Relationship between early maladaptive schemas (EMSs), adverse childhood experiences and mental health in adulthood among transgender individuals

<b>Background:</b> Transgender individuals experience a high level of distress over the lifespan and are at a higher risk of experiencing mental health conditions.<b>Objective:</b> The present study mainly aimed to investigate the complex relationship between early maladaptive schemas (EMSs), adverse childhood experiences and mental health conditions in adulthood among transgender individuals.<b>Method:</b> 220 participants completed an anonymous online study assessing sociodemographic and medical status, experience of childhood adversity (CTQ), EMSs (YSQ-S3), transgender specific quality of life (ETLI), current depression (PHQ-8), and generalised anxiety severity (GAD-7).<b>Results:</b> Transgender individuals tended to have a high prevalence for experiencing childhood adversity as well as for depressive and generalised anxiety symptoms and low quality of life in adulthood, while assigned female at birth (AFAB) transgender tend to be more vulnerable than assigned male at birth (AMAB) transgender. In general, transgender individuals showed an elevated pronounced level of EMSs, while AFAB transgender tended to focus more on the negative aspects in life, to strive more to pursue perfection and tended more to be highly critical towards others and especially themselves, as well as tended to believe that people should be harshly punished for making mistakes than AMAB transgender. According to the network analysis, schema domain and their EMSs were related to all assessed psychopathological outcomes, especially the schema domains <i>Disconnection and Rejection</i> and <i>Impaired Autonomy and Performance</i> seemed to be related to experience of childhood adversity and quality of life in adulthood.<b>Conclusions:</b> Transgender individuals seem to experience a high level of childhood adversity, which possibly leads to the development of an elevated level of EMSs. EMSs and their schema domains are associated with elevated depressive and generalised symptoms, as well as lower quality of life.