Date of Award
Doctor of Philosophy (PhD)
Lynnette Leidy Sievert
Biocultural, gender, immune function, stress, transitions, trans men
Health disparities, including higher rates of mental or physical illness, are found among members of minority or marginalized groups including people who identify as lesbian, gay, bisexual or transgender. However, there is a paucity of research incorporating both experiential components and measures of physical health, particularly among trans men during their transition from female to male. Trans men transition through the use of testosterone therapy (T) and surgical procedures in order to align their internal male gender identities with their physical presentation. This study combines the analysis of qualitative and quantitative data in order to understand trans men's experience of their changing bodies, identify the primary stressors faced during different stages of transition, and measure the biological manifestation of psychosocial stress during transition.
Sixty-five trans men who were utilizing testosterone (T), participated in this cross-sectional study of stress experience during transition. The study involved in-depth, in-person interviews and multiple biological measures including: 24-hours of blood pressure monitoring, three consecutive days of salivary sampling for measures of cortisol and testosterone, a blood-spot for measures of C-reactive protein (CRP), and anthropometric measures. The general hypothesis for this study was that men in earlier, more liminal stages of transition would experience more transition and gender-related stress than men later in the process and that this stress would manifest experientially, psychologically, and physiologically.
As expected, transition-specific psychosocial stress was associated with physiological measures, and was more pronounced among trans men in the liminal stages of transition. Moreover, comparisons of stress experience during different stages of transition uncovered variation in how trans men perceived and experienced changes in their bodies and social identity. A number of experiential aspects of transition were identified from the qualitative interviews and found to be linked to physiological stress measures including decreased nocturnal decline in blood pressure, increased cortisol levels, and increased C-reactive protein (CRP). In particular, issues related to transitioning identity stress (TIS), challenges linked to "passing" and being "out" as transgender, and specific acute stressors including the use of gender-specific public restrooms were each found to be independently associated with biological measures of stress.
DuBois, Leo Zachary, "Biocultural Perspectives on Gender, Transitions, Stress, and Immune Function" (2012). Open Access Dissertations. Paper 546.