Translation and Evaluation of Psychometric Properties of the Persian 8-Item Internalized Transphobia (IT) Scale in Iranian Transgenders
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Abstract
Objective: Internalized transphobia (IT) is influenced by societal norms and expectations, and it can have significant negative effects on the well-being and mental health of transgender individuals. The aim of this study was to translate and evaluate the psychometric properties of the Persian 8-item IT scale among Iranian transgender individuals in order to enhance the quality and quantity of research in this field.
Materials and methods: This cross-sectional and methodological study utilized convenience sampling to recruit 119 transgender individuals in Mashhad, the second most populous city in Iran, in 2021. The Persian translation of the IT scale was developed using the backward-forward translation method. Subsequently, various types of validity and reliability were assessed, including content validity using the content validity index (CVI) and content validity ratio (CVR), face validity based on the impact score, construct validity through confirmatory factor analysis (CFA), internal consistency measured by Cronbach's alpha, and test-retest stability analyzed using the intraclass correlation coefficient (ICC).
Results: The CVR ranged from 0.600 to 1, the CVI ranged from 0.800 to 1, and the impact score exceeded 1.5, indicating the appropriate content and face validity of the 8-item IT scale. The construct validity analysis revealed that the questionnaire is one-dimensional. The internal consistency, as measured by Cronbach's alpha, was 0.917, and the ICC for test-retest stability was 0.871.
Conclusion: The Persian version of the IT scale demonstrated high and acceptable psychometric properties. The brevity of this scale facilitates its dissemination and utilization in clinical settings.
1. American Psychological Association. Guidelines for psychological practice with transgender and gender nonconforming people. Am Psychol 2015;70(9):832-64.
2. Coleman E, Bockting W, Botzer M, Cohen-Kettenis P, DeCuypere G, Feldman J, et al. Standards of Care for the Health of Transsexual, Transgender, and Gender-Nonconforming People, Version 7. Int J Transgend 2012;13(4):165-232.
3. Keating L, Muller RT. LGBTQ+ based discrimination is associated with ptsd symptoms, dissociation, emotion dysregulation, and attachment insecurity among LGBTQ+ adults who have experienced Trauma. J Trauma Dissociation 2020;21(1):124-41.
4. Marshall E, Claes L, Bouman WP, Witcomb GL, Arcelus J. Non-suicidal self-injury and suicidality in trans people: A systematic review of the literature. Int Rev Psychiatry 2016;28(1):58-69.
5. Heylens G, Elaut E, Kreukels BP, Paap MC, Cerwenka S, Richter-Appelt H, et al. Psychiatric characteristics in transsexual individuals: multicentre study in four European countries. Br J Psychiatry 2014;204(2):151-6.
6. Testa RJ, Habarth J, Peta J, Balsam K, Bockting W. Development of the Gender Minority Stress and Resilience Measure. Psychol Sex Orientat Gend Divers 2015;2(1):65-77.
7. Testa RJ, Jimenez CL, Rankin S. Risk and Resilience During Transgender Identity Development: The Effects of Awareness and Engagement with Other Transgender People on Affect. J Gay Lesbian Ment Health 2014;18(1):31-46.
8. Bockting WO, Miner MH, Swinburne Romine RE, Dolezal C, Robinson BBE, Rosser BRS, et al. The Transgender Identity Survey: A Measure of Internalized Transphobia. LGBT Health 2020;7(1):15-27.
9. Bell K, Rieger E, Hirsch JK. Eating Disorder Symptoms and Proneness in Gay Men, Lesbian Women, and Transgender and Non-conforming Adults: Comparative Levels and a Proposed Mediational Model. Front Psychol 2018;9:2692.
10. Scandurra C, Bochicchio V, Amodeo AL, Esposito C, Valerio P, Maldonato NM, et al. Internalized Transphobia, Resilience, and Mental Health: Applying the Psychological Mediation Framework to Italian Transgender Individuals. Int J Environ Res Public Health 2018;15(3):508.
11. Alavi K, Jalali AH, Eftekhar M. Sexual Orientation in Patients with Gender Identity Disorder. J Psychiatry Clin Psychol 2014;20(1):43-9.
12. Mohammadi N. Life experiences of sexual minorities in Iran: limitations, adaptations and challenges. Quality & Quantity 2018;52(2):719-37.
13. Javaheri F. A Study of Transsexuality in Iran. Iranian Studies 2010;43(3):365-77.
14. Hidalgo MA, Petras H, Chen D, Chodzen G. The Gender Minority Stress and Resilience Measure: Psychometric Validity of an Adolescent Extension. Clin Pract Pediatr Psychol 2019;7(3):278.
15. Cronin TJ, Pepping CA, Lyons A. Internalized transphobia and well-being: The moderating role of attachment. Pers Individ Differ 2019;143:80-3.
16. Lee H, Tomita KK, Habarth JM, Operario D, Yi H, Choo S, et al. Internalized transphobia and mental health among transgender adults: A nationwide cross-sectional survey in South Korea. Int J Transgend Health 2020;21(2):182-93.
17. Scandurra C, Dolce P, Vitelli R, Esposito G, Testa RJ, Balsam KF, et al. Mentalizing stigma: Reflective functioning as a protective factor against depression and anxiety in transgender and gender-nonconforming people. J Clin Psychol 2020;76(9):1613-30.
18. Flynn MK, Bhambhani Y. Internalized transphobia, nondisclosure of gender identity, and life satisfaction among transgender and non-binary adults: The moderating roles of psychological flexibility and inflexibility. J Contextual Behav Sci 2021;20:194-201.
19. Rood BA, Reisner SL, Puckett JA, Surace FI, Berman AK, Pantalone DW. Internalized transphobia: Exploring perceptions of social messages in transgender and gender-nonconforming adults. Int J Transgend 2017;18(4):411-26.
20. Goldberg DP, Hillier VF. A scaled version of the General Health Questionnaire. Psychol Med 1979;9(1):139-45.
21. Malakouti SK, Fatollahi P, Mirabzadeh A, Zandi T. Reliability, validity and factor structure of the GHQ-28 used among elderly Iranians. Int Psychogeriatr 2007;19(4):623-34.
22. Koo TK, Li MY. A Guideline of Selecting and Reporting Intraclass Correlation Coefficients for Reliability Research. J Chiropr Med 2016;15(2):155-63.
23. Inderbinen M, Schaefer K, Schneeberger A, Gaab J, Garcia Nuñez D. Relationship of Internalized Transnegativity and Protective Factors With Depression, Anxiety, Non-suicidal Self-Injury and Suicidal Tendency in Trans Populations: A Systematic Review. Front Psychiatry 2021;12:636513.
24. Austin A, Goodman R. The Impact of Social Connectedness and Internalized Transphobic Stigma on Self-Esteem Among Transgender and Gender Non-Conforming Adults. J Homosex 2017;64(6):825-41.
25. Staples JM, Neilson EC, Bryan AEB, George WH. The Role of Distal Minority Stress and Internalized Transnegativity in Suicidal Ideation and Nonsuicidal Self-Injury Among Transgender Adults. J Sex Res 2018;55(4-5):591-603.
26. Brennan SL, Irwin J, Drincic A, Amoura NJ, Randall A, Smith-Sallans M. Relationship among gender-related stress, resilience factors, and mental health in a Midwestern U.S. transgender and gender-nonconforming population. Int J Transgend 2017;18(4):433-45.
27. Jackman KB, Dolezal C, Bockting WO. Generational Differences in Internalized Transnegativity and Psychological Distress Among Feminine Spectrum Transgender People. LGBT Health 2018;5(1):54-60.
28. Scandurra C, Dolce P, Vitelli R, Vincenzo V, Caravà C, Testa RJ, et al. The Italian validation of the gender minority stress and resilience measure. Psychol Sex Orientat Gend Divers 2020;7(2):208.
29. Anzani A, Biella M, Scandurra C, Prunas A. Desire for Genital Surgery in Trans Masculine Individuals: The Role of Internalized Transphobia, Transnormativity and Trans Positive Identity. Int J Environ Res Public Health 2022;19(15):8916.
30. Kline K, Randall AK. The Moderating Effect of Internalized Transphobia on the Association Between Gender Congruence and Sexual Satisfaction for Transgender Men. J LGBT Issues Couns 2021;15(1):93-109.
31. Algarin AB, Smith LR, Pines HA, Zapien-Vasquez MF, Padilla-Garcia R, Navarro-Alvarez S, et al. The Gender Minority Stress and Resilience Measure: Psychometric Validity for Use in Spanish. Transgender Health 2024;9(1):24-33.
32. Fatima A, Jami H, Muzzaffer K. Translation and Validation of Gender Minority Stress & Resilience Scale. Pak J Life Soc Sci 2022;4(3):530-40.
2. Coleman E, Bockting W, Botzer M, Cohen-Kettenis P, DeCuypere G, Feldman J, et al. Standards of Care for the Health of Transsexual, Transgender, and Gender-Nonconforming People, Version 7. Int J Transgend 2012;13(4):165-232.
3. Keating L, Muller RT. LGBTQ+ based discrimination is associated with ptsd symptoms, dissociation, emotion dysregulation, and attachment insecurity among LGBTQ+ adults who have experienced Trauma. J Trauma Dissociation 2020;21(1):124-41.
4. Marshall E, Claes L, Bouman WP, Witcomb GL, Arcelus J. Non-suicidal self-injury and suicidality in trans people: A systematic review of the literature. Int Rev Psychiatry 2016;28(1):58-69.
5. Heylens G, Elaut E, Kreukels BP, Paap MC, Cerwenka S, Richter-Appelt H, et al. Psychiatric characteristics in transsexual individuals: multicentre study in four European countries. Br J Psychiatry 2014;204(2):151-6.
6. Testa RJ, Habarth J, Peta J, Balsam K, Bockting W. Development of the Gender Minority Stress and Resilience Measure. Psychol Sex Orientat Gend Divers 2015;2(1):65-77.
7. Testa RJ, Jimenez CL, Rankin S. Risk and Resilience During Transgender Identity Development: The Effects of Awareness and Engagement with Other Transgender People on Affect. J Gay Lesbian Ment Health 2014;18(1):31-46.
8. Bockting WO, Miner MH, Swinburne Romine RE, Dolezal C, Robinson BBE, Rosser BRS, et al. The Transgender Identity Survey: A Measure of Internalized Transphobia. LGBT Health 2020;7(1):15-27.
9. Bell K, Rieger E, Hirsch JK. Eating Disorder Symptoms and Proneness in Gay Men, Lesbian Women, and Transgender and Non-conforming Adults: Comparative Levels and a Proposed Mediational Model. Front Psychol 2018;9:2692.
10. Scandurra C, Bochicchio V, Amodeo AL, Esposito C, Valerio P, Maldonato NM, et al. Internalized Transphobia, Resilience, and Mental Health: Applying the Psychological Mediation Framework to Italian Transgender Individuals. Int J Environ Res Public Health 2018;15(3):508.
11. Alavi K, Jalali AH, Eftekhar M. Sexual Orientation in Patients with Gender Identity Disorder. J Psychiatry Clin Psychol 2014;20(1):43-9.
12. Mohammadi N. Life experiences of sexual minorities in Iran: limitations, adaptations and challenges. Quality & Quantity 2018;52(2):719-37.
13. Javaheri F. A Study of Transsexuality in Iran. Iranian Studies 2010;43(3):365-77.
14. Hidalgo MA, Petras H, Chen D, Chodzen G. The Gender Minority Stress and Resilience Measure: Psychometric Validity of an Adolescent Extension. Clin Pract Pediatr Psychol 2019;7(3):278.
15. Cronin TJ, Pepping CA, Lyons A. Internalized transphobia and well-being: The moderating role of attachment. Pers Individ Differ 2019;143:80-3.
16. Lee H, Tomita KK, Habarth JM, Operario D, Yi H, Choo S, et al. Internalized transphobia and mental health among transgender adults: A nationwide cross-sectional survey in South Korea. Int J Transgend Health 2020;21(2):182-93.
17. Scandurra C, Dolce P, Vitelli R, Esposito G, Testa RJ, Balsam KF, et al. Mentalizing stigma: Reflective functioning as a protective factor against depression and anxiety in transgender and gender-nonconforming people. J Clin Psychol 2020;76(9):1613-30.
18. Flynn MK, Bhambhani Y. Internalized transphobia, nondisclosure of gender identity, and life satisfaction among transgender and non-binary adults: The moderating roles of psychological flexibility and inflexibility. J Contextual Behav Sci 2021;20:194-201.
19. Rood BA, Reisner SL, Puckett JA, Surace FI, Berman AK, Pantalone DW. Internalized transphobia: Exploring perceptions of social messages in transgender and gender-nonconforming adults. Int J Transgend 2017;18(4):411-26.
20. Goldberg DP, Hillier VF. A scaled version of the General Health Questionnaire. Psychol Med 1979;9(1):139-45.
21. Malakouti SK, Fatollahi P, Mirabzadeh A, Zandi T. Reliability, validity and factor structure of the GHQ-28 used among elderly Iranians. Int Psychogeriatr 2007;19(4):623-34.
22. Koo TK, Li MY. A Guideline of Selecting and Reporting Intraclass Correlation Coefficients for Reliability Research. J Chiropr Med 2016;15(2):155-63.
23. Inderbinen M, Schaefer K, Schneeberger A, Gaab J, Garcia Nuñez D. Relationship of Internalized Transnegativity and Protective Factors With Depression, Anxiety, Non-suicidal Self-Injury and Suicidal Tendency in Trans Populations: A Systematic Review. Front Psychiatry 2021;12:636513.
24. Austin A, Goodman R. The Impact of Social Connectedness and Internalized Transphobic Stigma on Self-Esteem Among Transgender and Gender Non-Conforming Adults. J Homosex 2017;64(6):825-41.
25. Staples JM, Neilson EC, Bryan AEB, George WH. The Role of Distal Minority Stress and Internalized Transnegativity in Suicidal Ideation and Nonsuicidal Self-Injury Among Transgender Adults. J Sex Res 2018;55(4-5):591-603.
26. Brennan SL, Irwin J, Drincic A, Amoura NJ, Randall A, Smith-Sallans M. Relationship among gender-related stress, resilience factors, and mental health in a Midwestern U.S. transgender and gender-nonconforming population. Int J Transgend 2017;18(4):433-45.
27. Jackman KB, Dolezal C, Bockting WO. Generational Differences in Internalized Transnegativity and Psychological Distress Among Feminine Spectrum Transgender People. LGBT Health 2018;5(1):54-60.
28. Scandurra C, Dolce P, Vitelli R, Vincenzo V, Caravà C, Testa RJ, et al. The Italian validation of the gender minority stress and resilience measure. Psychol Sex Orientat Gend Divers 2020;7(2):208.
29. Anzani A, Biella M, Scandurra C, Prunas A. Desire for Genital Surgery in Trans Masculine Individuals: The Role of Internalized Transphobia, Transnormativity and Trans Positive Identity. Int J Environ Res Public Health 2022;19(15):8916.
30. Kline K, Randall AK. The Moderating Effect of Internalized Transphobia on the Association Between Gender Congruence and Sexual Satisfaction for Transgender Men. J LGBT Issues Couns 2021;15(1):93-109.
31. Algarin AB, Smith LR, Pines HA, Zapien-Vasquez MF, Padilla-Garcia R, Navarro-Alvarez S, et al. The Gender Minority Stress and Resilience Measure: Psychometric Validity for Use in Spanish. Transgender Health 2024;9(1):24-33.
32. Fatima A, Jami H, Muzzaffer K. Translation and Validation of Gender Minority Stress & Resilience Scale. Pak J Life Soc Sci 2022;4(3):530-40.
| Files | ||
| Issue | Vol 18, No 1 (March 2024) | |
| Section | Original Articles | |
| DOI | https://doi.org/10.18502/jfrh.v18i1.15438 | |
| Keywords | ||
| Translations Reproducibility of Results Transgender Persons Iran | ||
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How to Cite
1.
Sadeghi M, Jamali J, Sheybani F. Translation and Evaluation of Psychometric Properties of the Persian 8-Item Internalized Transphobia (IT) Scale in Iranian Transgenders. J Family Reprod Health. 2024;18(1):44-52.
