Chinese-Language Transgender Congruence Scale Proves Reliable for Teens and Adults Alike

A new study published in BMC Psychology has put a widely used measure of gender identity well-being through one of its most demanding tests yet, evaluating the Transgender Congruence Scale (TCS) among transgender and gender diverse (TGD) adolescents and adults in China. The research team, led by Di Wu of Guangdong Ocean University together with colleagues from South China Normal University, Yunnan Normal University, Zhejiang Normal University and Central China Normal University, reports that a concise eleven-item Chinese version of the scale holds up remarkably well statistically, and that it measures the same underlying constructs in teenagers as it does in adults. That second finding, known as measurement invariance, is the kind of technical result that rarely makes headlines but matters enormously for anyone hoping to compare the experiences of young and older transgender people with the same scientific yardstick.

Transgender congruence, the psychological construct the scale is designed to capture, describes the degree to which TGD individuals feel genuine, authentic and comfortable with their external appearance and presence, and the extent to which they accept their own identity rather than a socially prescribed one. The concept sits at the heart of a growing body of research linking identity affirmation to mental health outcomes. Although the original TCS has been validated in several cultural contexts since its development, evidence about how it performs among Chinese-speaking adolescents and adults had remained thin. That gap mattered, because instruments imported from Western contexts can behave differently when translated, and clinicians and researchers need to know precisely what a score means before they build programs or draw conclusions around it.

To translate and adapt the scale, the team used a forward and back translation procedure, a standard but essential safeguard in cross-cultural psychometrics. Questionnaires are first translated into the target language, then independently translated back into the original language, allowing researchers to spot and correct subtle shifts in meaning before the instrument ever reaches participants. The investigators then recruited two independent samples of TGD participants in China. The first, comprising 287 individuals, was used for item analysis and exploratory factor analysis, the statistical procedure that reveals how items naturally cluster together without the researchers imposing a predefined structure. The second, larger sample of 685 participants was reserved for confirmatory factor analysis, measurement invariance testing, and assessments of reliability and validity.

The exploratory results delivered the first reassuring signal: the Chinese version retained the same structure as the original instrument. Eleven items survived, dividing into the two familiar subscales, Appearance Congruence and Gender Identity Acceptance, which together accounted for a cumulative 55.97 percent of the variance in responses. In practical terms, this means that Chinese-speaking participants understood the items in much the same way as the original scale intended, with questions about feeling at home in one’s outward appearance forming one cluster and questions about embracing one’s gender identity forming another.

Confirmatory factor analysis on the second sample then tested whether that two-factor model fit new data when the structure was specified in advance. The fit indices told a favorable story. The model yielded a chi-square of 212.043 with 40 degrees of freedom, a root mean square error of approximation (RMSEA) of 0.079, a Tucker-Lewis index (TLI) of 0.918, a comparative fit index (CFI) of 0.940, and a standardized root mean square residual (SRMR) of 0.047. For readers outside the field, CFI and TLI values above roughly 0.90 and SRMR values below 0.08 are conventional benchmarks for acceptable fit, and this model cleared them, suggesting the two-factor architecture is a credible representation of how transgender congruence is organized in this population.

Reliability, the question of whether the scale produces consistent measurements, also came through strongly. Cronbach’s alpha, a gauge of internal consistency, reached 0.87 for the Appearance Congruence subscale, 0.79 for Gender Identity Acceptance, and 0.89 for the total scale, all within or near the range typically considered satisfactory. To probe stability over time, 55 participants completed the scale again four weeks after their first administration. The test-retest reliability of the total scale was 0.71, a respectable figure for a psychological trait measure over a month-long interval, indicating that the instrument captures something reasonably stable about a person’s sense of congruence rather than fleeting mood.

Validity evidence emerged from the pattern of relationships between TCS scores and other well-established measures. Appearance congruence was negatively associated with negative physical self, an intuitive link given that the subscale concerns comfort with one’s outward presentation. Gender identity acceptance was negatively associated with internalized transphobia, consistent with the idea that accepting one’s own identity and absorbing society’s negative messages about it are opposing psychological forces. Meanwhile, total TCS-11 scores rose with life satisfaction and fell with nondisclosure, meaning participants who felt more congruent reported being more satisfied with their lives and were less inclined to keep their gender identity hidden. These convergent and divergent patterns are exactly what theory would predict, lending the scale what psychometricians call construct validity.

Perhaps the study’s most consequential finding concerns measurement invariance across age. Before researchers can meaningfully compare scores between groups, they must demonstrate that the instrument functions equivalently in each. The team tested and confirmed configural, metric, scalar and strict invariance across adolescent and adult groups, the full hierarchy of invariance testing, encompassing the structure of the scale, the strength of item loadings, the calibration of item thresholds, and even the consistency of measurement error. With strict invariance established, differences in raw scores between teenagers and adults can be interpreted as genuine differences in transgender congruence rather than artifacts of how the questions are understood at different ages.

Using that now-validated yardstick, the researchers uncovered an age-related pattern with real developmental significance. TGD adults reported higher total transgender congruence and higher appearance congruence than adolescents, whereas no age-group difference appeared in gender identity acceptance. In other words, the gap between generations lies specifically in how comfortable people feel with their outward appearance, while the capacity to accept one’s gender identity appears comparable across age groups. The authors suggest this could reflect the longer time adults have had to explore presentation options, access affirming resources, or settle into their sense of self, though the cross-sectional design of the study means age and cohort effects cannot be fully disentangled.

The study, approved by the Ethics Committee of South China Normal University and conducted in line with the Declaration of Helsinki, with participants under 18 requiring parental or guardian consent, opens a practical door for Chinese-language research on transgender health. A brief, eleven-item measure that works identically across adolescence and adulthood allows clinicians to track congruence over time, lets researchers run cross-age comparisons without statistical gymnastics, and gives community organizations a validated tool for needs assessments. The authors acknowledge the participating communities, including the Guangzhou trans team, whose collaboration made the recruitment of nearly a thousand TGD participants possible. As research on gender diverse populations expands in China and beyond, instruments like the TCS-11, tested and trusted in the language and context where they are used, will be essential to ensuring that the numbers driving policy and care reflect real experiences rather than translation artifacts.

Subject of Research: Psychometric validation of the Transgender Congruence Scale in Chinese transgender and gender diverse adolescents and adults

Article Title: Psychometric validity of the Transgender Congruence Scale in a sample of transgender and gender diverse adolescents and adults in the Chinese setting

Article References: Psychometric validity of the Transgender Congruence Scale in a sample of transgender and gender diverse adolescents and adults in the Chinese setting. (n.d.). https://doi.org/10.1186/s40359-026-05808-4

Image Credits: AI Generated

DOI: 10.1186/s40359-026-05808-4

Keywords: transgender congruence, psychometrics, scale validation, measurement invariance, gender identity, mental health, Chinese adolescents, reliability, validity, confirmatory factor analysis, BMC Psychology, gender diverse populations