Clinical & Counselling Psychology Review (CCPR)

Volume 5 Issue 2, Fall 2023

ISSN(P): 2412-5253 ISSN(E): 2706-8676
Homepage: https://journals.umt.edu.pk/index.php/CCPR

Article QR

Emotion Regulation and Self-Concept as Predictors of Interpersonal

Title:
Problems in Transgender Population of Pakistan

Author (s): Hibba Noor1, Sana Rehman2

1
University of Sialkot, Sialkot, Pakistan
Affiliation (s): 2
University of Malaysia, Sarawak, Malaysia
DOI: https://doi.org/10.32350/ccpr.52.05

History Received: March 02, 2023, Revised: September 14, 2023, Accepted: October 09, 2023

Noor, H., & Rehman, S. (2023). Emotion regulation and self-concept as

Citation: predictors of interpersonal problems in transgender population of
Pakistan. Clinical and Counselling Psychology Review, 5(2), 78–93.
https://doi.org/10.32350/ccpr.52.05

Copyright: © The Authors

Licensing: This article is open access and is distributed under the terms of
Creative Commons Attribution 4.0 International License
Conflict of
Interest: Author(s) declared no conflict of interest

A publication of
Department of Clinical Psychology
University of Management and Technology, Lahore, Pakistan
 Emotion Regulation and Self-Concept as Predictors of Interpersonal
Problems in Transgender Population of Pakistan
Hibba Noor1, and Sana Rehman2
1
Department of Humanities & Social Sciences, GIFT University, Gujranwala,
Pakistan
2
Medicine and Health Science Department, University of Malaysia, Sarawak,
Malaysia
Abstract
The current study aimed to investigate the psychosocial predictors of
interpersonal problems in transgender people of Pakistan. For this
purpose, a sample of (n = 72) transgender individuals were
recruited through the snowball sampling technique. The Emotion
Regulation Questionnaire (ERQ), Personal Self-Concept Questionnaire
(PSQ), and Interpersonal Problems Scale (IPS) were used to find out the
predicting role of emotion regulation, self-concept, and interpersonal
problems in transgender individuals, respectively. Data was analyzed
through SPSS (Version 25). The findings revealed a significant positive
relationship between all domains of emotion regulation namely awareness,
clarity, goals, strategies, and impulse and two domains of interpersonal
problems, namely sociability and involved. Only awareness and clarity
domains of emotion regulation were found to be inversely correlated with
the supportive domain of interpersonal problems. Furthermore, a
significant positive association was observed between self-concept and the
two domains of interpersonal problems, that is, sociability and involved.
However, the two domains of self-concept, namely self-fulfillment and
autonomy were observed to be inversely correlated with the supportive
domain of interpersonal problems. These findings indicate that
demographics (education) is a negative predictor of interpersonal
problems. On the contrary, the two domains of emotion regulation
(strategy and impulse) are positive predictors of interpersonal problems.
Furthermore, one domain of self-concept (autonomy) is also a positive
predictor of interpersonal problems. The study has significant theoretical
and practical implications considering the Pakistani cultural context.


Corresponding Author: [email protected]
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Keywords: emotion regulation, interpersonal problems, self-concept,

transgender
Introduction
Gender diversity among adults has increased to a considerable extent all
over the world. In particular, diverse gender categories are grouped in the
literature under the umbrella term transgender, such as transsexuals, drag
queens, butches, hermaphrodites, cross-dressers, masculine women,
effeminate men, sissies, and tomboys (Irshad et al., 2020: Saleem, &
Rizvi, 2017). However, the acceptance for genders other than male and
female is not in vogue throughout the world (Shah et al., 2018). Only a
few countries provide equal rights to other genders. In Pakistan, the term
"transgender" is used to refer to any individual who defies the traditional
gender norms set out by the society, such as drag queens, eunuch, real
hermaphrodites, transsexuals, and homo/biosexual cross-dressers
(Abdullah et al., 2012). The number of transgender people officially
registered by the Pakistani government in past were 10,418; however,
the true figure is believed to be significantly higher (Wazir & Goujon,
2019).
The life of transgender individuals is not easy in Pakistan and they
face substantial challenges. Transgender people encounter social and
economic discrimination, lack legal recognition, experience violence, and
lack acceptance from the society (Shah et al., 2018). In particular, it
becomes more problematic when they experience rejection from
significant others, such as family, friends, and parents (Manzoor et al.,
2021). The literature is enriched with the studies depicting the
interpersonal problems of transgender individuals (Claes et al., 2015;
Davey et al., 2015; Gamarel et al., 2019). However, not all transgender
people manifest interpersonal problems. According to the literature,
emotion regulation is a predictor of interpersonal/interpersonal
relationships in a diverse population (Messinger et al., 2022). Emotion
regulation refers to the capacity to exercise control over one's emotional
state. This includes evaluating stressful situations to reduce anger and
anxiety, masking obvious signs of anxiety and sadness, and concentrating
on things/the given tasks. Transgender people occasionally
depict emotional control, which has beneficial impacts on them but can
also have negative ones (Kapatais et al., 2023). Unfortunately, the

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multiplicity and poly victimization to the similar issues lead to weak

emotional regulations for transgender (Messinger et al., 2022).
The lack of emotional regulation leads to interpersonal difficulties in
transgender people. Recent data illustrated that transgender individuals
who are aware of their emotions depict fewer emotional problems and
strive to form strong relationships with their close ones. However, a lack
of familiarity with self-emotions leads to uncertainty (Solbakken et al.,
2023). Consequently, such individuals form weak relationships and feel
isolated. Furthermore, other dimensions of emotional regulation such as
clarity, goals, non-acceptance, distress situations, and strategies also play a
significant role in the formation of interpersonal relationships (Victor &
Kolinsky, 2016).
The literature is enriched with empirical studies that illustrate the
strong relationship between emotion regulation and interpersonal
difficulties. A recent study was carried out on adults to investigate the
relationship between emotion regulation difficulties and interpersonal
difficulties. The findings depicted a significant relationship between these
constructs (Solbakken, et al., 2023). Another recent study was carried
out to investigate the relationship between emotion regulation difficulties
and interpersonal conflict among people with borderline personality
disorder. The findings depicted that emotion regulation difficulties are
positively correlated with emotional conflict (Haliczer et al., 2021).
Studies based on the combination of emotion regulation and
interpersonal problems are not scarce in the literature. However, emotional
regulation and interpersonal difficulties of transgender people have been
studied separately, worldwide. According to Drescher et al. (2023),
transgender individuals experience difficulties in emotional
regulation which increases the risk of self-harm tendencies and induces
suicide attempts. In short, literature demonstrates a significant research
gap in studies about the emotional regulation and interpersonal difficulties
of transgender people in Pakistan.
Self-concept is how human beings view their actions, skills, and
distinctive qualities (Hisli Şahin et al., 2009). Transgender individuals
with a better sense of who they are have a more optimistic outlook on life.
On the other hand, transgender individuals who experience criticism and
rejection from their families and society have lower self-esteem and

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develop negative self-concepts for life. In response to societal rejection,

they develop a lack of self-fulfillment, autonomy, and
emotional control, which are the dimensions of self-concept (Davey et al.,
2015). In response to Due to their weak self-concept, they depict a lack of
sociability, assertiveness, supportive attitude, care, and dependent
tendencies in their relationships (Kiviruus et al., 2016).
In short, both emotion regulation and interpersonal
difficulties were found to be strongly associated with interpersonal
difficulties. Similarly, the literature provides for a strong association
between self-concept and interpersonal problems. The findings of
Kiviruusu et al. (2016) indicate that people who report greater and more
frequent interpersonal confrontations experience poorer and slower growth
in self-esteem from their youth to mid-adulthood.
Hisli Şahin et al. (2009) concluded that self-concept and locus of
control are linked to the actions taken throughout the process of resolving
interpersonal disputes. Positive self-concept and internal locus of control
are associated with the adoption of more efficient and beneficial
interpersonal conflict resolution strategies.
As far as demographic information is concerned, some demographics
were observed to be highly interlinked with emotion regulation, self-
concept, and interpersonal difficulties. Graziano et al. (2007) showed a
favorable correlation between emotion management and early
literacy. Literature students depict better emotional regulation as
compared to illiterate ones/other students. Peiffer et al. (2020) used
German psychology students (N = 1,243) to study the difference of self-
concept (SC) and self-efficacy (SE) in higher education. They concluded
that higher education leads to greater emotional regulation and control
(Hardie et al., 2021).
The literature demonstrates that emotion regulation, self-concept, and
interpersonal difficulties have been studied in diverse
populations but information regarding the transgender population
of Pakistan is still missing. Therefore, the current study aimed to
investigate the predictors of interpersonal difficulties in transgender
adolescents of Pakistan.

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Rationale
According to the above literature, transgender individuals experience
substantial interpersonal problems (Claes et al., 2015; Davey et al., 2015;
Gamarel et al., 2019). Furthermore, emotion regulation and self-concept
were found to be strong predictors of interpersonal problems. However,
data regarding the predictors of interpersonal problems among transgender
people is scarce in literature in the Pakistani context. Therefore, the
current study aims to investigate the predictors of interpersonal problems
of transgender individuals keeping in view the Pakistani cultural context.
Aim
The current study aimed at identifying if emotional regulation and self-
concept are predictors of interpersonal difficulties.
Objectives
The current study has the following objectives:
1. To investigate the relationship between emotion regulation, self-
concept, and interpersonal problems in transgender individuals.
2. To investigate demographical experience of emotional regulation, self-
concept and interpersonal problems in transgender
Hypotheses
The current study tests the following hypotheses:
1. There would be a positive relationship between emotion regulation,
positive self-concept, and interpersonal problems in transgender
individuals.
2. Emotion dysregulation and negative self-concept would act as positive
predictors of interpersonal problems in transgender individuals.
3. There would be significant differences among transgender individuals
regarding their experience of emotion regulation, self-concept, and
interpersonal problems on the basis of their education.
Method
Study Design and Sample
The current study used the cross-sectional survey research design. The
sample included 72 transgender 40% were from the community of
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Islamabad, and 25% were from the city of Lahore. They were chosen
using the snowball sampling method.
Measures
Difficulty in Emotion Regulation Scale (DERS-18)
The emotion regulation questionnaire comprises an 18-item scale
covering six domains, that is, awareness, clarity, goals, non-acceptance,
distress situations, and strategies. Non-acceptance is encoded inversely.
The scoring keys range from 1–5-point Likert scale. The age range 19-76
years. Emotional regulation was found to be in acceptable ranges with an
alpha coefficient value above .60-80, except for non-acceptance (Victor &
Kolinsky, 2016).
Personal Self-Concept Questionnaire (PSCQ)
PSCQ comprises 22 items covering four domains, namely self-
fulfillment, honesty, autonomy, and emotional self-concept. It is a 5-point
Likert scale which applies to the 15-65 age range (Goñi et al., 2011). In
the current study, two domains of self-concept were considered, that is, SF
and AU. These domains of self-concept were also found to be in the
acceptable range of Cronbach’s alpha .79-.80.
Interpersonal Problems (IPP)
The IPP-32 was designed to measure the interpersonal problems of the
general and medical population. The age range of the scale is 18-88 years
(Barkham et al., 1996). The scale comprises 32 items and covers eight
domains namely sociable, assertive, supportive, caring, dependent,
aggressive, involved, and open. In the current study, sociable, supportive
and involved domains of interpersonal problems have been were taken
into account. This scale was used for transgender individuals (Davey,
2015). The coefficient of the domains of interpersonal problems was also
found in the acceptable range of .07- .08.
Procedure
The data was collected from different communities of transgender
people from Gujranwala, Pakistan. Permission was taken from the
respective gurus of these transgender communities. In the consent form,
the researcher ensured participants about confidentiality throughout the
process. A total of 72 transgender individuals filled in the questionnaire.

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However, their majority was uneducated. So, it was challenging to collect

the data from the participants. Afterwards, data was analyzed through IBM
SPSS Statistics 25.
Results
Descriptive statistics, regression, t-test, and ANOVA results are
mentioned below.
Table 1
Demographic Characteristics of Participants (N=72)
Characteristics f %
Education
No education 41 56.9
Middle 10 13.9
Matric 21 29.2
Table 1 illustrates the descriptive statistics. In the current study, the
participants were categorized into five age groups, that is, 16-20 years
[12.5%, n=9], 21-25, [34.7%, n=25], 26-30 [25.0, n=18], 31-35 [11.1%,
n=8], and 36-40 [16.7%, n=12]. The majority (56.9%) reported themselves
as illiterate. While, 13.9% claimed their education as middle and 29.2%
claimed to have done matric. Approximately, 97.2% of participants were
transgender by birth and 2.8% were those who became transgender
through medical treatment.
Table 2
Cronbach’s Alpha
Variable k Alpha
Awareness 3 .80
Clarity 3 .66
Goal 3 .60
Impulse 3 .66
Non acceptance 3 .93
Strategies 3 .50
SF 6 .79
AU 5 .78
Sociable 4 .80
Supportive 4 .85
Involved 4 .60
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According to Table 2, the Cronbach’s alpha values of all domains

(awareness, clarity, goal, impulse and strategies) of emotion regulation
were found to be in acceptable ranges, with an alpha coefficient value
above .60-90. The domains of self-concept (SF and AU) were also found
to be in the acceptable range of .79-.80. Only the alpha value of one
domain of self-concept was below the acceptable range (0.50). The
domain of interpersonal problems also lies in the acceptable range of
Cronbach alpha for social involved and supportive domains.
Table 3
Correlation between Emotion Regulation, Self-Concept, and Interpersonal
Problems (N=72)
Variable awea Clarity goals Stra imp Non SF AU S SU IN
Awea 1 .69** .89** .67** .55** -.24* .36** .42** .37** -.11 .87**
Clarity 1 .69** .54** .71** -.75** .77** .83** .84** -.08 .86**
Goals 1 .77** .49** -.33** .40** .41** .44** .10 .87**
Stra 1 .44** -.16 .24* .24* .37** .42** .77**
Imp 1 -.63** .61** .69** .72** .19 .57**
Non 1 -.79** -.84** -.89** .02 -.49**
SF 1 .84** .86** -.12 .61**
AU 1 .90** -.04 .61**
S 1 .13 .63**
SU 1 -.12
IN 1
M 9.53 8.49 9.24 8.67 7.79 9.07 15.19 13.28 10.44 10.19 12.11
SD 3.59 3.40 3.10 2.74 2.52 4.55 6.00 5.35 4.84 4.54 4.51
Note. Awae= Awareness, Stra= Strategies, Non=Non acceptance, SF=
Self-Fulfillment, AU= Autonomy, IN=Involved
Table 3 reveals a significant positive relationship between all domains
of emotion regulation, namely awareness, clarity, goals, strategies, and
impulse with two domains of interpersonal problems, namely sociability
(r=.36) and involved (r=.87). Only awareness (r=-.11) and clarity (r=-
0.77) domains of emotion regulation were found to be inversely correlated
with the supportive domains of interpersonal problems. Furthermore,
a significant positive association was observed between the two domains
of self-concept, that is, self-fulfillment and autonomy and the two domains
of interpersonal problems, that is, sociability (r=.86: r=.90) and involved
(r=.60: r=.61). However, the two domains of self-concept, namely self-
fulfillment (r=-.12) and autonomy (r=-.04) were observed to be inversely
correlated with the supportive domain of interpersonal problems.
According to Table 4, statistically significant differences exist in
awareness and clarity domains of emotion regulation, self-fulfillment and

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autonomy domains of self-concept, and supportive and involved domains

of interpersonal problems. However, there is non-significant difference in
goals, strategies, impulsiveness and non-acceptance, domains of emotion
regulation and sociable, and domain of interpersonal problems.
Table 4
One-Way ANOVA for Education Difference
Illiterate Middle Matric
Variable F p
M S.D M S.D M S.D
Awareness 8.34 3.46 11.10 3.78 11.09 2.95 5.91 .000
Clarity 7.39 2.76 9.40 3.84 10.19 3.63 5.83 .010
Goals 8.51 3.08 10.10 3.57 10.24 2.62 2.73 .073
Strategies 8.49 2.89 9.20 2.94 8.76 2.41 .28 .751
Imp 7.44 2.59 8.60 2.41 8.09 2.41 1.07 .352
Non 9.90 4.01 8.20 5.98 7.86 4.66 1.65 .200
SF 13.29 4.99 17.50 6.59 17.81 6.42 5.39 .012
AU 11.78 4.73 14.90 6.10 15.43 5.43 4.09 .020
S 9.34 4.07 11.90 5.59 11.90 5.49 2.58 .085
SU 11.83 4.01 9.20 4.59 7.47 4.21 7.99 .002
IN 10.41 3.76 14.00 4.67 14.52 4.51 8.14 .001
Table 5
Predictors of Interpersonal Problems (N=72)
95% CI for B
Factors B SEB β R ∆R2
LL UL
Step 1 .04 .02
Education -0.83 -1.73 0.07 0.45 -.20
Step 2 .58 .54
Constant 6.16 1.62 10.69 2.28
Education -0.75 -1.45 -0.04 0.35 -.18
Stra 0.90 0.56 1.23 0.17 .63
Impulse 0.30 0.03 0.57 0.14 .24
Step 3 .78 .75
Education -0.62 -1.14 -0.10 0.26 -.15
Clarity -0.31 -0.61 -0.01 0.15 -.25
Stra 0.57 0.31 0.83 0.13 .40
NON 0.21 0.03 0.40 0.09 .29
AU 0.06 -0.09 0.20 0.07 .82
Note. Model 1, F (3.34), 1, 78, Model 2, F (714.65), 7, 72 Model 3, F
(28.04), 9, .72
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According to Table 5, Model 1 shows that education is not a

significant positive predictor of interpersonal difficulties. Model 2 shows
that education is a negative predictor, whereas strategy and impulse
domains of emotion regulation are positive predictors of interpersonal
problems. Model 3 shows that the autonomy domain of self-concept is a
positive predictor of interpersonal problems.
Discussion
The study sought to examine the predictors of transgender interpersonal
problems in the Pakistani context. The findings revealed a significant
positive relationship between all domains of emotion regulation, namely
awareness, clarity, goals, strategies, and impulse and two domains of
interpersonal problems, namely sociability and involved. The findings are
unique as emotional regulation does not support interpersonal
relationships among transgender individuals in Pakistan. Only one domain
of awareness was observed to be a negative predictor of interpersonal
relations. This is significant in view of literature which depicts
contradictory findings. A Norwegian study depicted a significant
relationship between emotion regulation and interpersonal relationships in
Norway's population within the age range 18-65 years (Solbakken, et al.,
2023). Another recent study was carried out to investigate the relationship
between emotion regulation difficulties and interpersonal conflict among
undergraduates with borderline personality disorder in Massachusetts,
USA.
The findings depicted that emotion regulation difficulties are
positively correlated with emotional conflict (Haliczer et al., 2021). In
European countries like Norway, gender types and formation are
considered as part and parcel of human rights and transgender experience
minimum discrimination. Consequently, their emotional regulation helps
them to maintain healthy interpersonal relationships (Gasol et al., 2022).
Unlike European countries, in Pakistan, transgender people have not
gained a significant or even an acceptable place in the society Reeck et al.
(2022). Therefore, despite having emotional regulation traits, they still
experience interpersonal difficulties. Hence, it can be concluded that
emotion regulation is not a true predictor of interpersonal problems
in transgender individuals of Pakistan.

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Despite this fact, a significant positive association was found to exist

between interpersonal problems and self-concept, except for one
interpersonal problem dimension (supportive). In other words, the current
study found that self-concept helps to maintain supportive interpersonal
relationships in the Pakistani transgender community, as compared to
emotion regulation. In Pakistan, the transgender identity is still
questionable/remains contentious and only two genders (male and female)
are considered for personal and occupational settings. (Saleem & Rizvi,
2017). This discrimination adversely impacts the self-concept of
transgender individuals and they start to evaluate their personal traits
poorly (Sani et al., 2023). Consequently, they report poor interpersonal
relationships and depict a lack of social skills and supportive attitudes
towards others. Moreover, their involvement in diverse social events was
found to be poor. The literature also depicts that self-concept impacts
interpersonal relationships. However, autonomy and SF were observed to
have a positive relationship with interpersonal problems.
Notably, it was found that the literature contradicts the current study
findings. According to Hisli Şahin et al. (2009), those with positive self-
concept and internal locus of control use conflict resolution strategies that
are more successful and beneficial to resolve interpersonal problems.
However, in Pakistan people are less flexible and more awareness is
needed to uplift the status of transgender people in Pakistan. They have
poor self-concept despite having emotional regulation which affects their
interpersonal relationship. According to the current findings, strategy and
impulse domains of emotion regulation and autonomy domain of self-
concept are positive predictors of interpersonal problems. The literature
supports the findings of the current study, since a substantial number of
studies found that emotion regulation and self-esteem are predictors of
interpersonal problems in a diverse population (Monell et al., 2015;
Solbakken et al., 2023).
According to the current study, education is a negative predictor of
interpersonal problems. The education level helps to broaden the
individual’s perspective. Therefore, a strong relationship between literacy
level and study constructs was found. The literature also depicts the same
results. Graziano et al. (2007) showed a favorable correlation between
emotion management and early literacy. Literature students depict better
emotional regulation as compared to illiterate ones/other students. Peiffer

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et al. (2020) studied German Psychology students to examine the

association between empirical distinction of self-concept and self-efficacy
in higher education. They concluded that higher education leads to more
emotional regulation and control. Hardie et al. (2021) depicted the current
educational practices for fostering interpersonal and communication skills.
The study found that educated people experience interpersonal issues
the least and solve them with insight.
Limitations and Recommendations
The current study was primarily quantitative. Qualitative research
should be carried out to investigate the in-depth understanding of the
phenomenon. Moreover, the current study was cross-sectional. Therefore,
longitudinal research should be carried out as well to investigate emotion
regulation, self-concept, and interpersonal problems of transgender
individuals throughout/across their lifespan. Furthermore, as the
majority of the study population was illiterate, better data collecting
strategies should be used in future studies to get more valid and reliable
results.
Implications
The research on transgender clearly outlines how they live their lives
despite all the prejudice and labels that the society assigns to them. This
study can aid in developing transgender-inclusive policies in the future to
promote their status in the society. Also, it would help psychologists to
design appropriate intervention plans.
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