“It's just very overwhelming to have all this stuff bottled up inside me”: A qualitative analysis of proximal minority stressors among trans youth in online forums

Background Trans youth face elevated mental health risks, yet proximal stress processes that contribute to this burden remain underexplored. The concept of proximal minority stress, which captures internalised stress experiences, was originally developed for sexual minority populations and studied largely in adults. Research rarely considers how trans adolescents’ lived realities shape their proximal stress experiences. This study addresses that gap, drawing on self-authored narratives of trans youth to offer insights into how they experience proximal stress in everyday life. Methods To explore how proximal stress experiences manifest in trans youths’ narratives, we conducted a qualitative content analysis of 172 threads from four publicly accessible online forums for trans youth. Using the Minority Stress Model as a theoretical lens, we applied an inductively expanded coding frame for the identification of proximal stressors and followed the LiLEDDA netnographic framework to ensure methodological rigor. Results In addition to three stressors consistent with the Minority Stress Model – anticipated stigma, identity concealment, and internalised transnegativity – our analysis suggests a fourth: the process of discovering one’s gender identity, which we propose as a previously unrecognised form of proximal stress. All four were shaped by youth-specific circumstances, particularly within family contexts. Anticipated stigma centred on fears of rejection, abuse, or invalidation, particularly by parents. Concealment was a common but costly strategy to preserve safety, though often constrained by appearance or gendered language. Internalised transnegativity appeared in varied forms, shaped by cisnormative gender norms and dominant societal narratives. Exploring their identities, many youths described the “trans impostor phenomenon”, involving doubts about the legitimacy of their identities, especially when these diverged from binary or medicalised norms. Conclusions Proximal stress among trans youth is shaped by developmental context, embodiment, and social norms. We propose youth- and trans-specific extensions to the Minority Stress Model: the centrality of parental dynamics, the constrained nature of concealment, and the stress of gender identity discovery within a cisnormative society. These findings underscore the need for affirming care and social environments sensitive to internalised stress experiences, alongside broader attention to the structural and relational contexts shaping trans youth’s stress experiences.