Relational Minority Stress Beyond the Individual: Caregiving Burden, Communication, and Social Support in Families of Transgender Young Adults within the Southern Italian Context

Abstract Introduction Minority stress theory has predominantly been used to explain psychological strain among stigmatized individuals, with limited attention to its potential extension within family systems. Addressing this gap, the present study examines whether caregivers of transgender (TG) young adults exhibit a pattern of domain-specific strain consistent with a relational extension of minority stress specifically within the Italian cultural framework. Methods In this cross-sectional study (conducted between February and March 2026), caregivers of TG young adults from southern Italian context ( n = 57) were compared with caregivers of cisgender individuals with obesity ( n = 25) and caregivers of cisgender individuals without chronic health conditions ( n = 62). The inclusion of caregivers of cisgender individuals with obesity served as a clinical control group to isolate the impact of weight-related stigma from gender-related minority stress. Results One-way ANOVAs revealed that caregivers of TG young adults reported significantly higher caregiving burden ( p < .001), greater stigma-related communication difficulties ( p < .001), and lower perceived social support ( p < .001) relative to both comparison groups. Hierarchical regression analyses further indicated that stigma-related communication difficulties significantly predicted caregiving burden beyond caregiver group membership and global psychological distress, with perceived social support moderating this relationship ( p < .001). Conclusions These findings provide empirical support for a relational extension of minority stress, suggesting that stigma-related processes may operate beyond directly stigmatized individuals and manifest within family systems as domain-specific caregiving strain rather than generalized distress. Policy Implications Our results underscore the need to expand minority stress frameworks, social policies and healthcare services to implement targeted programs for families - such as peer support networks and specialized counseling - aimed at alleviating caregivers’ burden within the specific challenges of the Italian welfare and social system.