WPATH 2022 – Impact of Misgendering on Non-Binary People’s Health and Wellbeing in Canada
Presentation by Kai Jacobsen on behalf of the Trans PULSE Canada team for the World Professional Association for Transgender Health (WPATH) 2022 Conference.
Presentation Abstract
Introduction:
Misgendering is known to have negative impacts on the health and well-being of transgender individuals, such as body dissatisfaction, disordered eating, and negative mental health outcomes. Conversely, gender affirmation is associated with better mental health outcomes. Although these relationships are well-documented in the literature for trans people generally, little is known about the effects of misgendering on non-binary people specifically.
Specific Aim:
Our research questions were: 1) Among non-binary people, what demographic and social factors are associated with frequency of misgendering? 2) Is less frequent misgendering associated with better health outcomes for non-binary people?
Materials and Methods:
In 2019, the Trans PULSE Canada team surveyed 2873 trans and non-binary people that were 14 years of age or older, living in Canada, and had a gender identity that differed from their sex assigned at birth. The survey was available in English or French via phone, online, on paper, or through peer researchers and took up to 70 minutes to complete. We analyzed the subgroup of participants (n=1327, 48%) who indicated their current gender identity was “non-binary, genderqueer, agender, or a similar identity.”
We prepared descriptive statistics for cross-tabulations between key demographic variables and frequency of misgendering, including Chi-square significance tests. Next, we conducted regression analysis between the frequency of misgendering (primary explanatory variable) and our health outcomes (i.e., depression score [CESD-10], anxiety score [OASIS], gender positivity [TYC-GPS] and distress [TYC-GDS], psychological well-being [BIT], and general self-rated health). We used multiple linear regression for depression and anxiety scores and our psychological well-being measure, and multiple logistic regression for general self-rated health.We controlled for confounding variables, as identified through a directed acyclic graph.
Results:
More than half (58%) of non-binary participants reported being misgendered daily, with 34% misgendered sometimes (every week, every month, or every year) and 7% never misgendered. Most (87%) participants reported correcting others when they were misgendered only half of the time or less. Most (57%) were very or quite upset when they were misgendered. Variables associated with more frequent misgendering included being younger, a person of colour, assigned female at birth, using they/them or multiple pronouns, and not having had all desired gender-affirming medical treatments or changed name. Regression analyses are ongoing, and we will report these results on the health impact of misgendering. We hypothesise that non-binary individuals who are misgendered less frequently will have better health and wellbeing.
Conclusions:
Non-binary people are frequently misgendered, often on a daily basis. Many feel upset when they are misgendered, but avoid correcting others. Non-binary people who are not able to express their gender in the ways that they want, including through medical and social transition, as well as younger, racialized, and assigned female at birth individuals are misgendered more frequently. Evidence-based strategies that address the impact of misgendering and the unique needs and realities of non-binary people are needed to promote non-binary people’s health and well-being.