(PS9-70) Minority Stress and Affirmation Related to Legal-preferred Name Consistency in a Gender Diverse Inpatient Sample

Use of legal names on health care documentation is a regulatory requirement. Research indicates that within the gender minority (GM) population, there is a disparity between people who have identical legal and preferred names versus those whose legal and preferred names do not match. Those with matching names (MN) report lower rates of psychological distress compared to differing names (DN) (Scheim et al., 2020). Legal-preferred name consistency may be protective by facilitating gender affirming interactions (Doyle et al., 2021). An inpatient setting, where legal name use is required to some extent, may create a nonaffirming environment. Deadnaming and misgendering are common stressors reported by GM people; however, the relationship between legal-preferred name consistency and gender minority stress has not been quantified. It is important to further investigate sources of minority-related stress within this population to inform their mitigation. In this study we compared minority stress and perceived affirmative experiences of GM individuals recruited from an inpatient setting. We predicted that DN participants would report higher levels of gender minority-related stress compared to MN participants. We also predicted that the DN group would be more likely to cite inconsistent name/pronoun use as a source of distress and be less likely to report feeling affirmed in their gender identity while on the inpatient unit. Participants included 45 GM inpatients (DN = 26, 57.8%; MN = 19, 42.2%). Gender identity reported in the sample was trans female (n=12), trans male (n=7), genderqueer/gender non-conforming (n=6), non-binary (n=11), and the remaining (n=9) who self-described as being genderfluid, bi-gender, agender, questioning, or having no identified terms. Participants completed the Gender Minority Stress and Resilience (GMSR) self-report measure, which assessed seven categories of stress: Gender-related discrimination, Gender-related rejection, Gender-related victimization, Non-Affirmation, Internalized transphobia, Negative Expectations for future events, and Non-Disclosure; and two resilience subscales: Pride and Community Connectedness. Participants also rated the extent to which they felt affirmed (response choices: yes, no, somewhat) during their inpatient stay. Data collection is ongoing (current n = 45, target n = 50); thus, current results are preliminary. A series of t-tests revealed that, contrary to our hypothesis, the groups did not differ on any of the GMSR stress scales. Exploratory analyses on the resilience scales indicated that the DN group reported significantly higher Pride than the MN group [t(43) = -2.16, p</em> = .036]. 47% of participants (n = 21) reported not feeling fully affirmed while on the inpatient unit. 71.4% who did not feel completely affirmed were a part of the DN group, although this difference was a statistical trend [χ²(1) = 3.01, p = .083]. These preliminary findings suggest that inconsistent usage of legal and preferred names within the GM population may be associated with less affirming inpatient behavioral health care. However, legal-preferred name inconsistency was not associated with gender minority stress, and instead may serve as a source of resilience (specifically Pride).