Matsuno says that identifying as a biracial Asian and white person growing up in Laramie, Wyoming, they felt like they didn’t belong among their majority-white peers. “I struggled a lot with my race,” they say. When they lived in Japan briefly at age six, they felt like they didn’t belong there, either. “I’ve had a similar struggle with gender,” Matsuno says. “My experiences didn’t match up with other trans people I knew, but they also didn’t match up with cis people either.” That “in between” feeling informed their work as a psychologist and researcher. In grad school, Matsuno became much more involved in trans and nonbinary communities. They started to understand what it could mean to be nonbinary, they say, and started to identify as nonbinary themself. But they noticed that they, as well as their other nonbinary friends, were anxious about how other people perceived their gender, and hypervigilant about others’ discomfort. Sometimes it was the way a cashier said “Sir” or “Ma’am,” or having to choose which public restroom felt safest to use. It used up a lot of mental and emotional energy, they say — and happened day after day. Those experiences motivated their work. Matsuno set out to study, among other mental health issues in LGBTQ+ communities, the unique stressors that nonbinary people face. We spoke with Matsuno about some of their research, which focuses on how microaggressions affect people’s view of their own identity and appearance, and how this work can help nonbinary people cope with body image issues. Everyday Health: Why was it important in your research to help document the unique struggles nonbinary people face and the ways psychology can help? Em Matsuno: When it came to research, I wanted to label the experiences I was having with gender, which is how I came across the minority stress model. [The term “minority stress” refers to how members of stigmatized social groups experience physiological and psychological effects related to how they’re treated by others, according to the American Psychological Association definition.] Minority stress was a way for me to understand and label the stressors that were unique to being LGBTQ+. One of my recent (and favorite) studies, The Enby Project, was designed to understand minority stress and resilience among nonbinary people. The first phase was a qualitative study that consisted of five focus groups and six individual interviews. We found that nonbinary people experience many of the same stressors as other LGBTQ+ people, such as discrimination, rejection, harassment, and violence. We also identified new minority stressors that may be unique to nonbinary people: misgendering, invalidation, and burdening. [The study data are preliminary and will likely be published in early 2023.] EH: Can you describe misgendering, invalidation, and burdening? EM: Nonbinary people experience misgendering — when someone makes incorrect assumptions about another person’s gender, such as using incorrect names, pronouns, or gendered language — all the time. We live in a binary normative society, and so people are constantly making binary assumptions about gender. Invalidation refers to when people either make statements about nonbinary identities not being real, or when people make statements that imply that the other person isn’t “really” nonbinary — such as, “you don’t look nonbinary.” Burdening refers to the extra mental and emotional labor expected of nonbinary people to educate or prove their identities or take care of cis people’s guilt. All three of these minority stressors seem to be experienced daily, and therefore may take a toll over time. We also found nonbinary people internalize these negative messages and struggle with feeling valid or “nonbinary enough.” EH: Let’s go back to that phrase, “you don’t look nonbinary.” Many of us who fall along the nonbinary part of the gender spectrum have heard lines like that before. Can you elaborate on why that type of language is so harmful? EM: I think people want nonbinary people to look androgynous because it makes it easier for them to read people’s gender. But really, it’s like saying all women should wear makeup and all men should have short hair. It takes away people’s autonomy and freedom to express themselves in ways that make them feel good. It’s hard for people to accept things that are not concrete. A lot of people think that gender is something that you can tell by looking at someone, either due to their gender expression (hair length, makeup, clothing, and other things) or by their body characteristics (height, build, pitch of voice, and so on). However, gender is self-defined and is not defined by body parts, appearance, or pronouns. It’s someone’s internal sense of being a man, woman, neither, both, or another gender altogether. Nonbinary people have all kinds of bodies and gender expressions, as do men and women. EH: What would you say to a person who thinks there’s just one narrow way to “look” or “be” nonbinary? EM: My advice would be, sit with the unknown, sit with the discomfort. Allow others to define who they are even if it’s different from what you might expect. Believe them, affirm them, and validate them. EH: Why and how do narrow ideas from others about what it means to be nonbinary cause nonbinary people to struggle with their own body image? EM: In our research we found that nonbinary people received and internalized normative narratives: messages about what it means to be “nonbinary enough” or what an ideal nonbinary person should look like and act like. Our participants associated being nonbinary with being white, thin, androgynous, and trans masculine, having gender dysphoria, and using they/them pronouns. These narratives can definitely influence body image. They may cause nonbinary people to want to change their body to meet other people’s expectations, or feel negatively about the parts of themselves that don’t fit this normative narrative. There can be pressure to prove the validity of your identity, which may include having a body that fits dominant narratives. EH: What would you say to someone who’s nonbinary, or thinks they might be nonbinary, and is having a hard time feeling like the way they look is “valid”? EM: Surround yourself with positive messages. I follow all kinds of nonbinary people on social media and I am constantly seeing the beautiful diversity within our community. To some degree we can choose what messages we are taking in on a day-to-day basis. When we try to change ourselves to fit in or find belonging, we actually distance ourselves even more from that goal. True connection comes when we are accepted for who we are authentically. I think one of the best parts about being nonbinary is breaking free from gender norms and rules. There are an infinite number of ways to be nonbinary, just as there are an infinite number of ways to be a man or woman. There is power in rejecting these boxes and the boxes we create within ourselves. This interview has been edited for length and clarity.