(PS6-31) Longitudinal Influence of Gender Congruence on Depression Through Coping: A Path Analysis

Abstract Text:

Background: Gender congruence (GC; i.e., discrepancy between one’s gender identity and physical body) is an important aspect of gender identity that has been shown to influence depression severity (Irineu et al., 2023) and may be especially important for an emerging adult population. Consistent with the minority stress model (Meyer, 2003), the present study is a path analysis examining the influence of GC over time on perceived social support, online and offline coping, sleep efficiency, and brooding rumination, as well as their subsequent influence on depression among young adults entering college. We hypothesize that GC will have longitudinal indirect effects on depression at 7 and 14 weeks post-baseline through brooding, social support, coping, and sleep.

Methods: Participants were 152 first-year university students (Mage = 18.4, SD = 0.5) who scored < 4.8 on a measure of GC, the Transgender Congruence Scale (TCS; Kozee et al., 2012). This cutpoint was chosen to capture the variance in GC among those with lower than maximal levels of GC (max TCS score = 5). Participants were recruited for the Lived Experiences Measured Using Rings Study (LEMURS; Price et al., 2023), a randomized controlled trial testing three different treatments for mental health challenges related to college transitions. Treatment adherence was low and so number of sessions attended was included in the model as a covariate. Participants completed measures of depression (Depression, Anxiety, and Stress Scale), brooding (Brooding subscale of the Ruminative Response Scale), and sleep efficiency (i.e., total sleep time/time in bed X 100 measured by Oura ring) 7 and 14 weeks post-baseline. Engagement with various coping strategies (the Online and Offline Coping Scales) and social support (Medical Outcome Study Social Support Scale) were assessed at baseline and 14 weeks post-baseline. Prior CFA’s derived the latent constructs for GC and perceived social support. Structural equation model path analyses were conducted using the R package lavaan. Standard errors and confidence intervals were calculated through 1000 bootstrapped replications.

Results: The model demonstrated good global fit for the data through various indices (e.g., Chi-square, tucker lewis index, root mean square of approximation). Indicators for both GC and perceived social support loaded significantly and as expected. Treatment was not a meaningful covariate and so was dropped from models. Path analysis determined that GC negatively and indirectly influenced depression through brooding rumination at 7 weeks (b = -1.02, SE = 0.49, 95% CI [-1.99, -0.14] p = .04) but not at 14 weeks (b = -9.58, SE = 6.64, 95% CI [-26.12, 0.98] p = .15).

Conclusions: Higher GC was linked to less brooding rumination, and subsequently higher GC may lower depression through brooding rumination 7 weeks later. GC was not significantly linked to depression through sleep efficiency, perceived social support, or online or offline coping. Results suggest that brooding rumination may be a meaningful mediator of GC’s influence on depression over time. However, future research should include repeated GC assessments.