Development and validation of the A-JOURNEY questionnaire to measure stressors and resources of trans people

Background: Various lines of research explore how psychosocial factors like gender dysphoria, minority stress, gender euphoria, and social support affect trans people’s mental health. Conceptualizations of these factors have continuously evolved, resulting in a diverse spectrum of ideas for research on stressors and resources, but also leading to a considerable risk of overlap and confusion. Thus, clarifying and distinguishing these factors is now crucial for improving research and mental health care in this population. This study aims to develop a comprehensive questionnaire on stressors and resources relevant to trans and non-binary individuals, designed for health services and therapy outcome research, and inclusive of all gender identities.Methods: Participants (n=483 trans adults; age range 18-62) filled out an online questionnaire of candidate items for a comprehensive questionnaire (A-JOURNEY) on stressors and resources as well as self-report measures for well-being and psychopathology to assess criterion validity. We used parallel analysis and exploratory factor analysis to identify the questionnaire’s factors and select items.Results: Analyses yielded a final A-JOURNEY questionnaire comprising 53 items that assesses nine stress factors and four resource factors. Extracted factors showed high reliability (𝛼=.77-.93) and correlated with mental health outcomes in the expected directions.Discussion: The A-JOURNEY questionnaire provides a comprehensive tool for assessing stressors and resources in trans and non-binary individuals, streamlining evaluation without requiring multiple measures. While validation for change sensitivity is still required, it shows promise for advancing psychological and healthcare research and may enhance our understanding of how specific trans-specific stressors/resources affect mental health.