Degree Type


Date of Award


Degree Name

Doctor of Philosophy





First Advisor

Frederick O. Lorenz

Second Advisor

Susan E. Cross


Over the decades, researchers and people in general have elaborated on distinctions regarding sexual orientation minorities. What was once classified as “homosexual” now distinguishes between gay men, lesbians, bisexual, and asexual individuals. Sexual orientation minorities experience unique stressors that negatively impact their psychological and physical health. Minority stressors, including perceptions that one’s sexual orientation is stigmatized, internalized prejudicial attitudes about one’s sexual orientation, and experiencing first-hand discrimination or violence as a result of one’s sexual orientation can all contribute to greater distress.

While these associations have begun to be explored for sexual orientation minorities, less is known about these similar effects for transgender individuals. In more recent years, transgender has been used to describe those whose gender identity, or perception of the self as male or female, is inconsistent with their assigned sex or those whose appearance and behavior are not consistent with gender expectations. Early research defined transgender individuals with clinical samples of transsexual individuals; other studies defined transgender individuals as having a gender identity that is inconsistent with their sex assigned at birth. The current study defines transgender as a more inclusive, “umbrella” term that represents multiple subgroups, including gender incongruent individuals, such as transsexual individuals, and gender nonconforming individuals, including cross-dressers, drag queens, drag kings, genderqueer, and gender fluid individuals. Reports of shockingly high rates of distress in transgender populations—rates of suicide ideation as high as 70%—call for greater understanding of the underlying causes.

At this point in time, relatively little is known about the relative strength of associations between stressors—those that are specific to an identity—and distress for transgender, sexual orientation minority, and heterosexual and cisgender (non-transgender) people. The present study found that transgender individuals experienced the highest levels of minority stressors, followed by sexual orientation minorities; heterosexual and cisgender people reported the lowest levels. While transgender individuals experienced the strongest association between experiences with discrimination and violence and physical distress, sexual orientation minorities experienced the strongest association between internalized prejudice and distress. Not surprisingly, heterosexual and cisgender participants experienced the weakest associations between all minority stressors and distress.

This study also considered potential moderating variables, including perceptions of social support and the degree to which one’s identity has been shared with others (outness). While outness was a significant moderator for transgender participants, buffering the associations between internalized prejudice and distress, it was not effective for other groups. Social support buffered the associations between perceptions of identity stigma and distress for heterosexual and cisgender participants and it buffered associations between perceptions of identity stigma and physical distress for sexual orientation minorities. Surprisingly, social support amplified the association between internalized prejudice and physical distress for sexual orientation minorities.

These findings advance toward the goal of understanding the relative prevalence of minority stressors for people who identify as sexual orientation or gender identity minorities and the very real impact these stressors can have on minorities’ psychological and physical well-being.


Copyright Owner

Karen Elaine Bittner



File Format


File Size

377 pages