Abstract Introduction The Transgender Congruence Scale (TCS) assesses appearance congruence and identity acceptance and has been validated among samples of TGD adults. Although the TCS has been used in studies of TGD adolescents, no studies have specifically examined the psychometric properties of the TCS in exclusively adolescent samples. The current study examined whether the TCS retains its construct and psychometric validity in a sample of TGD adolescents. Methods Participants included 529 adolescents, ages 12–17 years, who established care at a gender health clinic within a pediatric academic medical center in the Midwestern United States between 2013 and 2019. As part of standard of care, all participants completed a battery of psychosocial measures, including the TCS and measures of gender minority stress, body dissatisfaction, and anxiety and depressive symptoms. Analyses assessed the factor structure of the TCS, as well as convergent and discriminant validity. Results Confirmatory factor analysis identified a suboptimal fit of the two-factor model of the TCS in a sample of TGD adolescents. Subsequent exploratory factor analysis identified an optimal three-factor model reflecting appearance congruence, body congruence, and identity acceptance. Correlations indicated high internal consistency and construct validity of the three-factor model within a sample of TGD adolescents. Conclusions The two-factor TCS model for TGD adults may not psychometrically hold for TGD adolescents, and a three-factor model that distinguishes between appearance congruence and body congruence may be more appropriate. Future confirmatory analyses are needed with another sample of TGD adolescents. Policy Implications Results support preliminary psychometric properties of a three-factor model of the TCS for TGD adolescents, which can be used to track outcomes of gender-affirming care for minors over time in both clinical and research contexts.
Poquiz et al. (Fri,) studied this question.