Transgender stigma: A critical scoping review of definitions, domains, and measures used in empirical research

Abstract

Rationale: A growing body of transgender (trans) health research has explored the relationship between stigma and health; yet, studies have conceptualized and operationalized anti-trans stigma in multiple ways.

Objective: This scoping review aims to critically analyze quantitative measures of anti-trans stigma in the U.S. using a socioecological framework.

Method: We organized and appraised measures from 126 included articles according to socioecological level: structural, interpersonal, or individual.

Results: Of the identified articles, 36 measured anti-trans stigma at the structural level (i.e., institutional structures and policies), 102 measured anti-trans at the interpersonal level (i.e., community interactions), and 44 measured anti-trans stigma at the individual level (i.e., internalized or anticipated stigma). Definitions of anti-trans stigma varied substantially across articles. Most measures were adapted from measures developed for other populations (i.e., sexual minorities) and were not previously validated for trans samples.

Conclusions: Studies analyzing anti-trans stigma should concretely define anti-trans stigma. There is a need to develop measures of anti-trans stigma at all socioecological levels informed by the lived experiences of trans people.

Keywords: Measurement; Stigma; Transgender; United States.

Fig. 1:

Flow diagram of included and excluded records.

Fig. 2,

Proportions of included studies that measured stigma at each socioecological level.