The Spirituality and Religiosity of Transgender Persons and Mental Health

Introduction

The results of research to date show a link between spirituality and religiosity and mental well-being. When analyzing these data, it should be noted that they suggest the multidimensional nature of relationships. Research by Row KA, et al. [1] on the role of religiosity and spirituality in obtaining and maintaining mental health showed that spirituality and prayer were strong predictors of human well-being. Similar results were obtained in studies on the relationship between spirituality and religiosity and the mental functioning of mothers of children with autism and African-American students [2, 3]. In these studies, spirituality turned out to be a significant predictor of mental health and its components were stronger predictors of well-being than religious factors such as church attendance, involvement in religious activity, and religious beliefs. A positive relationship between spirituality and mental health was also noted among older persons suffering from old age ailments [1].

Spirituality

Analyzing the hitherto achievements of researchers who deal with the issues of spirituality, while not rejecting the achievements of other scientific fields, such as theology, it may be adopted that spirituality constitutes the essence of transcendence understood as an activity that goes beyond the currently experienced self or its present image [4]. Transcendence can take place both internally, and is then defined as self-fulfillment or personal development, as well as externally [5]. This external orientation of transcendence should be understood as the orientation of activity towards the Higher Being or Energy, i.e. another person perceived as having a unique value. This person is given priority by the individual over themselves, and their good is put above the good of the individual. In this approach, transcendence has the form of exchange and relation of the current self with the object it is directed to Miller WR, et al. [6]. It should be emphasized here that this approach does not require accepting the existence of any supernatural factor as a condition for the existence of transcendence itself [7]. Cognitive psychology provides grounds for understanding spirituality as a multidimensional theoretical construct, for which the essence is to understand transcendence as going beyond the “real self”. Due to this approach, spirituality, as other theoretical constructs, may be assigned a regulatory function in relation to specific areas of human activity. From this perspective, it is possible to see spirituality as an attempt to explain the specific human activity consisting in transcendence [8]. Taking such approach, spirituality is a theoretical construct that is not directly measurable, and does not differ in this respect from other psychological concepts such as personality, intelligence, will or cognition.

When analyzing recent studies on spirituality, both should be adopted, i.e. the definition proposed by Armstrong, who describes spirituality as “the presence of a relationship with a Higher Power that exerts an influence on the way in which the individual operates in the world” [9], as well as the one proposed by Shafranske EP, et al. [10], where spirituality is a “transcendent dimension in human experience discovered at moments when the individual asks questions regarding the significance of personal existence, and tries to place self in a broader ontological context.”

Religiosity

Religiosity as one of the dimensions of spirituality is subject to empirical studies on an equal footing with all other spheres of human life. Allport Zarzycka B [11] claims that there are two types of religious motivation: an internal one based on autonomous and specifically religious motives, and an external non-autonomous one based on other, often non-religious motives. It was stated by Stark R, et al. [12] that each of the great religions is coherent with others in terms of general forms that religiosity should be characterized by. Both concepts were used by Huber S [13] to create a model based on their synthesis. In Huber S [13] approach, religiosity should be understood as a psychological construct that takes a specific place in the hierarchy of human’s personal constructs [14]. He recognizes the existence of two positions in the system of religious constructs. The primary one, which reflects the internal orientation, which operates autonomously and expresses itself in the religious features of self-image, the consequences of life choices and religious experiences; and the subordinate one, which refers to the external orientation, which functions marginally, does not have a stable nature and, as a consequence, does not affect self-perception and daily behaviors. In this second orientation, religious behavior and experiences appear occasionally, and reasons for them are often non-religious.

Huber S [13] wanted to include the motivational aspect of the structural religiosity dimensions in his proposal. Based on the concept of personal constructs, he described religiosity as a psychological construct, equal to other personal constructs and having the same properties. Determining the functioning of the system of religious constructs, it is based on the role of attention, where a human focusing on reality perceives it through the prism of their religiousness, and based on that shapes their own experiences and behaviors. How profoundly religious constructs will impact on human experience depends on their position in the overall system of personal constructs. According to Huber S [13], religious experiences and feelings constitute a function of the position and content of a religious meaning system in the hierarchical system of personal constructs. He described religiosity in five dimensions: Interest in Religious Issues, Religious Beliefs, Prayer, Religious Experience, and Worship - the total of these dimensions results in the Centrality of Religiosity which constitutes a general indicator showing the importance and superiority of the system of religious constructs in a person’s life.

Happiness as One of Explanations for Human Mental Health and Well-being

According to the World Health Organization mental health includes our emotional, psychological, and social well-being. It affects how we think, feel, and act. It also helps determine how we handle stress, relate to others, and make choices. Mental health is important at every stage of life, from childhood and adolescence through adulthood. In the modern approach, mental health also corresponds with the meaning of happiness, which has two explanations. The first assumes that happiness includes internal rewarding and valuable experiences, positive beliefs about oneself and the world, or positive mental functioning. The second explanation refers to taking happiness as an emotion. Many authors deriving from the positive psychology trend use happiness as a psychological term for human mental health [15].

Theories related to happiness are divided into hedonistic [16], eudaimonistic [17], and the ones which mix both approaches [15]. There are several theories about happiness that try to define its basic elements. The best known mention subjective well-being [18], objective happiness [16], mental well-being [19], eudaimonistic well-being [17], authentic well-being [20], socio-psychological prosperity [21], and the layered theory of happiness [22]. Psychologists, who investigate happiness, claim that the person experiencing it is characterized by several positive features such as: autonomy, the fullness of experience, and personal growth [19]. The theory of happiness proposed by Seligman ME, et al. [20], in turn, states that a kind of “path to happiness” shapes the fullness of life; pleasure and positive emotions (pleasant life), commitment and influence (good life), and sense (meaningful life). In his later works, Seligman ME, et al. [20, 22] presents happiness as a three-layered structure in the layered theory of happiness with a positive attractor in the form of the will to live as the basis, the middle layer in the form of subjective well-being, and the outer layer as the present effects of experience and satisfaction with achieved results.

Transgenderism

In order to understand the phenomenon of transsexualism (in Latin transire - pass, sexus - sex), it is necessary to reach for the latest medical knowledge, as well as immerse in the history of human sexuality. Anthropologists note that transgender people are present in all cultures, and it is exclusively the attitude towards them that change depending on the approach and moral standards. For the first time, the phenomenon of transgenderism was described in 1949 by Robacha A [23] who constructed this concept to describe the incompatibility between the subjectively felt mental gender and other factors which determine the perception of sex associated with the opposite sex. According to Robacha A [23], transgenderism occurs when “the brain sex resulting from its structure and functioning is in conflict with the somatic, genetic, gonadal, hormonal, and administratively specified, and determined at the time of birth, record gender.” A transgender person feels trapped in a body belonging to a sex that does not match their own identification as a woman or a man; they also feel internal opposition to the cultural and social requirements for performing gender roles assigned to their record sex. Contrary to such cultures as the residents of Madagascar, North American Indians or Thailand, where the concept of the third sex exists (in the case of Indians - winkte - double soul), in European countries sex is perceived in binary manner, as female or male. For this reason, transgender people often face misunderstanding and discrimination resulting from the absence of their consent for different treatment of their sex role.

From a statistical point of view, transgenderism occurs in 1 in 30 thousand people born as biological men and in 1 in 100 thousand people born as biological women. This means that 4.6 transgender people are born in the world per 100,000 births. In Poland, the sex ratio in the case of transgender people is inverted against the world (3: 1) and amounts to 1: 3.4. This is most likely due to cultural reasons and diagnostic procedures, but reports show that in our country people in the W/M (in Polish: K/M) type are more likely to seek help than in the M/W (in Polish: M/K) type [24]. Unfortunately, despite extensive research, the causes of sex identity disorders have not been discovered to date. There are no explicit biological, cultural or environmental reasons for this phenomenon. At the moment scholars are inclined to believe that transgenderism etiology combines both genetic and neurodevelopmental factors including early fetal environmental factors. Anatomical differences which occur in transgender persons are well documented, e.g., the absence of thickening of the cerebral cortex in men and W/M persons, which occurs in both women and M/W persons. In clinical studies of transgender people, the strongest signal is the subjective feeling of incompatibility of the body with the mentally experienced sex. Very often these feelings appear already in early childhood, although most of them are revealed during adolescence. Transgender people in the clinical picture are divided into two types: M/W, i.e. a biological male with female sex sense-transgender woman, and W/M, i.e. a biological female with male sex sense- transgender male.

Results

To test our hypotheses, we provide descriptive analyses of variables, then correlational analyses between spirituality, religiosity, and happiness, and finally, the analysis of multivariate regression to test predictors of happiness (Table 1).

Correlational Analyses

In order to analyze the relationship between the dimensions of spirituality, religiosity, and happiness as an indicator of well-being, correlation analyzes based on Pearson’s r coefficient were performed. It was noted that all relationships between the dimensions of spirituality (spirituality-religiosity, ethical sensitivity, and harmony and spirituality) and the dimensions of happiness turned out to be significant and ranged from weak to strong relationships (Table 2), which means that the higher the level of spirituality characterizes the person, the higher the level of happiness they experience.

The obtained results indicate that the level of interest in religious issues significantly correlates with all dimensions of happiness, as well as with the overall result. Similar weak positive relations with the dimensions of happiness were also noted for the level of religious beliefs, the frequency of prayer, the dimension of religious experience, worship, and religiosity (Table 3).

It was also found out that spirituality and religiosity, and their dimensions correlate positively and strongly, only the irrelevant relation was noted between harmony as the dimension of spirituality and the dimension of religiosity – interest in religious issues (Table 4).

Regression Analyses-Happiness as a Function of Spirituality and Religiosity

In order to verify which of the relations between the dimensions of spirituality and religiosity, and the dimensions of happiness maintain the significant status in controlling all other variables, four regression analyzes were performed, separately for each dimension of happiness. In each analysis, the dimensions of spirituality and religiosity were introduced as predictors, excluding general indicators (religiosity and spirituality) and the spirituality-religiosity dimension. The exclusion of these three variables from regression models was imposed by the break of assumption about the absence of collinearity of the predictors (the VIF values for these variables exceeded 10 when included in the model). None of the regression models reported below showed violations of the tested assumptions. First, the combined impact of spirituality and religiosity on the overall dimension of happiness was analyzed. The model proved to be well fitted to the data, F(7. 133) = 18; p <0.001. The value of adjusted R2 = 0.46 indicates that the predictors introduced explained 46% of the variance of the dependent variable. Estimates of regression coefficients have been presented in Table 5. The results show that when controlling the impact of all variables, the only significant predictors of happiness were the dimension of harmony and the dimension of interest in religious issues.

In the second step, the combined impact of spirituality and religiosity on the sense of meaning was analyzed. The model again proved to be well fitted to the data, F(7. 133) = 14.7; p < 0.001. The value of adjusted R2 = 0.44 indicates that the predictors introduced explained 44% of the variance of the dependent variable. It was found out that when controlling the impact of all variables, the only significant predictors of the sense of meaning were again the dimension of harmony and the dimension of interest in religious issues (Table 6).

In the further step, the combined impact of spirituality and religiosity was analyzed on the level of optimal experience, i.e. the dimension of happiness. The model again proved to be well fitted to the data, F(7. 133) = 10.3; p < 0.001. The value of adjusted R2 = 0.35 indicates that the predictors introduced explained 35% of the variance of the dependent variable (Table 7). It turned out again that when controlling the impact of all variables, the only significant predictors of the level of optimal experience were the dimension of harmony and the dimension of interest in religious issues.

The model verifying the combined effect of spirituality and religiosity on the intensity of positive emotions turned out to be well fitted to the data, F(7. 133) = 18.6; p < 0.001. The value of adjusted R2 = 0.50 indicates that the predictors introduced explained 50% of the variance of the dependent variable. The results replicate the relations described previously: standardized bet values indicate that also in this case the dimension of harmony is associated with positive emotions in a positive and strong manner, while the dimension of interest in religious issues in a positive and very weak manner (Table 8).

In the further step, the combined impact of general spirituality and religiosity indicators and their interaction on the overall dimension of happiness was analyzed. The model proved to be well fitted to the data, F(3. 137) = 23.99; p < 0.001. The value of adjusted R2 = 0.33 indicates that the predictors introduced explained 33% of the variance of the dependent variable. Estimates of regression coefficients have been presented in Table 9. A significant, very strong impact of spirituality on the level of experienced happiness was noted. Also the effect of religiosity turned out to be statistically significant, however negative and weak. This means that when controlling the impact of spirituality on the overall sense of happiness, the higher the level of religiosity, the lower the level of happiness. At the same time, no significant interaction effect of the predictors was noted.

Spirituality vs. Denomination

The results obtained in the study indicate that the respondents differ in terms of spirituality depending on the declared denomination, F(4. 136) = 11.43; p < 0.001; η2 = 0.25 (results of the post hoc test with Bonferroni correction have been presented in Table 10). Atheists were characterized by a significantly lower level of spirituality than Christians, Catholics and people who declared a different denomination.

Spirituality, Religiosity and Happiness According to Age Groups

In order to check whether there is a correlation between the age of the respondents and the results obtained by them, a correlation analysis based on Pearson’s r coefficient between the level of spirituality, religiosity and happiness, and the age of the respondent was performed. Three age groups were adopted: 1-under 30 years of age, 2-from 30 to 50 years of age and 3 - over 50 years of age. The analysis showed a significant and weak correlation between all the variables (Table 11).

Discussion

When another Two Spirit Pow Wow Dance festival took place in Montana in 2018, numerous observers noted that most of the indigenous tribes existing in North America perceive transgenderism as a unique gift of nature, and attribute transgender people a talent to perceive all matters from multiple perspectives. In Native American cultures, double-soul people were accepted, not stigmatized or discriminated against, and their presence did not cause internal conflicts and did not provoke violence. Drawing on the history of social treatment of transgender people, it is possible to state clearly that their psychological well-being is strongly correlated with the spiritual development of both individuals and entire social groups. The study conducted for the purposes of this work confirms this thesis pointing to a strong relationship between spirituality and well-being of the respondents defined as happiness. This means that for transgender people, their spiritual development is closely related to the subjectively felt happiness, which explains their desire to constantly grow in this area. Taking earlier studies on the impact of spirituality on human mental health into account [1], this result constitutes the confirmation of the thesis that people with highly developed spirituality are declaratively happier in life. At the same time, it should be noted that the relationship between religiosity and the feeling of happiness is fairly weak. This confirms the assumption that people belonging to the minority, which is rejected by most religious movements in Poland, feel less strongly about their relationship with faith communities, and therefore the impact of their religiosity on mental well-being is weaker than indicated in earlier studies [2].

When analyzing the results, attention is drawn to the relationship between spirituality and the religiosity of transgender persons, which seems to be important in the context of the cultural perception of spirituality in Poland. The common acceptance of spirituality as an interest and participation in religious practices is a mistake that numerous people make. The study participants also pointed out in their comments that spirituality was often understood by them as belonging to a given religious association. The 2018 Public Opinion Research Center (CBOS) report on the religiosity of Polish people indicates that declarations of faith in God are almost universal and hardly change - from the end of the nineties invariably over 90% of respondents (92%-97%, currently 92%) have considered themselves as believers, and about one in ten people (recently every twelfth) assesses their faith as deep [26]. At the same time, the results of these studies show a strong correlation between declared faith and religiosity. In the examined group of transgender people, religiosity as a dimension of spirituality is strongly associated with interest in religious issues and worship, which is confirmed in the common trend presented in CBOS studies regarding the declarative combination of religiosity as a spiritual construct with religious practice and worship. Equally strong was the relationship between ethical sensitivity and all indicators of religiosity, which is reflected in the tendency of Polish people to identify their ethical choices with their faith (CBOS).

The relationship between the sense of harmony and religiosity in its all dimensions apart from the interest in religious subjects seems interesting. Analyzing the respondents’ statements, it is possible to conclude that their feeling of ostracism from the side of structured religion causes discouragement and seeking harmony and spiritual development outside formal faith communities. In the analyzed group, religiosity and ethical sensitivity turned out to be weakly related to the sense of happiness, contrary to the sense of harmony which relates to all dimensions of happiness. Considering that the majority of respondents declared the absence of or very weak attachment to formal religious structures, the obtained results seem to confirm the thesis that spiritual development, at least in the sense of harmony, does not have to be related to belonging to a community of faith, and thus-the spirituality of transgender persons may develop, despite ostracism from the side of orthodox religious communities.

The strong relationship of harmony with optimal experience, positive emotions, and a sense of the meaning of life indicates that transgender people participating in the study try to build their spiritual life on values which do not depend exclusively on a religious pattern, but are as universal as the whole of spirituality. This gives great hope in the search for such psychological interactions, directed at transgender people, which will try to develop their well- being and sense of happiness using a spiritual construct. It is also worth noting that the impact of religiosity on the relationship between spirituality and mental health was not confirmed in the study group. This is an important element of the discussion on the presence of transgender people in social life. The exclusion from the communities of faith experienced by transgender persons from the side of multiple monotheistic religions, although it has negative impact on their mental health, is not tantamount to limiting their spiritual development. Its course is to some extent independent, and it may constitute a condition for the thesis that spirituality will develop regardless of religious norms and ostracism. This thesis also seems to be confirmed by the fact that in transgender people the level of spirituality did not differ in the context of the declared denomination. Referring to the theory of spirituality as a construct independent of religiosity, which is a more complex attempt to strive for transcendence, it may be concluded that the lack of major differences between declarative denominations and agnosticism shows that transgender people reveal the aforementioned pursuit of spiritual self-development, even against their religious principles [6, 27].

Conclusion

The results of the study encourage further exploration in this area, the more so as participants in the study declared their development in the spiritual area, even in the face of discrimination affecting them. Some of the participants defines their sacred zone according to the definition proposed by Socha P [28] and also indicates a strong need to maintain harmony and ethical sensitivity, which was confirmed by the results of the studies. However, the some other comments points to the perception of spiritual development through the rebellion against discrimination experienced by non- heteronormative people. Relating those statements to the concept by Huber C [13] regarding religiosity as a personality construct, it may be observed how enormous impact the rejection by faith communities has on the mental health and spiritual development of people experiencing it. The obtained results incline to extend the scope of studies and verify how religious ostracism and discrimination affect both mental health and the spiritual development of non- heteronormative people in Poland [29, 30]. Respondents also pointed out the need to analyze the tool for examining spirituality in terms of excluding the religiosity component so that it would be possible to investigate the spiritual development of people declaring themselves as atheistic and/or not practicing.