Research

Overview

In a rapidly evolving world where systems often fail to keep pace with our understanding of human experience and misinformation spreads like wildfire, interdisciplinary psychological research is uniquely positioned to drive meaningful change. My work seeks to integrate principles and theories founded in social, cognitive, and health psychology with insights from fields such as public health, media studies, and political science to tackle critical and current issues. My past work has engaged such issues through:

​

1. The examination of systems of health through the lens of transgender and gender diverse (TGD) health

2. Understanding susceptibility to and correcting misinformation.

​

​

Examining systems of health through the lens of TGD health

Systems of health are a complex series of interlocking structures, ranging from access to healthcare to the very environment that we live in. These systems enforce significant barriers to the highest attainable standard of health for the most marginalized populations. My first line of research applies the lens of marginalization – by examining health and health outcomes of transgender individuals in context, we can understand where and under what circumstances systems of health break down. My work has examined how situational factors, such as discrimination and community connection, influences the potentially positive relationship between outness and psychological distress (Wall et al., 2022; Stigma and Health), as well as how current anti-transgender legislation negatively impacts the psychological wellbeing of TGD individuals (Wall, Duffy, et al., in prep; invited for submission at American Psychologist). My work has also examined the role of substance use in coping with psychological distress in the context of the COVID-19 pandemic, finding that those who experienced higher rates of psychological distress were more likely to use substances to cope with stressors, and, in turn, more likely to show increased use of substances more generally (Benotsch, Wall¸et al., 2023; The American Journal of Drug and Alcohol Abuse).
 

While health exists outside of healthcare settings, understanding the experiences of minoritized populations within healthcare systems is vital in building towards equity driven health outcomes. In the first of its kind, I engaged in an in-depth exploration of gender-related medical misattribution and invasive questioning (GRMMIQ). GRMMIQ, known by the colloquial name “trans broken arm syndrome,” is a form of medical discrimination characterized by the perception of TGD patients through the medicalized lens of their gender identity or medical transition. For instance, a TGD patient may present to a healthcare provider with the eponymous broken arm, and the provider ultimately claims HRT led to or caused the injury. My work found high rates of these experiences while developing a thematic framework through which to understand such experiences (Wall, Patev, & Benotsch, 2023; Social Science and Medicine). My work has also examined TGD experience in sexual and reproductive healthcare settings and found that participants are often faced with a lack of accessibility, transantagonism, and outright abuse (Tabaac, Wall, et al., in prep).
 

Healthcare experiences, however, extend beyond the direct interactions between providers and patients. TGD patients report difficulty finding knowledgeable providers and having to teach their providers about TGD healthcare. So, what are future healthcare providers being taught about TGD populations? My work has found that current healthcare students reported fewer than six total hours of coursework, primarily accounted for by elective courses, brief discussions about gender affirming care, and mentions that “transgender people exist” (Wall, Patev, & Benotsch, in prep). After finding a provider, TGD individuals must navigate a privatized healthcare system intrinsically bound to financial health. Insurance, then, becomes vital to afford healthcare. While some insurance companies now cover select gender affirming healthcare, coverage is not applied equitably across the nation or across individual insurance policies. My work has suggested that nearly 50% of transgender people who have insurance faced arbitrary barriers to coverage for care including underinsurance, gatekeeping, and denial of claims as “medically unnecessary” (Wall, McLamore, Patev, & Benotsch, in prep).
 

Finally, TGD individuals have a long, and sometimes problematic, history with research itself – research that impacts how we understand TGD individuals and health. My colleagues and I have engaged in a systematic review to interrogate the way researchers have used demographic questions to identify TGD individuals, finding that many of the previous “gold standard” methods contained significant flaws that could potentially yield underestimations of the TGD population size or fail to account for an evolving understanding of gender and gender identity (Wall, Chwa, et al., under review). Such issues may lessen our understanding of health-related disparities while failing to properly account for the actual identities of participants in research. Research also plays a role in political decision making. Recent anti-transgender policies have often claimed that 60-80% of transgender youth cease identifying as transgender. These beliefs about “desistence” are founded in previous research, however one of my recent projects has applied a critical lens to this often-cited statistic. By integrating meta-analytic techniques and a contextual review, we have found that this “desistance rate” is likely highly overestimated due to a combination of volunteer bias, methodological considerations, and environmental contexts (Wall, McLamore, & Sakaluk, under review). Rather than using these statistics to guide policy, my work suggests that we must take them with a grain of salt. This last research project incorporating mistaken beliefs about transgender desistence rates led me to examining anti-transgender legislation more generally – legislation founded in misinformation.

 

​

Understanding susceptibility to and correcting misinformation

Since 2021, the have been over 1500 anti-transgender bills and policies proposed at the state and federal level that have been intended to impact the health, safety, and wellbeing of transgender individuals, as well as the rights of transgender individuals to exist in public spaces. These efforts, which have led to restrictions or bans on best practice medicine for transgender youth in 25 states, rely on multiple claims that are either misrepresent facts  or present outright falsehoods. It was this realization that inspired my new second line of research where I seek to understand what makes individuals susceptible to misinformation, what forms of debunking may be most effective, and what we can do to help reduce overall susceptibility to misinformation.
My first foray into misinformation sought to examine what makes individuals susceptible to misinformation about gender affirming healthcare. Using a theoretically driven structural equation modelling approach, I simultaneously examined the impacts of superficial information processing (i.e., fast or “lazy” thinking), motivated reasoning, and social influence on susceptibility to misinformation, and I have found that the two strongest predictors are motivated reasoning and social influence. It wasn’t simply lazy thinking – people believed this misinformation because it conformed to their worldview and the worldviews of respected others (Wall, McLamore, & Benotsch, in prep). I am currently in the process of conceptually replicating these results to examine misinformation about vaccines and abortions. Such results would not only help us better understand the underlying pathways but allow us a better understanding of how to disrupt such pathways. Beyond this, I have an ongoing project that seeks to increase our understanding of individual reactions to updated scientific information. In this work, we are providing participants with corrections to popularly believed, but incorrect, “facts” and examining whether acknowledging a previously held scientific belief impacts reactivity and trust in the actual correction. While still in its initial stages, this work has the potential to inform how we may open the door to active and intentional correction.