Intimate partner violence (IPV) refers to physical, psychological, and/or sexual abuse or aggression by or toward an intimate partner (e.g., spouse, boyfriend/girlfriend, romantic or sexual partner; Breiding et al., 2015). These experiences have been linked to several adverse mental health outcomes, including symptoms of depression, anxiety, and posttraumatic stress disorder (PTSD; Lagdon et al., 2014). These findings have led IPV to be recognized as a significant, common health issue in the general population; however, less attention has been paid to the experiences and consequences of IPV among transgender and gender diverse (TGD) people (i.e., those whose gender identity and/or expression differs from their sex assigned at birth; American Psychological Association 2015; Peitzmeier et al., 2020).

Nevertheless, a growing body of research suggests that multiple forms of IPV victimization may be prevalent among TGD individuals. Specifically, a recent systematic review of IPV prevalence among TGD people (Peitzmeier et al., 2020) found that the rates of any lifetime IPV victimization ranged from 6.3 to 83.3%, with a median of 37.5% prevalence of lifetime physical victimization, 25.0% of lifetime sexual victimization, 16.7% of past-year physical victimization, and 10.8% of past-year sexual victimization. Indeed, the same review found that TGD people appear to experience IPV victimization – especially physical victimization – at higher rates than their cisgender peers, regardless of sexual orientation. The reviewed studies also indicated that TGD people may be more likely to experience psychological or sexual IPV victimization than cisgender people, although the disparities were not always statistically significant. These disparities have also been observed among college-aged TGD and cisgender individuals (Whitfield et al., 2021).

TGD people also experience identity-specific forms of violence and/or aggression within their intimate relationships. For example, perpetrators may restrict a TGD person’s access to valuable resources, such as gender affirming treatment or community-level support, in order to maintain power and control (Cook-Daniels, 2015). Indeed, measures have been developed to assess these identity-specific forms of IPV, including transgender-related IPV (T-IPV; Peitzmeier et al., 2019) and identity abuse related to one’s sexual and/or gender minority identity (IA; Scheer et al., 2019), in recent years. More specifically, the T-IPV Scale assess dimensions of IPV that are specific to TGD individuals, including control over a partner’s gender presentation or transition, attempts to sabotage a partner’s transition, and telling a partner that TGD people are undesirable (Peitzmeier et al., 2019). The IA Scale, by contrast, captures a broader set of abusive behaviors related to one’s gender and/or sexual identity, including forced public affection, limiting community support, threatening to out, and psychological abuse related to one’s gender and/or sexual identity (Scheer et al., 2019). One sample of transmasculine individuals reported rates of lifetime and past-year T-IPV to be 38.9% and 10.1% respectively (Peitzmeier et al., 2019). Similarly, a study of IA among LGBTQ + people found that TGD participants reported the highest rates of lifetime and past-year IA, at 49.3% and 18% respectively, as compared to their cisgender counterparts (Woulfe & Goodman, 2021). Both studies underscore the importance of aspects of IPV that are specific to gender minority identities, and that may not be captured by measures of IPV that were designed for use with cisgender, heterosexual people.

Studies of IPV victimization prevalence rates among TGD individuals have rarely compared subgroups within this population. However, some past research reviewed by Peitzmeier et al. (2020) found no difference in IPV victimization across sex assigned at birth, demonstrating that TGD people who were assigned female at birth (AFAB) were just as likely to experience IPV victimization as those who were assigned male at birth (AMAB). Similarly, no differences in IPV victimization have been observed between binary (e.g., transgender man, transgender woman) and nonbinary (e.g., gender nonbinary, gender nonconforming, genderqueer, genderfluid, etc.) transgender people. However, these studies have generally not examined sex assigned at birth or binary/nonbinary identity in relation to more specific forms of victimization and perpetration (i.e., psychological, physical, sexual IPV), or in relation to identity-specific IPV such as IA and T-IPV.

Mental Health Among TGD People

TGD individuals are at greater risk for a variety of mental health problems compared to their cisgender peers, including depression, anxiety, and PTSD. For example, past research has established that TGD individuals are more likely to be depressed than cisgender men and women (Klemmer et al., 2021; Oswalt & Lederer, 2017; (Reisner et al., 2014, 2016a). Regarding anxiety disorders, past studies suggest that TGD youth and young adults are more likely to be diagnosed with an anxiety disorder than their cisgender counterparts (Oswalt & Lederer, 2017; (Reisner et al., 2014, 2016a). And while limited research has been conducted on PTSD among TGD people in general, one study of homeless LGBTQ + people found that transgender men and women were more than three times as likely to report a PTSD diagnosis, as compared to cisgender men and women (Flentje et al., 2016). Similarly, another more recent study found that transgender military veterans were significantly more likely to be diagnosed with PTSD than cisgender veterans (Wang et al., 2021).

Certain sociodemographic characteristics may place TGD individuals at further vulnerability for these negative mental health outcomes. For example, one study found that TGD people of color reported higher levels of depression and anxiety than White TGD individuals (Lefevor et al., 2019). Similarly, Latina transgender women were observed to be at elevated risk for depression compared to White transgender women (Bazargan & Galvan, 2012). There is also evidence that nonbinary individuals experience anxiety at higher rates than binary transgender people (Cheung et al., 2020; Stanton et al., 2021). Younger TGD people are also at higher risk for anxiety than older TGD people (Puckett et al., 2021; Seelman et al., 2017). Additionally, lower socioeconomic status was associated with higher rates of anxiety in two studies of TGD samples (McDowell et al., 2019; Seelman et al., 2017). Unemployment was also associated with higher rates of PTSD among transgender people (Seelman et al., 2017). Finally, lower educational attainment was associated with depression in TGD individuals (Hoffman, 2014). On the other hand, there has been little prior research regarding the differences in negative mental health outcomes by sexual orientation among TGD populations. However, past research has extensively documented that sexual minorities experience higher rates of depression and anxiety than their heterosexual counterparts (Institute of Medicine, 2011).

IPV and Mental Health Among TGD People

Despite the established relationship between IPV and negative mental health outcomes in other populations, only a few studies have directly examined these associations among TGD people. One such study (Henry et al., 2021) examined the associations between several mental health outcomes and four different types of IPV: psychological, physical, sexual, and injury victimization. Results from the study indicated that all four forms of IPV were positively correlated with anxiety, and all but physical IPV victimization were associated with depression. However, other studies have found physical IPV to correlate with depression. For example, Bukowski et al. (2019) found that past-year physical IPV victimization was associated with greater depressive symptomatology in a sample of Black transgender women. Another study found similar results in TGD youth (Goldenberg et al., 2018), showing that those with depression were almost 8 times more likely to report lifetime physical IPV victimization compared to those without depression. Lastly, depressive symptoms were associated with multiple forms of victimization in a sample of TGD adults, including physical and sexual IPV victimization (White Hughto et al., 2017).

While these studies have made important contributions to the literature, there has been limited research that considers the associations between identity-specific forms of IPV and mental health of TGD populations. One such study (Peitzmeier et al., 2019) found that lifetime T-IPV was significantly associated with past-month PTSD symptoms and past-week depressive symptoms in a sample of adult TGD people. Similarly, Woulfe and Goodman (2020) found that IA was associated with depressive and PTSD symptoms above and beyond general forms of IPV among a TGD subset of LGBTQ adults. Taken together, these studies suggest that identity-specific forms of IPV are important to consider when studying IPV and its implications among TGD populations. Notably, however, no studies have examined T-IPV or IA as they relate to anxiety.

Young Adulthood

While some studies have examined IPV victimization in general samples of TGD adults, few studies have focused specifically on TGD youth or young adults. The lack of research assessing TGD emerging and young adults is noteworthy, as this period is characterized by important developmental changes, such as initiating romantic relationships, moving away from home, and increased substance use and sexual behaviors (Arnett, 2000). These developmental changes may also coincide with transition-related milestones. Specifically, despite some variance among different TGD identity groups, emerging and young adulthood have been documented as a key period when TGD people, especially those of younger generations, adopt a TGD identity and initiate major social and/or medical transition processes (Puckett et al., 2021; Tatum et al., 2020). These transition steps may include coming out as TGD, starting gender-affirming care (e.g., hormone treatment, gender-affirming surgeries), living as one’s affirmed gender, and changing one’s legal gender marker. Of the few studies that examine IPV among TGD young adults, most focus on only one or two forms of IPV (e.g., Bhochhibhoya et al., 2021; Cantor & Fisher, 2015) and/or only include a subgroup of TGD identities as part of the sample (e.g., Smith et al., 2017). Moreover, no studies to date have examined experiences of IA and T-IPV among TGD emerging and young adults specifically.

Gaps in the Literature

While there is a growing body of research regarding IPV among TGD young adults, there are several notable gaps in the literature. First, while some studies have examined physical and sexual forms of IPV victimization in this population, few studies have examined verbal, emotional, and/or psychological IPV victimization (hereafter referred to as psychological IPV). As such, it is difficult to estimate the prevalence of these deleterious experiences. Second, no studies have examined IA or T-IPV among TGD young adults specifically, highlighting the need for greater use of population-specific measures of IPV. Additionally, few studies have assessed sociodemographic differences in IPV, IA, and T-IPV among TGD people, and among TGD young adults in particular. Understanding these potential sociodemographic differences may allow TGD subgroups that might be at heightened risk for these experiences of violence and abuse to be identified, and for outreach and intervention efforts to be shaped accordingly. Finally, few studies have examined IPV, IA, and T-IPV in relation to mental health outcomes in this population and, to our knowledge, no studies have examined these factors collectively in their associations with mental health symptoms. Assessing the extent to which these identity-specific forms of IPV relate to mental health outcomes may allow us to better address these problems and to target them in a holistic fashion.

Current Aims

Given the gaps in the extant literature, the current study had the following exploratory aims: (1) to estimate the prevalence of lifetime and past-year psychological, physical, and sexual IPV victimization, IA, and T-IPV in a sample of (N = 200) TGD young adults in New York City; and (2) to assess the associations between lifetime and past-year psychological, physical, and sexual IPV victimization, IA, and T-IPV with symptoms of depression, anxiety, and PTSD in the sample.

Materials and Methods

Participants and Procedures

Two-hundred self-identified TGD young adults residing in the greater New York City area participated in the current study. In-person data collection started in July 2019 and ended in early March 2020 due to the COVID-19 pandemic. Participants were recruited via active and passive methods, including via (1) in-person events (e.g., Pride events), (2) social media posts (Facebook, Instagram, Twitter, Reddit), (3) online dating apps (Tinder, Grindr), (4) LGBTQ-related email listservs, and (5) referrals from transgender health care providers and institutions, LGBTQ + organizations, and previous participants of the study. All participants were initially screened based on self-reported age, gender identity, fluency in English, and place of residence. To be eligible for the current study, participants had to (1) be between the ages of 18 and 30 years old; (2) self-identify as transgender or gender nonconforming (e.g., transgender man, transgender woman, gender nonbinary, genderqueer, genderfluid, agender); (3) be capable of reading and responding in English; and (4) be able to attend an onsite visit to the lab.

Eligible participants came to the lab and completed a computer-based survey (Qualtrics) that assessed sociodemographic information, experiences of both IPV perpetration and victimization (i.e., psychological, physical, and sexual), experiences of identity-specific IPV, and three mental health outcomes. Written informed consent was obtained from all participants included in the study. Respondents received $35 for their participation and were given the opportunity to engage in a participant referral program for additional compensation. Specifically, participants who were willing to refer others to the study were given a referral number and received $5 for each eligible referral (maximum four referrals). All study activities were approved by the Institutional Review Board of (BLINDED FOR REVIEW).

Measures

Sociodemographic Information

Sociodemographic information was obtained via multiple-choice questions in the sociodemographic section of the survey, including age, born in the United States (U.S.), generational status, race/ethnicity, gender identity, sexual identity, perceived socioeconomic status (SES), educational level, employment status, and living as one’s affirmed gender.

Age

Age was assessed continuously using a single self-report item.

Born in the United States

Whether participants were born in the U.S. was assessed using a single yes/no item.

Generational Status

Generational status was assessed using a single item (“What is your generational status?”) with the following response choices: first generation (i.e., you and one/both of your parents were born outside the U.S.), second generation (i.e., you were born in the U.S. but one/both parents were born outside the U.S.), third generation (i.e., you and your parents were born in the U.S.), and fourth or more generation were born in the U.S.

Race/Ethnicity

Race/ethnicity was measured using two items. The first was a yes/no item: “Do you identify as Hispanic and/or Latino/a/x?”. The second, “What race do you consider yourself to be?”, had the following response choices: White or Caucasian, Black or African American, American Indian or Alaska Native, Asian, Native Hawaiian or Pacific Islander, multi-racial (please specify), and not listed (please specify). For these analyses, the two race/ethnicity variables were collapsed into a single variable and categorized as: White, Latinx, Black, Asian/API, bi/multiracial, and other.

Gender Identity

Gender identity was assessed using a multiple-choice question (single selection) in the sociodemographic section of the survey. The options included male (transgender man/masculine), female (transgender woman/feminine), gender nonbinary, gender nonconforming, genderqueer, genderfluid, agender, two-spirit, and prefer to self-disclose. For these analyses, this variable was recategorized as: male, female, nonbinary, and genderqueer/fluid/non-conforming/agender.

Sexual Identity

Sexual identity was measured using a single item with the following response choices: straight/heterosexual, gay/homosexual, bisexual, pansexual, asexual, prefer to self-disclose, prefer not to say, and queer. For these analyses, the variable was recategorized as: straight, gay/lesbian, bisexual, pansexual, other, and queer.

Perceived Socioeconomic Status

SES was measured using a single item with the following response choices: lower, middle, and upper class.

Educational Level

Education level was assessed using a single item with the following response choices: less than high school degree, high school graduate (high school diploma or equivalent including GED), some college but no degree, associate degree in college (2-year), bachelor’s degree in college (4-year), master’s degree, doctoral degree, and professional degree (JD, MD). For these analyses, this variable was recategorized as: high school or less, some college, college, and graduate school.

Employment Status

Employment status was measured using a single item with the following response choices: working full-time (paid employee), working part-time (paid employee), self-employed, not working (temporary layoff from a job), not working (looking for work), not working (retired), not working (disabled), not working (other), and prefer not to answer. For these analyses, this variable was recategorized as: working full-time, working part-time, self-employed, unemployed (looking for work), disability, full-time student, and other.

Living as Affirmed Gender

Participants reported whether they were living as their affirmed gender (i.e., the gender identity they currently identify with) by answering a single yes/no item (“Do you currently live in your affirmed gender all or almost all of the time? [Your affirmed gender is the one you see as accurate for yourself.]”).

Intimate Partner Violence

General Intimate Partner Violence

Lifetime and past-year experiences of IPV were assessed with a modified version of the Conflict Tactics Scale (CTS; Feldman et al., 2008). The modified version contains 12 yes/no items that record experiences of psychological, physical, and sexual victimization and perpetration, with six items assessing lifetime experiences (e.g., “Have you ever been verbally, emotionally, or psychologically abused by a lover or romantic partner?”) and six assessing past-year experiences (e.g., “In the past year, have you been verbally, emotionally, or psychologically abused by a lover or romantic partner?”).

Identity-Specific Intimate Partner Violence

Identity-specific forms of IPV were assessed using two measures, the Transgender-related Intimate Partner Violence Scale (T-IPV; Peitzmeier et al., 2019) and the Identity Abuse Scale (Woulfe & Goodman, 2021). The T-IPV is a four-item scale that was specifically developed to assess identity-specific experiences of IPV in TGD populations (e.g., “Did a partner threaten or blackmail you into doing something by threatening to ‘out’ you as transgender to someone?”). The response options captured both lifetime and past-year experiences (e.g., “This has never happened,” “Not in the past year, but it did happen,” “Once in the past year,” etc.). The scale demonstrated high reliability in this study (lifetime and past year α = 0.82 and 0.86 respectively). The four items were collapsed to create the two dichotomous variables that were used in these analyses: lifetime T-IPV and past-year T-IPV.

The Identity Abuse Scale is a seven-item scale that measures IPV victimization with homophobic, biphobic, and/or transphobic content. Unlike the T-IPV, which is specific to TGD populations, IA assesses IPV as it relates to one’s sexual identity in addition to their gender identity (e.g., “The person used my sexual orientation or gender identity against me”). The scale demonstrated high reliability in this study (lifetime and past-year α = 0.89 and 0.88 respectively). Like the T-IPV, the response options captured both lifetime and past-year experiences of IA. The seven items were similarly collapsed to create two dichotomous variables to be used in these analyses: lifetime IA and past-year IA.

Mental Health Symptoms

Depression

Depression was assessed using the Patient Health Questionnaire (PHQ-9; Kroenke et al., 2001). The PHQ-9 is a nine-item scale that measures the frequency of depression symptoms during the past 2 weeks. Items were scored on a 4-point Likert scale ranging from 1 (“not at all”) to 4 (“nearly every day”), and a total score was calculated as the sum of each item score, with higher scores indicating greater severity of depression. The PHQ-9 demonstrated excellent internal consistency in this study (α = 0.91).

Anxiety

Anxiety was measured with the General Anxiety Disorder scale (GAD-7; Spitzer et al., 2006). The GAD-7 is a seven-item scale that measures the frequency of general anxiety symptoms during the past 2 weeks. Items were scored on a 4-point Likert scale ranging from 1 (“not at all”) to 4 (“nearly every day”), and a total score was calculated as the sum of each item score, with higher scores indicating greater severity of anxiety. The GAD-7 demonstrated excellent internal consistency in these analyses (α = 0.93).

Posttraumatic Stress Disorder

PTSD was measured with an abbreviated version of the Post-traumatic Stress Disorder Checklist (PCL-6; Lang & Stein 2005). The PCL-6 is a six-item scale that evaluates experiences of PTSD during the past month. Items were scored on a 5-point Likert scale ranging from 1 (not at all) to 5 (extremely), and a total score was calculated as the sum of each item score, with higher scores indicating greater severity of depression. The PCL-6 demonstrated very good internal consistency in this study (α = 0.88).

Analytic Plan

First, descriptive statistics were computed for all variables of interest. Next, bivariate correlations between the lifetime and past-year IPV and mental health variables were calculated. Finally, we used three hierarchical linear regression models to identify the unique contributions of general forms of IPV (i.e., psychological, physical, and sexual IPV) and identity-specific forms of IPV (i.e., IA and T-IPV) in association with recent symptoms of depression, anxiety, and PTSD, while controlling for the sociodemographic covariates. To do so we entered the sociodemographic covariates in the first step of the models. In the next step of each model, we entered the lifetime general and identity-specific forms of IPV. In the final step of each model, we entered the past-year general and identity-specific forms of IPV to determine whether associations between lifetime IPV variables and mental health outcomes remained robust, and whether the past-year IPV variables explained additional variance in mental health outcomes above and beyond lifetime IPV experiences.

For the multivariate models, only cases with complete data were used, resulting in analytic samples of (n = 171) for the model examining depression and (n = 172) for the models examining anxiety and PTSD. Regarding the missing data, no variable had more than 4% missing, and no case had more than 7 of the 23 variables missing. Missing data diagnostics revealed that there were no systematic differences in the missing data by the 10 sociodemographic variables of interest, after 6 outlier cases were removed. And finally, all model assumptions were met to conduct these hierarchical linear regression analyses.

Results

The mean age of participants in the sample was 24.4 years old (SD = 3.2). As displayed in Table 1, the sample was relatively diverse in terms of several sociodemographic characteristics. With respect to gender identity, approximately 35% of participants identified as genderqueer/fluid/non-conforming/agender, while 26% identified as nonbinary, 24% as female, and 16% as male. Regarding sexual identity, approximately 28% of participants identified as queer, 20% as pansexual, 14% as gay or lesbian, 14% as bisexual, 13% as straight, and 12% reported a sexual identity that was not listed. With respect to race/ethnicity, approximately 37% of participants identified as White, 29% as Latinx, 21% as Black, 8% as bi/multiracial, 4% as Asian/API, and 3% identified with a race/ethnicity category that was not listed. All other sociodemographic characteristics are summarized in Table 1.

Table 1 Sociodemographic characteristics of a sample of (N = 200) transgender and gender diverse young adults in New York City
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The prevalence of each IPV variable is summarized in Table 2. Regarding lifetime IPV, IA was the most prevalent (57.0%), followed by sexual IPV (40.0%), physical IPV (38.5%), T-IPV (35.5%), and psychological IPV (32.5%). With respect to past-year IPV, psychological IPV was most common (29.0%), followed by IA (27.5%), physical IPV (20.0%), T-IPV (14.0%), and sexual IPV (12.5%). All of the lifetime and past-year IPV variables were significantly correlated with each other, but the relationships varied in strength (r = .16 to 0.67; see Table 2). Additionally, all of the mental health variables were moderately to strongly correlated with one another (r = .65 to 0.72).

Table 2 Prevalence and bivariate correlations between lifetime and past-year intimate partner violence and mental health variables among a sample of (N = 200) transgender and gender diverse young adults in New York City
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Hierarchical Regression Models

Depression

The mean depression score was 11.5 (SD = 7.4). The results of the hierarchical linear regression model examining depression are presented in Table 3a. In step one of the hierarchical model, SES (B = -2.21, p = .034) and education (B = 1.57, p = .043) were associated with depression (R2 = 0.09, F(10, 160) = 4.04, p = .138). At step two, the addition of the lifetime IPV variables was associated with a significant change in the variance accounted for in the model (ΔR2 = 0.15, F(5, 155) = 7.10, p < .001). In this step, reporting lifetime IA (B = 3.37, p = .012) was associated with higher depression scores; SES and education were no longer statistically significant at this step. At step three, the addition of the past-year IPV variables was not associated with a significant change in the variance accounted for in the model. However, lifetime IA (B = 3.78, p = .012) and past-year T-IPV (B = 5.66, p = .010) were associated with higher depression scores in this final step.

Table 3a Hierarchical linear regression models predicting symptoms of depression in a sample of (n = 171) transgender and gender diverse young adults in New York City
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Anxiety

The mean anxiety score was 11.3 (SD = 6.6). The results of the hierarchical linear regression model examining anxiety are presented in Table 3b. None of the sociodemographic variables were significantly associated with higher anxiety scores in step one of the model (R2 = 0.05, F(10, 161) = 0.80, p = .63). At step two, the addition of the lifetime IPV variables was associated with a significant change in the variance accounted for in the model (ΔR2 = 0.12, F(5, 156) = 5.11, p = .001). In this step, younger age was significantly associated with higher anxiety scores (B = -0.38, p = .019). At step three, the addition of the past-year IPV variables was not associated with a significant change in the variance accounted for by the model. However, younger age (B = -0.38, p = .022) and lifetime IA (B = 2.89, p = .043) were significantly associated with higher anxiety scores in this final step.

Table 3b Hierarchical linear regression models predicting symptoms of anxiety in a sample of (n = 171) transgender and gender diverse young adults in New York City
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Posttraumatic Stress Disorder

The mean PTSD score was 12.0 (SD = 6.5). The results of the hierarchical linear regression model examining PTSD are presented in Table 3c. The model including the sociodemographic variables was not statistically significant at step one (R2 = 0.06, F(10, 161) = 0.97, p = .470). No variables were significantly associated with PTSD scores in this step. At step two, the addition of the lifetime IPV variables was associated with a statistically significant change in the variance accounted for by the model (ΔR2 = 0.12, F(5, 156) = 2.28, p = .006). In this step, younger age (B = -0.38, p = .016) and lifetime IA (B = 3.18, p = .009) were significantly associated with higher PTSD scores. At step three, the addition of the past-year IPV variables was not associated with a significant change in the variance accounted for by the model. However, younger age (B = -0.40, p = .012) and lifetime IA (B = 3.48, p = .011) continued to be significantly associated with higher PTSD scores in this final step.

Table 3c Hierarchical linear regression models predicting symptoms of PTSD in a sample of (n = 171) transgender and gender diverse young adults in New York City
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Discussion

The present study first sought to estimate the prevalence of lifetime and past-year general forms of IPV (i.e., psychological, physical, and sexual victimization) and identity-specific forms of IPV (i.e., IA and T-IPV) in a sample of (N = 200) TGD young adults in New York City. These findings indicated that both lifetime and past-year general and identity-specific IPV were common among this sample. Indeed, the prevalence rates of lifetime and past-year physical and sexual IPV reported by the TGD young adults in the current study were higher than the median prevalence estimates in a systematic review of studies of IPV among TGD adults (Peitzmeier et al., 2020). While the prevalence rate of past-year psychological IPV in the current study was also higher than that reported in a previous study (Whitfield et al., 2021), the lifetime psychological IPV in the current study was lower (Henry et al., 2021). Similarly, the estimates of lifetime and past-year IA in this sample were higher than those in a previous study of TGD adults (Woulfe & Goodman, 2021). Regarding T-IPV, the lifetime and past-year prevalence rates observed in this study were in line with previous estimates derived from a sample of transmasculine adults (Peitzmeier et al., 2019), although the lifetime prevalence was higher than that reported in a more recent study (Peitzmeier et al., 2021).

Taken together, these findings suggest that experiences of IPV, both general and identity-specific, are prevalent and occur relatively early in the lives of TGD people living in New York City. However, it is unclear to what extent the urban location may have impacted the results. A systematic review of urbanicity in relation to IPV in cisgender women found that rates were similar in urban, suburban, and rural areas, but IPV in rural areas may have worse psychosocial outcomes due to limited access to services (Edwards, 2015). Few studies have assessed this relationship in TGD samples, and those that do exist have mixed findings. Specifically, Goldenberg et al. (2018) reported higher prevalence of IPV in the more rural South and Midwest United States than in the more urban Northeast and Mid-Atlantic regions, while Kattari et al. (2022) found that urbanicity was associated with the T-IPV experience of being threatened to be outed by a partner, but not with sexual or physical IPV. Similarly, findings have also been mixed regarding whether TGD people are more likely to experience discrimination when accessing services. Bradford et al. (2013) found that TGD people were more likely to experience discrimination in urban areas, but Seelman (2015) did not find such an association in TGD people attempting to access IPV-related services. Thus, given how these prevalence estimates compare to earlier studies, it is important to keep in mind the urban context of this sample.

The second aim of the present study was to examine the associations between lifetime and past-year forms of IPV with recent symptoms of depression, anxiety, and PTSD. By entering the more distal experiences (i.e., lifetime IPV) in the earlier steps of the hierarchical regression models, followed by the more proximal experiences (i.e., past-year IPV) in later steps, we were also able to assess whether more recent experiences of IPV explained significantly more variance in the three mental health outcomes, as compared to the lifetime experiences.

In the model examining depression, lifetime IA and past-year T-IPV were significantly associated with recent symptoms of depression. While several studies have documented associations between physical IPV and depression (Bukowski et al., 2019; Goldenberg et al., 2018), neither lifetime nor past-year physical IPV were significantly associated with depression in the multivariate models of the present study. That being said, the current finding is consistent with Henry et al.’s (2021) finding that physical IPV was not related to depression. Interestingly, the prior studies that found an association between physical IPV and depression used samples that were either entirely (Bukowski et al., 2019) or mostly (75%; Goldenberg et al., 2018) transfeminine. On the other hand, both the Henry et al. (2021) study and the current study used a sample with a more even distribution between transfeminine, transmasculine, and nonbinary individuals. It may be worth exploring in future research whether the association between physical IPV and depression is stronger in, or even unique to, transfeminine individuals. The effect of physical IPV on depression may be facilitated by transmisogyny, the unique intersectional oppression of transfeminine people (Arayasirikul & Wilson, 2019). Future research should explore whether transmisogyny could partially explain differential effects of physical IPV on depression in transfeminine versus transmasculine people.

Additionally, the finding regarding lifetime IA supports earlier research that documented associations between lifetime and past-year IA and recent symptoms of depression (Woulfe & Goodman, 2020). The finding regarding T-IPV is also in line with an earlier study that documented associations between T-IPV and depression (Peitzmeier et al., 2019), although it was past-year T-IPV, not lifetime, that was significantly associated with depression symptoms in the current study. These findings that identity-specific forms of IPV were especially strong in their associations with symptoms of depression are in accord with prior research demonstrating an association between discrimination experiences and depression in TGD populations (Bazargan & Galvan, 2012; Scandurra et al., 2018; White Hughto et al., 2017). Identity-specific IPV can be understood as a form of discrimination occurring within an intimate relationship, so it is plausible that the individual effects of IPV and discrimination on depression would be compounded when they are combined.

Fewer prior studies have examined associations between various forms of IPV, anxiety, and PTSD among TGD people. In the model examining anxiety, younger age and lifetime IA were the only variables significantly associated with higher anxiety symptoms in the final step. Regarding IA, as with depression, prior research has found discrimination to be related to anxiety symptoms in TGD populations (Puckett et al., 2020; Scandurra et al., 2018). Therefore, the experience of discrimination within one’s intimate relationship could be expected to be associated with anxiety symptoms as well.

Regarding PTSD, as in the model examining anxiety, age and lifetime IA were the only variables significantly associated with PTSD symptoms in the final step of the multivariate model. The current results corroborate earlier research that documented associations between lifetime IA and PTSD (Woulfe & Goodman, 2020). Like depression and anxiety, discrimination experiences have been shown to be associated with PTSD symptoms in prior research with TGD populations (Keating & Muller, 2020; (Reisner et al., 2016b). Considering that identity-specific forms of IPV involve discrimination within the context of an intimate relationship, it makes sense that identity-specific IPV experiences would be more strongly associated with PTSD symptoms than general forms of IPV.

Overall, IA was the one IPV variable that was associated with all three negative mental health outcomes. These findings may be considered in light of recent efforts to build a Pantheoretical Model of Dehumanization which integrates Objectification Theory (Fredrickson & Roberts, 1997) and the Minority Stress Model (Hendricks & Testa, 2015; Meyer, 2003) to explain psychopathology among TGD people (Moradi, 2013). This integrated model implicates experiences of anti-transgender discrimination in poor mental health in this population, with these dehumanizing experiences being internalized and resulting in internalized transnegativity due to failure to conform to sociocultural standards of masculinity and femininity. Although it has primarily been used to explain eating-related pathology to date (Brewster et al., 2019; Velez et al., 2016), one recent study has found these dehumanization experiences to relate to general psychological distress (Cascalheira & Choi, 2022). The current study’s findings could be interpreted in line with this model, with IA representing anti-transgender discrimination.

Implications

These findings have several implications for research, practice, and policy. First, they underscore that experiences of IPV are common among TGD young adults. As such, additional research is warranted to better understand what factors place this population at greater risk for IPV, and how to prevent or intervene on such experiences. In addition, given the elevated prevalence rates found in this population, health professionals should consider screening for IPV when working with TGD young adults. Relatedly, policymakers should expand funding for and access to IPV-related resources, which are relatively scant for TGD people. These resources should aim to specifically target TGD young adults to counter the high prevalence rates.

Second, these findings highlight the relatively stronger associations between identity-specific forms of IPV and mental health outcomes, compared to general forms of IPV. As such, both researchers and health professionals should include these experiences when assessing IPV in gender and sexual minority populations. Identity-specific IPV measures (e.g., the Identity Abuse Scale) may capture specific forms of IPV that more general measures fail to account for. This would allow researchers to more thoroughly study IPV in this population and help health professionals to identify at-risk clients who may be missed by measures designed for use with cisgender, heterosexual individuals. Relatedly, given the associations between these identity-specific forms of IPV and mental health symptoms, policymakers should increase funding for mental health research and treatment for TGD populations.

Finally, as of this writing, no prevention or treatment interventions exist to address IPV in TGD populations in general, or among TGD young adults specifically. Therefore, researchers must begin to develop and test such prevention and/or treatment interventions to be used with these populations. Health professionals may be important collaborators in these intervention research efforts, as they have experience working with TGD clients and doing so with few resources or referrals to offer such individuals. Lastly, policymakers should increase funding of IPV intervention research, particularly for TGD populations.

Limitations

The findings of the current study should be considered in light of its limitations. First, as the data is from a cross-sectional study, no causal inferences can be drawn. However, given that the IPV variables contained some temporal information (i.e., lifetime versus past-year), and the mental health variables all pertained to recent symptoms (i.e., past two weeks for depression and anxiety and past month for PTSD), some tentative temporal relationships can be inferred.

Second, the data was collected in-person at a single site in New York City, resulting in a relatively geographically homogenous sample. As such, these findings may not generalize to TGD young adults living in more rural areas. On the other hand, a strength of the sample was its relative diversity in terms of other sociodemographic characteristics (e.g., race/ethnicity). Additionally, as a result of the study’s design, the sample had a limited range of age. Thus, these findings may not generalize to TGD adults (i.e., over age 30). However, given that early experiences of IPV are a robust predictor of experiences of IPV later in life in other populations (e.g., Stults et al., 2021), it is important to study IPV and how it impacts mental health during this influential stage of life.

Fourth, the measure used to assess perceived socioeconomic status was not a validated measure. Instead, the self-report item captured participants’ perceptions of their socioeconomic status given three response choices: lower, middle, and upper class. Future researchers should consider using more well-established measures of SES.

Fifth, psychological, physical, and sexual IPV victimization and perpetration were measured using a single dichotomous item for each construct, for a total of six items. As such, we may not have captured the full range of behaviors that a more comprehensive measure of IPV (e.g., the Conflict Tactics Scale; Feldman et al., 2008) would have assessed. Nevertheless, the six items in this study, which were adapted from the Conflict Tactics Scale, were useful in estimating prevalence of lifetime and past-year IPV at rates similar to or higher than observed in previous studies.

Sixth, the IA and T-IPV measures may assess similar constructs. However, they demonstrated adequate convergent and discriminant validity in the current study. Specifically, Kazdin (2003) recommends correlation coefficients of moderate strength (r = .40–0.60) to show convergent validity without compromising discriminant validity. The phi correlation coefficients between lifetime and past-year IA and T-IPV were 0.53 and 0.55 in the present study, which are within the indicated range. As such, both measures were used in these analyses.

Finally, the sample size, while sufficient to conduct these analyses, may have limited the ability of some variables to achieve statistical significance in the multivariate models. To address this, variables that achieved a p-value between 0.05 and 0.07 are highlighted in the tables as being marginally significant, as they may warrant further investigation in future research.

Conclusion

Taken together, the present findings indicate that experiences of both general and identity-specific forms of IPV are common among TGD young adults, and several forms of IPV are related to deleterious mental health outcomes in this population. Indeed, lifetime IA appears to be the most pernicious, as it was related to all three negative mental health outcomes in this study. Furthermore, past-year T-IPV was associated with recent depression symptoms. As such, identity-specific forms of IPV warrant additional attention from researchers, healthcare professionals, and policymakers, as they may place TGD young adults at risk for negative mental health outcomes.