Psychological Needs and Well-Being in TGNB Adults

Journal of Counseling Psychology | 2025, Vol. 72, No. 4, p. 311-320

Basic Psychological Needs, Authenticity, and Well-Being in Transgender and Nonbinary Adults

Zakary A. Clements; Brown School of Social Work and Public Health, Washington University in St. Louis

Sharon S. Rostosky; Department of Educational, School and Counseling Psychology, University of Kentucky

“Transgender and nonbinary (TNB) people are those whose gender identity does not align with that expected based on their sex assigned at birth. Nonbinary people, more specifically, do not identify within the expected male/female gender binary. The stigma and discrimination that TNB people face and the resulting negative impacts on their psychological and health outcomes are well-documented… Less known is the relevance of general psychological processes, such as basic psychological needs (BPN) satisfaction, to important positive outcomes such as eudaimonic well-being (EWB). While all human beings have BPN that may affect their well-being, it is important to test these associations in populations whose social context poses challenges and creates barriers. Such is the social context of TNB people, many of whom, despite the risks of harm, find ways to create lives of meaning and purpose” (p. 311). 

“When TNB people’s BPN satisfaction is obstructed, the development and expression of authenticity may also be compromised. Given the importance of authenticity, we would expect negative effects on EWB. Alternatively, when BPN are protected and facilitated, TNB people may feel safe enough to be authentically themselves, supporting their efforts to live lives of purpose and meaning. We found only one study of cisgender adolescents that documented links from one basic psychological need (i.e., autonomy) to authenticity, which was further linked to higher levels of well-being. Given the sociopolitical context in which TNB people seek to satisfy their BPN and create authentic lives of meaning and purpose, we sought to model these associations in a TNB sample of adults. We hypothesized that BPN satisfaction would be directly and positively associated with authenticity and EWB. Second, we hypothesized that higher levels of authenticity would help explain significant positive associations between BPN satisfaction and EWB” (p. 313). 

“Participants (N = 489) ranged in age from 18 to 61 (M = 26.32, Mdn = 24, SD = 6.72), resided in the United States, and identified as transgender (60%), nonbinary (68%), genderqueer (26%), agender (14%), trans woman (11%), trans man (24%), and Two Spirit/third gender (1%). Eight percent wrote in other self-labels (e.g., abinary, demiboy, demigirl; 8%). They identified their race as White/ European American (67%), Multiracial (15%), Black/African American/Caribbean American (7%), Latino/a/x/Chicano/South American (5%), Asian/Asian American (3%), and prefer not to answer (3%). Participants indicated their primary sexual orientation as bisexual (27%), queer (21%), pansexual (14%), asexual (11%), lesbian (10%), gay (10%), straight (3%), and identity not listed (e.g., demisexual, greysexual; 5%)” (p. 313). The measures used in the study are: the Questionnaire for Eudaimonic Well-Being, the Basic Psychological Needs and Frustration Scale, and the The 12-item Authenticity Scale. 

“Our findings confirmed the importance of BPN satisfaction to EWB in TNB individuals. We found that satisfaction of BPN for autonomy, relatedness, and competence was significantly and directly associated with higher levels of EWB, or a sense of enduring meaning and purpose in one’s life. We also found that authenticity, or living true to oneself, helps to explain this association” (p. 316). 

“Our findings suggest that clinicians should assess and attend to TNB clients’ basic needs satisfaction. All human beings have needs for autonomy, relatedness, and competence. Actively acknowledging these needs and assessing how these needs are being satisfied is part of affirming the whole person. It is important to help TNB clients identify and articulate their basic needs and generate solutions for meeting them. An intervention that prompts clients to identify and assert their needs for interpersonal connection and social support may be delivered by text messages to more socially isolated TNB clients. The findings from this study suggest that helping TNB people satisfy their basic needs for autonomy, relatedness, and competence is important to their well-being.

Authenticity, like “outness” or “the self,” is not a fixed category or trait, but rather a process that unfolds in a specific context. Therefore, therapists should validate their TNB clients’ explorations of when and where they experience authenticity, as well as facilitators and barriers to their authenticity. An effective therapeutic alliance begins with creating a safe space for authentic expression between the therapist and the client.

Therapists’ multicultural orientation skills, including self-reflection on one’s own gender identity, an attitude of humility and “not knowing,” and curiosity that validates clients’ experiences rather than implicitly imposing one’s assumptions and biases, can help to forge an effective working alliance. Actively affirming clients’ authentic gender identity expression in therapy, often by seemingly small actions (i.e., microaffirmations) such as using correct names and pronouns or complimenting clothing, helps establish safety, builds a positive working alliance, and facilitates positive therapy outcomes.

According to the findings of this study, authenticity may serve as a conduit between BPN satisfaction and EWB. Therapists and their clients should reflect on experiences of authenticity and barriers to authenticity that arise in daily interactions with family, work, and community. Creating environments that support autonomy, including people’s authentic gender expression, could assist in ameliorating the well-documented TNB health disparities and promote EWB.

In addition to providing affirmative and supportive counseling at the individual level, psychological service providers can serve as advocates for their clients in the face of discriminatory political attacks and legislative bills. They can also educate communities on the importance of supporting the BPN of TNB people. Some recent conceptual work has suggested that a lack of social safety (as it manifests at all levels of the ecological system) may precede gender minority stress and account for health disparities even when gender minority stress is relatively low. The findings from this study have implications for families, schools, communities, and health service providers who share responsibility for providing and advocating for safety and support for the BPN satisfaction, authenticity, and EWB of TNB people” (p. 317-318).

“The coauthors who conducted the present study included an early-career White trans man and a late-career White cisgender woman, which likely influenced the choice of theoretical focus on self-determination and authenticity. Future research might test other theoretically based hypotheses that reflect more collectivistic and interdependent cultural values. The average age of the sample was 26 years old, so findings may not generalize to TNB adolescents who may be in a particularly important developmental stage relative to the pursuit of authentic living or to older adults who are consolidating and evaluating the meaning and purpose of their lives.

While our sample included TNB people with diverse racial and ethnic identities, subsamples were not large enough to examine group differences by identity intersections, which is an important area for future research. For example, we found that people of color participants reported lower levels of authenticity, which bears more exploration in future research. The influences of socioeconomic status, education, and geography are also important contexts that likely shape basic needs fulfillment and might be assessed in future studies.

We also note that the data for this study were collected during an ongoing pandemic and a time of considerable increase in political animosity toward TNB people. This sociopolitical context is important to keep in mind, as these experiences may have impacted participants’ self-reports of the psychological constructs in the model. Future research should directly assess the effects of political attacks and discriminatory legislation on these and other psychological processes.

The findings from this study suggest that SDT may be a useful framework from which to consider the psychological well-being of TNB people. While our aim was to test a general psychological model using a general measure of authenticity, we know that gender identity-specific authenticity is also important for TNB people. Further, despite the grounding of our hypotheses in theory and previous research findings, a longitudinal design further establishes the temporal order of variables. Meanwhile, cross-sectional mediation analysis is a starting point for exploratory and sufficiently powered model testing.

Most likely, there are bidirectional influences among self-determination factors, authenticity, and EWB. For example, TNB people who perceive themselves as more authentic in more social contexts may also feel more empowered and supported to pursue personal, social, and work-related goals that give them a greater sense of autonomy, relatedness, and competence. On the other hand, current and growing institutional and interpersonal barriers to satisfying these BPN may interfere with authentic living and EWB. These barriers and the toll they may take on well-being need to be documented. The focus of the present study was on a circumscribed number of general psychological processes and a limited set of hypotheses about contributors to EWB. Future studies might examine other theoretically grounded general psychological processes such as coping and resiliency that may also contribute to EWB” (p. 317).