Developing Resilience in Transgender and Nonbinary Individuals - Exploring the Impact of Social Challenges in the Metaverse

Assessing changes in levels of comfort and satisfaction related to gender identity with The Psychological Gender Affirmation Scale which contains 5 items, ranging from 1 - Not at all to 5 - Extremely. Higher scores indicate better outcomes.

Assessing changes in resilient attitudes from a general perspective with the Brief Resilience Scale (6 items on a 5-point Likert response scale, ranging from 1 - Strongly disagree to 5 - Strongly agree) and from a specific view of gender minority resilience with the Gender Minority Stress and Resilience Measure. Only the resilience items will be selected from the 58-items scale (5 items for Community connectedness and 8 items for Pride). Responses range from 0 - Strongly disagree to 4 - Strongly agree. Higher scores indicate better outcomes.

Assessing changes in perceived distal (Discrimination, Rejection and Victimization - 17 items) and proximal stress factors (Non-affirmation of gender identity, Internalized transphobia, Nondisclosure and Negative future expectations - 28 items) with the Gender Minority Stress and Resilience Measure (selecting only stress-related items) and in mental health symptoms with the Depression, Anxiety, Stress Scale (DASS), containing 21 items. Higher scores mean worse outcomes.

Assessing changes in approached coping mechanisms with the Trans and Nonbinary Coping Measure containing 28 items and 6 subscales with both adaptive and maladaptive types of coping, on a 5-point Likert scale (1 - I do not do this to 5 - I almost always do this). Scoring significance depends on the nature of the coping mechanisms.

Assessing changes in self-compassionate attitudes with the Short Form of the Self-Compassion Scale, containing 12 items on a 5-point Likert response scale ranging from 1 - Almost never to 5 - Almost always. Higher scores mean better outcomes.

Assessing changes in perceived social support with the Multidimensional Scale of Perceived Social Support, containing 12 items on a 7-point Likert response scale (ranging rom 1 - Very strongly disagree to 7 - Very strongly agree). Higher scores mean better outcomes.

Assessing changes in positive characteristics of gender identity with the Transgender Positive Identity Measure with 24 items with a 7-point Likert response scale (ranging from 1 - Strongly disagree to 7 - Strongly agree).

Short mood check questions for the beggining and end of the sessions with items from The World Health Organization-Five Well-Being Index (6-point Likert scale).

Changes in self-focused attention specific to gender minorities with the Gender Identity Reflection and Rumination Scale, containing 15 items on a 4-point Likert scale (1 - almost never to 4 - almost always). Higher scores for reflection mean better outcomes.

Changes in assertiveness are assessed with the Short Form of the Simple Rathus Assertiveness Scale, with 19 items on a 6-point Likert response format (1 - very unlike me to 6 - very much like me). Higher scores mean better outcomes.

Assessing enhacement in self-efficay with the General Self-Efficacy Scale with 10 items on a 4-point Likert scale (1 - Not true at all to 4 - Exactly true). Higher scores mean better outcomes.

Gender dysphoric symptoms are assessed pre-intervention (at baseline) to establish an initial level of gender-dysphoria for participants with the Gender Preoccupation and Stability Questionnaire containing 14 items with a 5-point response Likert scale. Higher scores mean increased gender dysphoria.

The DSM-5-TR Self-Rated Level 1 Cross-Cutting Symptom Measure is used for a primary screening process at baseline to identify potential elevated psychiatric problems. Higher scores mean worse mental health conditions.

Past experiences of microaggressions are assessed with two scales, one for binary transgender participants (Gender Identity Microaggressions Scale) containing 14 items, and one for nonbinary transgender participants (The Nonbinary Gender Microaggressions) Scale containing 23 items. Higher scores mean negative experiences with microaggresions.