Project AFFIRM

Identity Development, Risk, and Resilience among Gender Diverse Populations

Walter O. Bockting, PhD

Principal Investigator

Previous research has found that the vast majority of transgender individuals experienced discrimination and documented health inequities. Much of the data, however, is limited by the use of small convenience samples of transgender women with a history of sex work, recruited from AIDS and social service agencies. The goal of this study is to move beyond these limitations by using purposive, venue-based sampling to recruit a broad, diverse sample of transgender people in 3 U.S. cities--New York, San Francisco, and Atlanta-and enroll them into a mixed-method longitudinal study to test an adaptation of the minority stress model, investigating vulnerability, risk and resilience in the context of identity development.

The aims of the study are: (1) To describe the process of transgender identity development based on qualitative lifeline interviews with a sample of 90 transgender individuals ages 16 and older, and identify periods of acute vulnerability and characteristics of resilience; (2) Informed by findings from Aim 1, to refine a model combining identity development, minority stress, and resilience, and to develop/adapt measures to assess the model's key constructs; (3) To test the model of resilience in a cohort of transgender individuals (N = 480) stratified by city, gender, and age, and follow them over time (baseline, 1-, 2-, and 3-year follow up interviews); and (4) To triangulate qualitative and quantitative data on identity development and minority stress processes in order to inform the future development and testing of intervention strategies aimed at fostering resilience and reducing stigma and discrimination. By achieving these aims, this study will make a significant advance in scientific knowledge about gender identity development, minority stress processes (enacted stigma, felts stigma, concealment, shame and their impact on health and psychosocial adjustment), minority coping (on an individual as well as community level), and the development of resilience over time. The study is innovative in its focus on an understudied minority population, the application of the lifeline interview method to this population, and the adaptation and testing of the minority stress model within the context of transgender identity development.



U.S. Transgender Population Health Survey

Principal Investigator: Ilan Meyer, PhD

Walter Bockting, PhD

TransPop Study, a first-of-its-kind U.S. transgender population health survey, is being conducted by researchers at the Williams Institute at UCLA School of Law, Columbia University, Harvard University, and The Fenway Institute at Fenway Health. The study will be the first national probability sample of transgender individuals in the U.S. and thus will be provide a more accurate and detailed picture of the issues faced by transgender people. The study will provide researchers and policy makers with unbiased estimates about demographics, health outcomes and well-being, and health care needs of the transgender population, which will be crucial for designing evidence-based public health and policy interventions. 

The TransPop study aims to:

  • Describe demographic parameters of the U.S. transgender population, such as race/ethnicity, age, gender identity, education, employment, etc.

  • Describe basic health outcomes and health behaviors, such as health status, health care access, quality of life, etc.

  • Describe experiences of transgender people with interpersonal and institutional discrimination in areas such as healthcare, employment, housing, etc.

  • Describe transgender identity history and transition-related experiences.