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Validation of the Spanish version of the transgender identity survey: A tool to assess internalized transphobia

International Journal of Impotence Research (2026)Cite this article

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Abstract

Internalized transphobia (IT) is the rejection that transgender and gender non-conforming people (TGNC) feel towards themselves because of the internalization of negative values, prejudices, and/or stereotypes that prevail in society. This study aimed to adapt and validate a Spanish version of the Transgender Identity Survey (TIS) to assess IT in Spanish-speaking TGNC individuals. The sample consisted of 207 TGNC Spanish adults aged between 18 and 63 years (25.11 ± 8.16) who completed the TIS, along with measures of self-esteem and body image. Translation, cross-cultural adaptation, and validation analyses of the TIS were carried out. A reduced version of the original scale composed of 15 items in a one-dimension to assess IT was obtained through Exploratory Factor Analysis (EFA). Validity evidence based on the internal structure was tested through Confirmatory Factor Analysis (CFA). The indices from the CFA showed that the reduced version of the TIS had an acceptable fit: χ2 = 250.11, p < 0.001; CFI = 0.86; GFI = 0.96; RMSEA = 0.09 (0.07–0.10); SRMR = 0.06. The scale showed adequate reliability values (α = 0.890; Ω = 0.892). Correlations between TIS, self-esteem and body image reported convergent validity evidence. The Spanish version of the TIS provides a useful, reliable, and valid instrument for both research and clinical areas, supporting interventions aimed at reducing internalized stigma and promoting well-being and self-acceptance in the gender-diverse community.

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Data availability

The datasets generated and analysed during the current study are available in an open research repository: https://doi.org/10.5281/zenodo.18387339.

References

  1. Campbell M, Hinton JDX, Anderson JR. A systematic review of the relationship between religion and attitudes toward transgender and gender-variant people. Int J Transgend. 2019;20:21–38. https://doi.org/10.1080/15532739.2018.1545149

    Article  PubMed  PubMed Central  Google Scholar 

  2. Lombardi E. Varieties of transgender/transsexual lives and their relationship with transphobia. J Homosex. 2009;56:977–92. https://doi.org/10.1080/00918360903275393

    Article  PubMed  Google Scholar 

  3. Miller LR. Grollman EA. The social costs of gender nonconformity for transgender adults: Implications for discrimination and health. Sociol Forum (Randolph NJ). 2015;30:809–31. https://doi.org/10.1111/socf.12193

    Article  Google Scholar 

  4. Garro M, Novara C, Di Napoli G, Scandurra C, Bochicchio V, Lavanco G. The role of internalized transphobia, loneliness, and social support in the psychological well-being of a group of Italian transgender and gender non-conforming youths. Healthcare. 2022;10:2282 https://doi.org/10.3390/healthcare10112282

    Article  PubMed  PubMed Central  Google Scholar 

  5. Downing JM, Przedworski JM. Health of transgender adults in the U.S., 2014–2016. Am J Prev Med. 2018;55:336–44. https://doi.org/10.1016/j.amepre.2018.04.045

    Article  PubMed  Google Scholar 

  6. Reisner SL, Greytak EA, Parsons JT, Ybarra ML. Gender minority social stress in adolescence: disparities in adolescent bullying and substance use by gender identity. J Sex Res. 2015;52:243–56. https://doi.org/10.1080/00224499.2014.886321

    Article  PubMed  Google Scholar 

  7. 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;15:508 https://doi.org/10.3390/ijerph15030508

    Article  PubMed  PubMed Central  Google Scholar 

  8. Lefevor GT, Boyd-Rogers CC, Sprague BM, Janis RA. Health disparities between genderqueer, transgender, and cisgender individuals: An extension of minority stress theory. J Couns Psychol. 2019;66:385–95. https://doi.org/10.1037/cou0000339

    Article  PubMed  Google Scholar 

  9. Zheng L, Li Y, Xie Z, Yang C The validation of the gender minority stress and resilience measure and mental health among Chinese transgender and gender nonconforming people. Transgend Health 2023; https://doi.org/10.1089/trgh.2023.0059

  10. Dickey LM, Singh AA. Social justice and advocacy for transgender and gender-diverse clients. Psychiatr Clin North Am. 2017;40:1–13. https://doi.org/10.1016/j.psc.2016.10.009

    Article  PubMed  Google Scholar 

  11. Meyer IH. Prejudice, social stress, and mental health in lesbian, gay, and bisexual populations: Conceptual issues and research evidence. Psychol Bull. 2003;129:674–97. https://doi.org/10.1037/0033-2909.129.5.674

    Article  PubMed  PubMed Central  Google Scholar 

  12. Hatzenbuehler ML. How does sexual minority stigma “get under the skin”? A psychological mediation framework. Psychol Bull. 2009;135:707–30. https://doi.org/10.1037/a0016441

    Article  PubMed  PubMed Central  Google Scholar 

  13. 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;76:1613–30. https://doi.org/10.1002/jclp.22951

    Article  PubMed  Google Scholar 

  14. Herek GM, Gillis JR, Cogan JC. Internalized stigma among sexual minority adults: Insights from a social psychological perspective. Stigma Health. 2015;1:18–34. https://doi.org/10.1037/2376-6972.1.s.18

    Article  Google Scholar 

  15. 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;18:411–26. https://doi.org/10.1080/15532739.2017.1329048

    Article  Google Scholar 

  16. Bockting W Internalized transphobia. In: The International Encyclopedia of Human Sexuality. (Bolin A, Whelehan P eds.) New Jersey: John Wiley & Sons, Inc; 2015; pp. 583–625. https://doi.org/10.1002/9781118896877.wbiehs236

  17. Bockting WO, Miner MH, Swinburne RE, Dolezal C, Robinson BB, Rosser BR, et al. The transgender identity survey: A measure of internalized transphobia. LGBT Health. 2020;7:15–27. https://doi.org/10.1089/lgbt.2018.0265

    Article  PubMed  Google Scholar 

  18. Kennis M, Duecker F, Elaut E, T’Sjoen G, Loeys T, Sack AT, et al. Daily sexual behavior, sexual esteem, and body image in transgender and cisgender individuals. J Sex Res. 2023;60:859–67. https://doi.org/10.1080/00224499.2022.2158172

    Article  PubMed  Google Scholar 

  19. 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;64:825–41. https://doi.org/10.1080/00918369.2016.1236587

    Article  PubMed  Google Scholar 

  20. Sánchez FJ, Vilain E. Collective self-esteem as a coping resource for male-to-female transsexuals. J Couns Psychol. 2009;56:202–9. https://doi.org/10.1037/a0014573

    Article  PubMed  PubMed Central  Google Scholar 

  21. Tabaac A, Perrin PB, Benotsch EG. Discrimination, mental health, and body image among transgender and gender-non-binary individuals: Constructing a multiple mediational path model. J Gay Lesbian Soc Serv. 2018;30:1–16. https://doi.org/10.1080/10538720.2017.1408514

    Article  PubMed  Google Scholar 

  22. Velez BL, Breslow AS, Brewster ME, Cox R, Foster AB. Building a pantheoretical model of dehumanization with transgender men: Integrating objectification and minority stress theories. J Couns Psychol. 2016;63:497–508. https://doi.org/10.1037/cou0000136

    Article  PubMed  Google Scholar 

  23. Rosenberg M Society and the Adolescent Self-Image. Princeton: Princeton University Press; 1965, https://doi.org/10.1515/9781400876136

  24. Muth JL, Cash TF. Body‐image attitudes: What difference does gender make? J Appl Soc Psychol. 1997;27:1438–52. https://doi.org/10.1111/j.1559-1816.1997.tb01607.x

    Article  Google Scholar 

  25. Vázquez-Morejón RJ, García-Bóveda RJ, Vázquez-Morejón AJ. Rosenberg self-esteem scale: reliability and validity in Spanish clinical population. Apuntes de Psicología. 2004;22:247–55.

    Google Scholar 

  26. Tylka TL, Wood-Barcalow NL. The Body Appreciation Scale-2: Item refinement and psychometric evaluation. Body Image. 2015;12:53–67. https://doi.org/10.1016/j.bodyim.2014.09.006

    Article  PubMed  Google Scholar 

  27. Swami V, García AA, Barron D. Factor structure and psychometric properties of a Spanish translation of the Body Appreciation Scale-2 (BAS-2). Body Image. 2017;22:13–17. https://doi.org/10.1016/j.bodyim.2017.05.002

    Article  PubMed  Google Scholar 

  28. Arcos-Romero AI, Moyano N, Sierra JC. Psychometric properties of the orgasm rating scale in context of sexual relationship in a Spanish sample. J Sex Med. 2018;15:741–9. https://doi.org/10.1016/j.jsxm.2018.03.005

    Article  PubMed  Google Scholar 

  29. Browne MW, Cudeck R Alternative ways of assessing model fit. In: Testing structural equation models (Bollen KA, Long JS eds.). Sage: Newbury Park, CA; 1993; pp. 136-62.

  30. McDonald RP, Ho MH. Principles and practice in reporting structural equation analyses. Psychol Methods. 2002;7:64–82. https://doi.org/10.1037/1082-989x.7.1.64

    Article  PubMed  Google Scholar 

  31. Ferrando PJ, Anguiano-Carrasco C. The factorial analysis as a research technique in psychology. Papeles del Psicólogo. 2010;31:18–33.

    Google Scholar 

  32. Harper BE. The relationship between black racial identity and academic achievement in urban settings. Theory Pract. 2007;46:230–8.

    Article  Google Scholar 

  33. Ward J, Winstanley D. Coming out at work: Performativity and the recognition and renegotiation of identity. Sociol Rev. 2005;53:447–75. https://doi.org/10.1111/j.1467-954x.2005.00561.x

    Article  Google Scholar 

  34. Van den Brink F, Vollmann M, van Weelie S. Relationships between transgender congruence, gender identity rumination, and self-esteem in transgender and gender-nonconforming individuals. Psychol Sex Orientat Gend Divers. 2020;7:230–5. https://doi.org/10.1037/sgd0000357

    Article  Google Scholar 

  35. Wolfradt U, Neumann K. Depersonalization, self-esteem and body image in male-to-female transsexuals compared to male and female controls. Arch Sex Behav. 2001;30:301–10. https://doi.org/10.1023/a:1002752214526

    Article  CAS  PubMed  Google Scholar 

  36. Vosvick M, Stem W. Psychological quality of life in a lesbian, gay, bisexual, transgender sample: Correlates of stress, mindful acceptance, and self-esteem. Psychol Sex Orientat Gend Divers. 2019;6:34–41. https://doi.org/10.1037/sgd0000303

    Article  Google Scholar 

  37. Neff KD, Vonk R. Self‐compassion versus global self‐esteem: Two different ways of relating to oneself. J Pers. 2009;77:23–50. https://doi.org/10.1111/j.1467-6494.2008.00537.x

    Article  PubMed  Google Scholar 

  38. Maniaci G, La Cascia C, Sartorio C, Ferraro L, Giammanco A, Anselmo R, et al. Alterations in body image, self-esteem and quality of life in a sample of Italian transgender individuals before gender-affirming surgery. PSY. 2022;28:163–70. https://doi.org/10.36148/2284-0249-462

    Article  Google Scholar 

  39. Mullen G, Moane G. A qualitative exploration of transgender identity affirmation at the personal, interpersonal, and sociocultural levels. Int J Transgend. 2013;14:140–54. https://doi.org/10.1080/15532739.2013.824847

    Article  Google Scholar 

  40. Simons L, Schrager SM, Clark LF, Belzer M, Olson J. Parental support and mental health among transgender adolescents. J Adolesc Health. 2013;53:791–3. https://doi.org/10.1016/j.jadohealth.2013.07.019

    Article  PubMed  PubMed Central  Google Scholar 

  41. Travers R, Bauer G, Pyne J, Bradley K, Gale L, Papadimitriou M. Impacts of strong parental support for trans youth: A report prepared for Children’s Aid Society of Toronto and Delisle Youth Services. Ontario: Trans Pulse; 2012. p. 1–5. https://transpulseproject.ca/wp-content/uploads/2012/10/Impacts-of-Strong-Parental-Support-for-Trans-Youth-vFINAL.pdf Available from:[Accessed 2026 Jan 27]

    Google Scholar 

  42. Healy KZ Internalized Transphobia, Minority Stress, and Collective Self-Esteem. Diss. The Ohio State University, 2011.

  43. 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;2:65–77. https://doi.org/10.1037/sgd0000081

    Article  Google Scholar 

  44. Singh AA, Hays DG, Watson LS. Strength in the face of adversity: Resilience strategies of transgender individuals. J Couns Dev. 2011;89:20–27. https://doi.org/10.1002/j.1556-6678.2011.tb00057.x

    Article  Google Scholar 

  45. Frost DM, Meyer IH. Measuring community connectedness among diverse sexual minority populations. J Sex Res. 2012;49:36–49. https://doi.org/10.1080/00224499.2011.565427

    Article  PubMed  Google Scholar 

  46. Owen-Smith AA, Gerth J, Sineath RC, Barzilay J, Becerra-Culqui TA, Getahun D, et al. Association between gender confirmation treatments and perceived gender congruence, body image satisfaction, and mental health in a cohort of transgender individuals. J Sex Med. 2018;15:591–600. https://doi.org/10.1016/j.jsxm.2018.01.017

    Article  PubMed  PubMed Central  Google Scholar 

  47. van de Grift TC, Cohen-Kettenis PT, Steensma TD, De Cuypere G, Richter-Appelt H, Haraldsen IR, et al. Body satisfaction and physical appearance in gender dysphoria. Arch Sex Behav. 2016;45:575–85. https://doi.org/10.1007/s10508-015-0614-1

    Article  PubMed  Google Scholar 

  48. Nobili A, Glazebrook C, Arcelus J. Quality of life of treatment-seeking transgender adults: A systematic review and meta-analysis. Rev Endocr Metab Disord. 2018;19:199–220. https://doi.org/10.1007/s11154-018-9459-y

    Article  PubMed  PubMed Central  Google Scholar 

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Acknowledgements

We would like to thank all the participants who generously contributed their time and effort to this study. We are deeply grateful for your participation.

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No funding was received.

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Authors and Affiliations

  1. Department of Psychology, Faculty of Psychology and Education, Universidad Loyola Andalucía, Seville, Spain

    Laura Esteban, Iván Bellido & Ana Isabel Arcos-Romero

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  1. Laura Esteban
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  2. Iván Bellido
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  3. Ana Isabel Arcos-Romero
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Contributions

IB: data curation; formal analysis; writing – original draft. AIAR: conceptualization; formal analysis; writing – review and editing. LE: conceptualization; formal analysis; writing – review and editing.

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Correspondence to Ana Isabel Arcos-Romero.

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This study was previously approved by the Ethics Committee of the Universidad Loyola Andalucía.

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Esteban, L., Bellido, I. & Arcos-Romero, A.I. Validation of the Spanish version of the transgender identity survey: A tool to assess internalized transphobia. Int J Impot Res (2026). https://doi.org/10.1038/s41443-026-01238-3

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