifying as transgender and is associated with poor mental health, above and beyond the contribution of relevant covariates. Additional research is needed to identify those at greatest risk for the adverse effects of stigma.