Examining Sexual Orientation Subtypes and Their Moderating Effects Among Transgender Individuals in Pakistan

Abstract

Purpose of the study was to examine among gender nonconforming (GNC) individuals in Pakistan with regards to their mental health outcomes while exploring the moderating role of sexual orientation within the Gender Minority Stress and Resilience (GMSR) framework. A total of 420 individuals made up the sample including 205 female gender nonconforming (FGNC) individuals (M=25.93, SD=6.31) and 215 male gender nonconforming (MGNC) individuals (M = 22.68, SD= 5.40). Higher levels of gender dysphoria and childhood non-conforming behavior was reported by FGNC participants as compared to their MGNC peers. Sex assigned at birth demarcated sexual orientation wherein FGNC participants were mostly labelled as heterosexual or asexual, while MGNC participants were generally identified as bisexual or homosexual. Moderation analyses highlighted those negative impacts of gender dysphoria on mental health outcomes are often shielded by heterosexual orientation, whereas asexual orientation was linked with better quality of life and reduced anxiety across both groups. Homosexual and bisexual orientations, however, in contrast, were associated with greater vulnerability, exhibiting the compounding effects of multiple minority stressors. These findings highlight the interplay of gender identity and sexual orientation in forming psychosocial outcomes among GNC populations. The results emphasize the value of culturally tailored assessment tools and interventions which cater for both distal and proximal minority stressors. Augmenting resilience through individual, family, and community-level backing can enhance quality of life and mental health for gender nonconforming individuals. Recognizing sexual orientation as a key moderator within the minority stress process is critical for developing inclusive, evidence-based frameworks that are attuned to Pakistan’s sociocultural context.