They Ought to Know: The Relationship Between Nondisclosure of Transgender Identity, Self States, and Suicidality

Date of Submission

2026

Degree Type

Dissertation

Degree Name

Doctor of Psychology (PsyD)

Department

Psychology

Department Chair

Stephanie Felgoise, PhD, ABPP

First Advisor

Stephen Poteau, PhD

Second Advisor

Donald Masey, PsyD

Third Advisor

Stephanie Yoder, PsyD

Abstract

Introduction. Transgender individuals face elevated risk for suicide attempts, suicide deaths, anxiety, depression, and other forms of psychological distress. Contributing factors include internal stressors such as gender dysphoria, self-stigma, and rejection, as well as external stressors like discrimination, social isolation, violence, bullying, and limited access to affirming healthcare. Psychological strain related to nondisclosure of transgender identity is especially relevant. Research suggests that identity concealment may create unique internal stressors due to misalignment among multiple “self-states.” Self-discrepancy theory proposes that greater gaps between actual, ideal, and ought selves are associated with reduced self-worth, emotional distress, maladaptive coping, interpersonal conflict, and motivational difficulties. Examining these discrepancies in relation to psychological and social adjustment offers a framework for understanding factors that shape transgender well-being and for identifying therapeutic strategies that promote congruence across self-states.

Objectives. This study examined the impact of transgender identity nondisclosure on psychological well-being. It evaluated whether concealment was associated with greater discrepancies between the actual and ought self and how these discrepancies related to suicidality, including suicidal ideation and attempts. The study also assessed perceived stigma as a potential moderator. Together, these factors were explored to clarify mechanisms underlying suicide risk and inform interventions aimed at risk reduction.

Methods. Transgender adults (18+) were recruited online to complete a survey assessing demographics, identity disclosure, suicidality, and internalized transphobia. An adapted Self-Discrepancies Scale measured discrepancies across self-states.

Discussion. Findings may inform identity-affirming, targeted interventions to reduce suicide risk and support psychological well-being among transgender adults.

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