Purpose: We describe the development of a measure of internalized transphobia, defined as discomfort with one's transgender identity as a result of internalizing society's normative gender expectations.
Methods: An item pool was created based on responses from a small clinical sample (N = 12) to an open-ended questionnaire. Expert judges reviewed the items, resulting in a 60-item instrument for empirical testing. We conducted exploratory factor analysis (EFA) by using a community sample of 430 transgender individuals (aged 18–72, mean [M] = 37.4, standard deviation [SD] = 12.0), and confirmatory factor analysis (CFA) by using an online sample of 903 transgender individuals (aged 18–66, M = 31.6, SD = 11.1). Construct validity was examined by using correlations with instruments assessing related constructs administered to the online sample.
Results: EFA resulted in a 52-item instrument with four subscales: Pride, Passing, Alienation, and Shame. CFA, after removal of half of the items, retained the four-factor structure. The final 26-item scale showed excellent internal consistency (0.90) and test–retest reliability (0.93). The factors showed a pattern of association with crossgender identity, gender ideology, outness, felt stigma, self-esteem, and psychological distress consistent with moderate-to-good construct validity.
Conclusion: Internalized transphobia can be conceptualized as four inter-related dimensions: pride in transgender identity (reverse scored), investment in passing as a cisgender person, alienation from other transgender people, and shame. The Transgender Identity Survey reliably assesses this construct, useful in research to understand the impact of minority stress on transgender people's health. It can also be used in clinical practice to assess internalized transphobia at intake and follow-up.

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Information & Authors


Published In

cover image LGBT Health
LGBT Health
Volume 7Issue Number 1January 2020
Pages: 15 - 27
PubMed: 31880493


Published online: 13 January 2020
Published in print: January 2020
Published ahead of print: 24 December 2019


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Walter O. Bockting, PhD [email protected]
Program for the Study of LGBT Health, Division of Gender, Sexuality, and Health, New York State Psychiatric Institute/Columbia Psychiatry and the Columbia University School of Nursing, New York, New York.
Program in Human Sexuality, Department of Family Medicine and Community Health, University of Minnesota Medical School, Minneapolis, Minnesota.
Michael H. Miner, PhD
Program in Human Sexuality, Department of Family Medicine and Community Health, University of Minnesota Medical School, Minneapolis, Minnesota.
Rebecca E. Swinburne Romine, PhD
Lifespan Institute, University of Kansas, Laurence, Kansas.
Curtis Dolezal, PhD
Program for the Study of LGBT Health, Division of Gender, Sexuality, and Health, New York State Psychiatric Institute/Columbia Psychiatry and the Columbia University School of Nursing, New York, New York.
Beatrice “Bean” E. Robinson, PhD
Program in Human Sexuality, Department of Family Medicine and Community Health, University of Minnesota Medical School, Minneapolis, Minnesota.
B.R. Simon Rosser, PhD
HIV/STI Intervention and Prevention Studies Program, Division of Epidemiology and Community Health, University of Minnesota School of Public Health, Minneapolis, Minnesota.
Eli Coleman, PhD
Program in Human Sexuality, Department of Family Medicine and Community Health, University of Minnesota Medical School, Minneapolis, Minnesota.


Address correspondence to: Walter O. Bockting, PhD, Program for the Study of LGBT Health, Division of Gender, Sexuality, and Health, New York State Psychiatric Institute, Columbia Psychiatry and the Columbia University School of Nursing, 1051 Riverside Drive, Unit 15, New York, NY 10032 [email protected]

Author Disclosure Statement

No competing financial interests exist.

Funding Information

The research on which this article is based was funded by grants from the National Institute on Drug Abuse (R01 DA015269, Walter O. Bockting, PI) and the Eunice Kennedy Shriver National Institute of Child Health and Human Development (R01 HD057595, Walter O. Bockting, PI).

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