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Impacts of Strong Parental Support for Trans Youth

  • October 2012
  • Affiliation: Trans PULSE
Authors:
Robb Travers at Wilfrid Laurier University
Robb Travers
Greta Bauer at University of Minnesota Twin Cities
Greta Bauer
Jake Pyne at York University
Jake Pyne
Kaitlin Bradley
Kaitlin Bradley
Kaitlin Bradley
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Building our communities through research
2 October, 2012
Impacts of Strong Parental Support for Trans Youth
A report prepared for Children’s Aid Society of Toronto and Delisle Youth Services
1
Purpose of Report
The aim of this report is to provide preliminary data on the
health impacts of parental support for trans (transgender or
transsexual) youth aged 16 to 24 in Ontario.
Little is known about the ways in which acceptance or
rejection by one’s family is predictive of health or well-
being outcomes among trans youth. However, exposure to
homophobia is now generally regarded as having significant
implications for the health and well-being of lesbian, gay
and bisexual youth. Numerous studies over the last two
decades reveal negative health, mental health, and quality
of life outcomes, including high rates of depression and
anxiety, low self-esteem, problematic alcohol and drug use,
and suicide. Recent studies have demonstrated a strong
effect of parental acceptance during adolescence in
protecting against these outcomes for lesbian, gay, bisexual
and transgender (LGBT) young adults.1,2
partnership between members of the trans community,
community-based organizations, and academic researchers
who are committed to improving the health of trans people.
Trans PULSE is funded by the Canadian Institutes of Health
Research.
Data and Analysis Methods
Survey data were collected from a total of 433 trans
participants (youth and non-youth) by internet or paper
survey. The survey included items on health-related
measures, including social determinants of health, psycho-
social measures, health care experiences, and sexual health.
Participants were trans people aged 16 and over who lived,
worked, or received health care in Ontario. A broad
definition of “trans” was used; participants needed only to
identify themselves as trans. Participation was not limited to
particular trans identities, nor were they required to have
begun or completed a social or medical gender transition.
Figure 1. Proportion of trans youth age 16-24 years in Ontario
experiencing positive health and life conditions, by
level of parental support
72
66
70
64
58
100
92
33
31
15
13
42
45
82
0
10
20
30
40
50
60
70
80
90
100
Satisfied with
life*
VG/excellent
physical
health
VG/excellent
mental
health*
High self
esteem*
Intent to
parent
Adequate
housing*
Adequate
food
Parent(s) somewhat to not at all supportive
* = statistically significant difference (p < 0.05)
However, homophobia and transphobia can function
in differing ways, and trans youth have trans-specific
needs and vulnerabilities that may not necessarily be
captured in studies of LGBT youth.
Given the lack of information on impacts of parental
support for trans youth, we assessed the degree to
which parental support for trans youth’s gender
identity and expression had an impact on overall
satisfaction with life, self-assessed physical and mental
health, self-esteem, depression, and suicidality. We
report on these results below.
Trans PULSE Project
This report was produced using data collected during
the second phase of the Trans PULSE Project, a
community-based, mixed-methods research project
aiming to understand and improve the health of trans
people in Ontario. The Trans PULSE team is built on a
2
Social transition can include a change of name, gender
pronoun and gender presentation. Medical transition can
include interventions such as hormone therapy, gender-
affirming surgeries, and in adolescence, the administering of
gonadotropin releasing hormone analogues (GnRHa) to delay
the onset of puberty.
Participants were recruited through respondent-driven
sampling (RDS) over a 12-month period in 2009-2010,
including 123 trans youth, 84 of whom had socially
transitioned gender (or begun to), come out to their parents,
and provided information reporting how supportive their
parents were of their gender identity or expression. This
analysis is based on data from these 84 youth. RDS is a
tracked chain-referral method for recruitment and analysis,
and is designed to limit bias in studies of hidden populations.3
A hidden population is any group or community from which a
random sample cannot be obtained. Data were analysed
using RDSAT 6.0 software.4
In Trans PULSE, each participant could recruit up to three
additional participants. Recruitment patterns were tracked,
individual network sizes (the number of other eligible people
known) were assessed, and these data were used to weight
all statistics based on each participant’s probability of
recruitment. Statistics presented are thus population
estimates for networked trans youth in Ontario (i.e. those
who know at least one other trans person in the province).
Parental Support
We analysed our data for two levels of parental support “not
strongly supportive” and “strongly supportive”. We estimate
that 34% of trans youth in Ontario who are “out” to their
parents and have begun to socially transition have parents
they would describe as “very supportive” of their gender
identity or expression; 25% indicated their parent(s) were
“somewhat supportive” and 42% “not very” or “not at all”,
for a total of 67% in the “not strongly supportive” group.
Life Satisfaction, Physical and Mental Health
Knowing one has social and family supports is very important
in the development of one’s overall sense of health and well-
being. In Trans PULSE, parental support of youth’s gender
identity and expression was directly associated with how
trans youth rated their health and general well-being. Figure
1 shows the proportion of trans youth, aged 16-24 years in
Ontario, experiencing positive health and life conditions, by
level of parental support.
We wanted to know if feeling supported for one’s gender
identity and expression had an impact on trans youth’s
general satisfaction with their lives, which we assessed with
the question “how satisfied are you with your life in
general?” and on their self-reported ratings of mental health
(ranging from poor to excellent).
Figure 1 shows that trans youth who indicated their parents
were strongly supportive of their gender identity and
expression were significantly more likely (72%) to report
being satisfied with their lives than those with parents who
were not strongly supportive (33%). Also statistically
significant, 70% of those with parents strongly supportive of
their gender identity and expression reported positive
mental health compared to 15% of those whose parents
were not strongly supportive.
We also wanted to know if the level of support trans youth
experience from their parents for their gender identity and
expression impacts their evaluation of their overall physical
health. We measured this by asking youth to rate their
health ranging from poor to excellent. While not statistically
significant, of those with strongly supportive parents, 66%
reported very good or excellent overall health compared to
31% of those with parents not strongly supportive of their
gender identity and expression. We note that a lack of a
statistically significant difference does not imply
equivalence, especially given the low statistical power to
detect differences with a small sample size (n=84).
It is also known from many studies of young people’s
psychological well-being, that parental support is a strong
predictor of healthy self-esteem. In Trans PULSE, we
assessed self-esteem using the Rosenberg Self-Esteem Scale
(1965), defining “high self-esteem” as scoring 20 or higher;
having parents strongly supportive of one’s gender identity
and expression indeed had a significant impact on self-
esteem. Of those with strongly supportive parents, 64%
reported high self-esteem compared to only 13% whose
parents were not strongly supportive.
Healthy psychological development in young people is also
generally accompanied by a sense of optimism about the
future. Studies of gay, lesbian and bisexual youth show that
many are anxious about their futures, worrying that they
Figure 2. Proportion of trans youth age 16-24 years in
Ontario experiencing negative health and
life conditions, by level of parental support
23
34
4
75
70
57
0
10
20
30
40
50
60
70
80
90
100
Depressive
symptoms*
Considered
suicide, past yr
Suicide attempt,
past yr*
Parent(s) very supportive
Parent(s) somewhat to not at all supportive
* = statistically significant difference (p < 0.05)
3
won’t have long-term relationships or families. We asked
participants if they intended to parent in the future by asking
"Would you like to have or adopt a child in the future?” While
not statistically significant, among those with parents strongly
supportive of their gender identity or expression, 58%
reported an intent to have children compared to 42% of
those whose parents were not strongly supportive.
Figure 2 shows the proportion of trans youth aged 16-24
years in Ontario experiencing negative health and life
conditions, by level of parental support for their gender
identity and expression. We were particularly concerned
about mental health and suicide risk among trans youth given
the range of studies showing these associations among
lesbian, gay and bisexual youth. We used the 20-item CES-D
scale designed to measure depressive symptomatology in the
general population. The presence of depressive symptoms
(CES-D 16) was significantly related to whether trans youth
had parents supportive of their gender identity and
expression. A clear difference emerged with depressive
symptoms reported by only 23% percent of those with
supportive parents in contrast with 75% of those whose
parents were not strongly supportive.
To attain a recent measure of suicide risk, we asked
participants if they had considered suicide in the past year,
and whether they had attempted it. Consideration of suicide
was common, and was reported by 35% of youth whose
parents were strongly supportive and 60% of those whose
parents were not strongly supportive. Particularly alarming is
that among this latter 60%, nearly all (57%) had actually
attempted suicide in the past year. In contrast, only 4% of
those with strongly supportive parents attempted suicide.
While 4% is still far too high, the impact of strong parental
support can be clearly seen in the 93% reduction in reported
suicide attempts for youth who indicated their parents were
strongly supportive of their gender identity and expression.
Housing and Food Security
Trans youth were classified as inadequately housed if they
indicated they were currently homeless, in precarious
housing situations (e.g. couch-surfing, living in a boarding
house), or had great difficulty making housing payments
while being below the low-income cut-off. Having adequate
housing was reported by 100% of youth with parents strongly
supportive of their gender identity and expression, but only
by 45% of youth whose parents were not strongly supportive.
We also wanted to measure the impact of parental support
on whether trans youth had enough food. Having adequate
food was defined as whether a household had enough to eat
over the past year. While not statistically significant, for those
with parents strongly supportive of their gender identity and
expression, 92% reported having adequate food compared to
82% of those with parents not strongly supportive.
Implications of Our Findings
Trans PULSE data have considerable implications for
parents/caregivers and for those working with trans youth in
schools and services. First and foremost, our findings show
clear associations between the support that trans youth
experience from their parents and numerous health
outcomes. The most significant differences show that trans
youth who have strong parental support for their gender
identity and expression report higher life satisfaction, higher
self-esteem, better mental health including less depression
and fewer suicide attempts, and adequate housing
compared to those without strong parental support. These
findings draw a direct relationship between strong parental
support and the reduction of significant risk factors for trans
youth.
Our findings related to suicide consideration, self-reported
poor physical health, inadequate access to food, and having
a reduced intention to parent should not be ignored or
dismissed because the differences between groups were not
statistically significant, given our low statistical power to
detect differences in this analysis. Indeed, the estimates for
effects are still large and paint a consistent picture that is
worrisome enough to warrant attention from service
providers, parents and other caregivers, and policy-makers.
For parents and caregivers, our data have many
implications. Our earlier results (not shown) revealed that
having a “somewhat supportive” parent did not have a
significantly more positive effect on youth than if their
parents were not at all supportive of their gender expression
and identity. This indicates that anything less than strong
support may have deleterious effects on a child’s well-being.
These results should be viewed in light of recent suggestions
that LGBT youth may rate their families as more supportive
than their behaviours would indicate. Our findings suggest
the need for parents of trans youth to find adequate support
for themselves so that they can provide the strong support
that their children need.
The experience of having a child come out as trans can be
overwhelming for some parents. Parents worry about what
other people will think and how their child will fit into their
cultural or faith communities. Some parents feel shame or
grief because their child is different than they expected and
many worry that their child will be bullied or will lead an
unhappy life. For some families, a non-judgemental
counsellor can help to process these fears. For others, peer
support from other parents of trans youth, either on-line or
in person, where available, is their greatest resource.
Wherever parents seek support, it is important that they
express and process these complex feelings with other
adults and not with their child. While some parents worry
that being trans will cause their child to be unhappy,
ultimately our data indicate that it is parents and caregivers
themselves who provide the foundation for their children’s
4
health and well-being with their support. Therefore, policy-
makers and service providers need to ensure effective
services are available directly for parents and caregivers of
trans youth.
Those working professionally in school settings, child
welfare, residential and other services should be aware of
the risks facing trans youth whose parents are unsupportive
of their gender expression and identity. These youth face
significant and life-threatening risk factors, directly related
to lacking support at home. Teachers, service providers and
administrators may lack the knowledge or skill to intervene
in situations where trans youth are being bullied, and some
may wrongly assume that these youth will find the support
they need at home. This may not be the case. Indeed, our
data suggest that parents, in many cases, are not supportive,
leaving youth to fend for themselves, possibly increasing
their feelings of alienation, abandonment and despair. With
such high rates of suicidal ideation and actual suicide
attempts among trans youth, anything that adversely
impacts their mental health will be detrimental. The
presence of an active Gay-Straight Alliance (GSA) in a school
is an important and crucial resource for trans youth, and
may serve to meet some of their needs. Studies, however,
show that trans youth often feel alienated in GSAs as the
strong focus on gay and lesbian experience may not
adequately address the reality and needs of trans youth.
Service providers may not be aware that trans youth are in
their midst. The erasure and invisibility of trans youth,
coupled with a general lack of knowledge among youth
service providers about their issues, renders their needs
invisible. Trans youth may also be actively ignored in
services, or they may avoid accessing services altogether, for
fear of being stigmatized by service providers for presenting
outside of traditional gender boundaries. Yet, resources for
building trans-inclusive services exist.5-8 Trans-inclusive
youth programs that provide trans youth with a safe and
confidential space to access professional and peer supports
are crucial in helping to decrease feelings of depression and
the despair that precedes suicidal ideation and attempts.
Suicide crisis lines, in particular, must build their capacity to
respond to the needs of trans youth. Like school-based
personnel, service professionals should not assume that
trans youth are receiving supports at home. Indeed, our
data show that parental responses at home may be the root
cause of many adverse health and well-being outcomes.
Finally, our data point to an urgent need for policy-makers
to make themselves familiar with the needs of this very
vulnerable group of youth, and to respond accordingly with
resources that will help to ameliorate a very desperate
situation. For example, providers in a range of settings,
including schools, mental health, child welfare, residential,
and social and health care services, require appropriate
policies, practices, training and resources to ensure that
service provision to trans youth is delivered with dignity and
respect, and is free from any bias or barriers related to
gender identity or gender expression.
We were not able to examine the ways that parental
support for gender may impact trans youth differently in
relation to other parts of their identities, such as race,
culture, language, newcomer status, disability, etc.
However, multiple levels of invisibility, marginalization,
alienation or victimization could alter risks and produce
different outcomes for trans youth with intersecting
identities. Therefore service providers and policy-makers
need to also address the needs, risks and protective factors
that affect those trans youth who may experience unique
challenges due to intersecting identities.
For trans youth, the availability of both on-line and local
supportive resources is increasing. We include information
below about crisis lines and services that are sensitive to the
needs of trans youth. It is also possible that the presence of
other supportive adults can mitigate some of the negative
effects of having unsupportive parents. As such, we
encourage youth to seek out supportive and safe adults in
the community or in counselling services who can offer
guidance and counselling supports through difficult times.
For some parents, their attitude toward their trans child
may improve over time. While we don’t know enough about
this empirically, studies that focus on the families of lesbian,
gay and bisexual individuals show that many parents come
to terms with their child’s sexual orientation over time, and
become more supportive. While many trans youth can and
do find a way to move on with their lives, despite a lack of
parental support, we feel that they should not have to do so
alone. We urge policy makers, service providers,
communities and families to take the necessary steps to
effectively recognize, welcome and support trans youth, and
to eliminate any gender-based bias or barriers.
References
1. Ryan C, Huebner D, Diaz RM, Sanchez J. Family rejection as a predictor of negative
health outcomes in white and Latino lesbian, gay, and bisexual young adults.
Pediatrics 2009;123(1):346-352.
2. Ryan C, Russell ST, Huebner D, Diaz R, Sanchez J. Family acceptance in adolescence
and the health of LGBT young adults. Journal of Child and Adolescent Psychiatric
Nursing 2010;23(4):205-213.
3. Heckathorn DD. Respondent-driven sampling II: Deriving valid population estimates
from chain-referral samples of hidden populations. Social Problems 2002;49(1):11-34.
4. Volz E, Wejnert C, Degani I, Heckathorn DD. Respondent-Driven Sampling Analysis
Tool (RDSAT) Version 6.0.1. Ithaca, NY: Cornell University.
5. Bauer GR, Hammond R, Travers R, Kaay M, Hohenadel KM, Boyce M. “I don’t think
this is theoretical; this is our lives”: How erasure impacts health care for transgender
people. Journal of the Association of Nurses in AIDS Care 2009;20(5):348-361.
6. Children’s Aid Society of Toronto. Out and Proud Affirmation Guidelines – Practice
Guidelines for Equity in Gender and Sexual Diversity. Toronto, ON, 2011.
7. Mottet L, Tanis J. Opening the door to inclusion of transgender people: The nine keys
to making lesbian, gay, bisexual and transgend er organizations fully transgender-
inclusive. New York: National Gay and Lesbian Task Force Policy Institute and the
National Center for Transgender Equality, 2008.
8. Ryan C. Helping families support their lesbian, gay, bisexual, and transgender (LGBT)
children. Washington, DC: National Center for Cultural Competence, Georgetown
University Center for Child and Human Development, 2009. Available at:
http://nccc.georgetown.edu/documents/LGBT_Brief.pdf.
E-Bulletins, presentations and articles available at:
www.transpulseproject.ca
To contact Trans PULSE:
info@transpulseproject.ca
1-877-547-8573
Report prepared by:
Robb Travers, PhD; Greta Bauer, PhD, MPH; Jake Pyne, MSW;
Kaitlin Bradley, MSc, for the Trans PULSE team; Lorraine
Gale, MSW, for Children’s Aid Society of Toronto; and Maria
Papadimitriou, MSc, MPH, for Delisle Youth Services.
Trans PULSE is funded by Project Partners
5
Resources for Trans Youth
ONTARIO WIDE
The LGBT Youth Line - A hotline staffed by youth, for youth
1-800-268-9688 http://www.youthline.ca/index.php
HALTON
LGBTTTIQQAA Youth Support Group @ Positive Space Halton
905-875-2575 ext 239 http://search.hipinfo.info/record/BTN4873
KITCHENER / WATERLOO
OK2BME - Group for LGBT youth
ok2bme@kwcounselling.com http://www.ok2bme.ca/
LONDON
Open Closet – Social support group for LGBT 14-18 year olds
http://www.hivaidsconnection.ca/open-closet
Trans Youth London - Group for trans youth
https://www.facebook.com/TransYouthLondon?ref=ts
OTTAWA
Pink Triangle Youth Group for LGBT Youth
613-563-4818 or volunteer.coordinator@ptsottawa.org
YSB Spectrum - LGBT Youth Group
613 241 7788 ext 409 or hiv@ysb.on.ca
THUNDER BAY
The Other 10% @ Children's Centre Thunder Bay - Drop-in LBGTTIQ
+ questioning group for 12-25 year olds
807-343-6373
Trans* Support Collective - Youth-friendly group for trans people
and supporters
tbtsc2012@gmail.com https://www.facebook.com/pages/Trans-
Support-Collective/194317560663423
TORONTO
Griffin Centre – Several groups for LGBT Youth including a group for
youth of colour (Spektrum) and LGBT youth labelled with
intellectual disabilities (Compass)
416-222-1153 http://www.griffin-centre.org/spektrum.php
Pride and Prejudice Program @ Central Toronto Youth Services -
Groups and counselling for LGBT Youth
416-924-2100 http://www.ctys.org/
STARS (Strong and Resilient) @ Delisle Youth Services - Group for
queer, trans and questioning youth
416-482-0081 http://delisleyouth.org/pages/stars-y
Supporting Our Youth (SOY) - A program of the Sherbourne Health
Centre - A variety of groups and programs for LGBT youth,
including Trans Fusion Crew, a group for trans youth
416-324-5077 http://www.soytoronto.org/
Trans Youth Toronto @ The 519 Church Street Community Centre -
Drop In group for trans youth.
416-355-6792 mpage@the519.org
http://www.the519.org/programsservices/transprograms/transyo
uthtoronto
Resources for Parents of Trans Youth
Fact Sheet: “Supporting Gender Independent Children”, for health
and social service providers
http://www.rainbowhealthontario.ca/admin/contentEngine/cont
entDocuments/Gender_Independent_Children_final.pdf
Families in Transition – on-line resource for parents of trans youth
Central Toronto Youth Services
http://www.ctys.org/sites/default/files/familiesintransition-
a_resource_guide_for_parents-080608.pdf
Family Acceptance Project (USA) - On line resources for families of
LGBT Youth
http://familyproject.sfsu.edu/
Gender Identity Hotline - PFLAG CANADA - Hotline which parents
and others can call for support
Toll-free: 1-888-822-9494 gender@pflagcanada.ca
http://www.pflagcanada.ca/en/index-e.php
Gender Spectrum (USA) - On-line resources for parents of trans or
gender variant children
http://www.genderspectrum.org/
“If you are concerned about your child’s gender behaviors” – On-
line resource manual for parents of gender variant children.
Children's National Medical Center in Washington DC
http://www.childrensnational.org/files/PDF/DepartmentsandProg
rams/Neuroscience/Psychiatry/GenderVariantOutreachProgram/G
VParentBrochure.pdf
Rainbow Health Ontario - Series of brochures for parents of
gender independent children will launch in 2013
www.rainbowhealthontario.ca
Stephanie A. Brill and Rachel Pepper. (2008). The Transgender
Child: A Handbook for Families and Professionals. Cleis Press.
TransParent Canada
http://www.transparentcanada.ca/?file=kop1.php
... For trans young people, navigating the daily challenges that cisgenderism, i.e., "the ideology that delegitimises people's own designations of their genders and bodies" (Ansara & Hegarty, 2014, p. 260) perpetuates can be life-threatening. Accordingly, trans young people are at increased risk of experiencing rejection, discrimination, aggression and non-affirmation; these experiences occur across all life domains, including within the family (Clark et al., 2014;Grossman & D' Augelli, 2007;Hendricks & Testa, 2012;Strauss et al., 2020;Travers et al., 2012). Levels of experienced parental rejection or ambivalence are markedly similar across studies, with around two thirds of parents falling into this category as reported by their child (Clark et al., 2014;McDermott et al., 2016;Strauss et al., 2017;Travers et al., 2012). ...
... Accordingly, trans young people are at increased risk of experiencing rejection, discrimination, aggression and non-affirmation; these experiences occur across all life domains, including within the family (Clark et al., 2014;Grossman & D' Augelli, 2007;Hendricks & Testa, 2012;Strauss et al., 2020;Travers et al., 2012). Levels of experienced parental rejection or ambivalence are markedly similar across studies, with around two thirds of parents falling into this category as reported by their child (Clark et al., 2014;McDermott et al., 2016;Strauss et al., 2017;Travers et al., 2012). ...
... Parental rejection is related to negative outcomes such as increased self-harm and suicidality, increased risk-taking behaviors and higher levels of mental health difficulties such as depression and low self-esteem (Grossman & D' Augelli, 2007;Grossman et al., 2005;Sansfaçon et al., 2018;Strauss et al., 2020;Taliaferro et al., 2019;Wilson et al., 2016;Wilson et al., 2012;Yadegarfard et al., 2014). Crucially, anything other than strong parental support can have harmful impacts on trans young peoples' wellbeing (Travers et al., 2012). Parental rejection also has other serious, far-reaching impacts for trans youth; they are significantly over-represented across the areas of homelessness, sexual exploitation and the care system (Bateman, 2014;Choi et al., 2015;McCormick et al., 2016). ...
Parental Challenges, Facilitators and Needs Associated with Supporting and Accepting Their Trans Child’s Gender
Article
  • Nov 2022
Parental support is strongly correlated with protective factors for trans youth yet most experience parental rejection or ambivalence regarding their gender. Many parents report a desire to support their child but indicate lack of understanding and support as key barriers. We aimed to develop a nuanced understanding of the challenges and facilitators experienced by Australian parents in developing understanding, support and acceptance of their child’s gender and their needs to do so. Using data from semi-structured interviews (N = 30), the General Inductive Approach (GIA) was employed to explore primary themes within parental narratives. Participants described a range of complex emotions and exhausting mental burden as they simultaneously supported their child, searched for information, and navigated multiple systems (e.g., school, health). Good-quality information, seeing positive change in their child once affirmed and peer connections were powerful facilitators for increased support. There was strong thematic unity regarding their needs. Parents reported wanting an online ‘one-stop hub’ with evidence-based information and resources, and access to others’ lived experiences. Better understanding of the parental experience and what parents need to optimally support their child holds implications for the development of online interventions to promote parental understanding, support and acceptance of a child’s gender.
View
... It is well established that parents exert significant influence over their child's development (Resnick et al., 1997), given they shape the home environment, have financial power and are a formative influence from birth. Families provide a key developmental context for trans youth and can confer both risk and resilience, particularly once the young person's gender identity becomes known to their family (Simons et al., 2013;Travers et al. et al., 2012). Importantly, parental acceptance and support of trans youths' gender identity is strongly correlated with protective factors across a range of outcomes. ...
... Importantly, parental acceptance and support of trans youths' gender identity is strongly correlated with protective factors across a range of outcomes. Specifically, trans young people with support experience greater self-esteem, higher quality of life, safer sex practices, lower rates of mental health difficulties such as depression, suicidality and self-harm, and decreased rates of homelessness when compared with trans youth experiencing ambivalent, low or no parental support (Aramburu Alegría, 2018;Durwood et al., 2017;Katz-Wise et al., 2018;Olson et al., 2016;Travers et al. et al., 2012;Wilson et al., 2012). Crucially, research indicates that anything less than strong parental support can have detrimental impacts on trans young people's health and wellbeing (Travers et al., 2012). ...
... Specifically, trans young people with support experience greater self-esteem, higher quality of life, safer sex practices, lower rates of mental health difficulties such as depression, suicidality and self-harm, and decreased rates of homelessness when compared with trans youth experiencing ambivalent, low or no parental support (Aramburu Alegría, 2018;Durwood et al., 2017;Katz-Wise et al., 2018;Olson et al., 2016;Travers et al. et al., 2012;Wilson et al., 2012). Crucially, research indicates that anything less than strong parental support can have detrimental impacts on trans young people's health and wellbeing (Travers et al., 2012). Research also indicates that parental rejection is a common experience for trans young people. ...
Factors Influencing Parental Acceptance of Trans Children and Young People: Findings from Trans Pathways
Article
  • Sep 2022
Trans youth are at high risk of mental health difficulties and negative life events. Strong parental support is highly protective however there is little understanding of what factors facilitate the process of parental understanding and acceptance of a child’s gender identity. We aimed to better understand a) preexisting factors influencing levels of parental acceptance of their child’s gender identity; b) the factors parents find helpful in facilitating acceptance of their child’s gender identity once they become aware; and c) how parents experience extended family, cultural and religious reactions. Using cross-sectional survey data, we explored the experiences of parents and guardians (N = 194). Quantitative data were primarily analyzed using Bayesian regression models and qualitative data were thematically analyzed. Several factors were salient in influencing parental acceptance, including the nature of their child’s gender identity, and levels of awareness and acceptance of the child’s gender identity at time of initial parental awareness. Multiple factors aided acceptance, including information, peer support, and the quality of the dyadic relationship. Findings provide a better understanding of how parental acceptance of a child’s gender identity develops. We provide recommendations on what may help parents to optimally support their child, such as accessible, good-quality information.
View
... A Toronto study showed that 57% of transgender youth ages sixteen to twenty-four would attempt suicide if they were in a "somewhat to not at all supportive" home. The transgender youth from a "very supportive" family only attempted suicide at a 4% rate (Travers, Bauer, and Pyne 2012). ...
Transgender Ideology & Gender Dysphoria: A Catholic Response
Book
Full-text available
  • Sep 2021
Throughout the previous century, medical professionals aimed to ease the inner tensions found within transgender individuals by conforming their outer appearances to their preferred gender identities. Repeated studies have found a reduction of gender dysphoria through sex reassignment surgeries and hormone therapies. Although well-intentioned, these efforts were on their own insufficient for relieving the underlying distress caused by gender dysphoria. Moreover, transgender individuals, even after sex reassignment procedures, have higher risks of mortality, neoplasms, suicidal behaviors, and psychiatric morbidity than the general population. Faith-based conversion therapies double the morbidity rates of transgender individuals. A religious approach not based on medical science produces worse outcomes than providing no support at all. A lack of family and communal support of transgender youths leads to increased homelessness, prostitution, and substance abuse. The uncompromising, tough-love approach does not lead to positive outcomes for many transgender youths. Medical evidence from the previous decade suggests a neurodevelopmental cause for transgender identities; however, studies on Rapid-Onset Gender Dysphoria point to social causes for the spike of adolescents identifying as transgender. While high rates of pre-adolescent children diagnosed as transgender desist in their dysphoria, some studies have shown that adolescents who take hormone blockers do not desist into their early twenties. Longer-term follow-up studies are needed to know the effects hormone blockers have on desisting when prescribed early. Nominalist gender theorists have integrated transgender identities into their ideology, whereby the body, mind, and spirit are not essentially united. Although these ideologies attempt to liberate individuals from restrictions of biological realism, this ideology has not offered transgender people an inner sense of peace. According to a 2018 Human Rights Campaign study, individuals who identify as non-binary and other newly named gender identities suffer from the highest levels of depression, anxiety, and suicide attempts. Under the transgender umbrella are three groups of people: (1) those with early-onset gender dysphoria, (2) those with Rapid Onset Gender Dysphoria, and (3) gender theorists who are part of the 4th wave of feminism. Those with early-onset gender dysphoria suffer from a medical condition that desists at a rate of 80% by adolescence—the 20% who persist benefit from some form of social transformation into the opposite sex. The vast majority of people calling themselves transgender are from the second category who are mostly adolescent females. Like self-harm and eating disorders, this social contagion peaks at seventeen years of age, desisting in adulthood. Autistic young people are significantly affected. This group is primarily looking for an identity and supportive community. The gender theorist has capitalized on this chaos and effectively presented the transgender identity as a way of reinvention. Those with gender dysphoria require support, those with gender confusion need guidance, and gender theorists need to be philosophically challenged. Thomistic realism offers additional resources for transgender individuals, which secular science cannot offer on its own. Thomism embraces all disciplines of science and the humanities to present a holistic expression of the truth. The Thomistic heuristic utilizes medical science and seeking to restore nature by the least invasive means while depending on virtues and grace to provide wisdom and character to overcome obstacles. This book argues that using a Thomistic heuristic in line with church teaching is better than medical therapies alone, faith-based conversion therapy, or adopting a nominalist-based gender theory ideology.
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Schools Often Fail to Expect Trans and Nonbinary Elementary Children: What Gender Independent, Nonbinary, and Trans Children Desire
Article
  • Sep 2022
Background/Context This article is drawn from a doctoral research study that involved co-research between as adult trans academic and their child, a nonbinary 11-year-old. It mounts an epistemic challenge to education that assumes children to be cis, and either boys or girls. GIaNT children (Gender Independent, and Nonbinary, Trans) are often talked about but seldom directly engaged about their wants and desires in education, but my study addresses this problem and centers their agency. Purpose/Research Question/Focus of Study The purpose of the study was to generate knowledge and insight into how 2SLGBTQ children, and children from 2SLGBTQ families, envision education spaces and programs that meet their needs. It also investigates the potentiality and significance of a parent-and-child researcher team to engage caregivers and children in co-imagining liberatory education spaces as 2SLGBTQ cultural spaces. Participants Participants were 17 children (ages 4–12 years) and 12 adults from 11 households; the focus in this article is on the 12 children who identified their gender as other than cis. Research Design A qualitative, arts-based participatory research methodology was employed. While the parent-child research team of a trans adult and a nonbinary 11-year-old conducted semi-structured interviews with both children and parents, the focus in this article is on the former. Participants were also invited to draw their ideal learning space. Interviews were video recorded, transcribed, and coded. Findings/Results GIaNT children in this study desired learning spaces that are ready for them, that affirm their self-assigned genders, and that understand that people define their own genders. They wanted to be believed as who they said they were. They wanted safe access to bathrooms and schools to be communities, not just places of learning, and they recognized that learning happens outside of school. They desired an end to gender policing in schools, and in online learning, participants wanted schools that were safe and celebratory of all their identities and of all their peers. They wanted schools that are antiracist and decolonizing, that practice universal access, that teach queer and trans history and culture, and that provide meals and transportation. Conclusions/Recommendations The study highlighted the creative potentialities of GIaNT children to provide generative insights into gender-affirming school spaces. It advocates for children to be engaged in processes of creating their own learning experiences. GIaNT children called for schools to be more equitable, antiracist, and decolonizing, committed to practicing universal access, teaching queer and trans history and culture, and providing meals and transportation.
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Een beeld krijgen van de relaties tussen transgender en genderdiverse jongeren en hun verzorgers
Article
  • Aug 2022
De mentale gezondheid en identiteitsontwikkeling van transgender en genderdiverse jongeren (TGD) worden beschermd door steun en acceptatie vanuit het gezin. Hoewel in sommige studies wel is gekeken naar de rol van steunende gezinsrelaties voor TGD-jongeren, is nog niet eerder diepgaand onderzocht hoe TGD-jongeren en hun verzorgers aankijken tegen deze relaties binnen het gezinssysteem of naar hoe ze die karakteriseren. In deze kwalitatieve studie onderzochten we de perspectieven van TGD-jongeren en hun verzorgers op de relaties jongere-verzorger en verzorger-verzorger binnen het gezinssysteem. We wierven daarvoor een steekproef uit de algemene bevolking van twintig gezinnen (20 TGD-jongeren, leeftijd 7–18 jaar, en 34 verzorgers), afkomstig uit drie regio’s in de Verenigde Staten. In de groep TGD-jongeren waren meerdere genderidentiteiten vertegenwoordigd; de verzorgers waren moeders (n = 21), vaders (n = 12) en één oma. Bij alle deelnemende gezinsleden werd individueel een semigestructureerd interview afgenomen, met onder andere vragen over de gezinsrelaties. Van de interviews werden woordelijke transcripties gemaakt, die met een thematische-analysebenadering werden geanalyseerd. De analyses leverden een beeld op van complexe wederzijdse gezinsrelaties, met vijf contextuele factoren die deze relaties beïnvloedden: school, gemeenschap, werkplek, religie en familie. De identiteitsontwikkeling van de TGD-jongeren bleek sterk verbonden met de manier waarop verzorgers op hun kinderen reageren, van ze leren en zich aan hen aanpassen; en de identiteitsontwikkeling van de TGD-jongeren bleek ook sterk verbonden met hoe de verzorgers met elkaar omgaan. De bevindingen illustreren hoe acceptatie door verzorgers en gezinscohesie mogelijk hand in hand gaan, en dat de jongeren en hun verzorgers dezelfde contextuele factoren noemden als het gaat om factoren die een impact hebben op hun gezinssysteem. Dit onderzoek laat zien dat het in gezinsbehandelingen belangrijk is om TGD-jongeren en hun verzorgers gelijkwaardige posities te geven, om op die manier de TGD-identiteitsontwikkeling te bevestigen en ondersteunen.
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Collaborative Autoethnography for Feminist Research
Chapter
Full-text available
  • Apr 2022
Recent research on transgender children and youth suggests that strong parental support helps achieve greater quality of life and positive wellbeing, and helps reduce risk of self-harm, depression, and suicide. Parents face immense challenges in supporting and advocating for their youth and only a fraction will end up engaging in ally-ship and activism with, or on behalf of, their children. This chapter is written by critical scholars and parents of trans and gender diverse children or their allies engaged in advocacy work. We shared our experiences of deploying critical autoethnography as a feminist practice for disrupting, exposing, and critically analysing social and structural power, making room for the unspoken, unseen, invisible aspects of labour and taking action towards a more just society. Feminist methodologies are used to unpack our engagement with advocacy work and evoke an ‘experience near’ or insider view of the ways in which parental advocacy is performed by the researcher-participants while limited by their social locations.
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Ideología Transgénero y Disforia de Género: Una respuesta Católica
Book
Full-text available
  • Oct 2021
Durante el siglo pasado, los profesionales de la medicina intentaron aliviar las tensiones internas de los transexuales ajustando su apariencia externa a sus identidades de género preferidas. En repetidos estudios se constató una reducción de la disforia de género mediante cirugías de reasignación de sexo y terapias hormonales. Aunque bienintencionados, estos esfuerzos fueron por sí solos insuficientes para aliviar la angustia subyacente causada por la disforia de género. Además, las personas transexuales, incluso después de los procedimientos de reasignación de sexo, tienen mayores riesgos de mortalidad, neoplasias, comportamientos suicidas y morbilidad psiquiátrica que la población general. Las terapias de conversión basadas en la fe duplican las tasas de morbilidad de los individuos transgénero. Un enfoque religioso no basado en la ciencia médica produce peores resultados que no proporcionar ningún tipo de apoyo. La falta de apoyo familiar y comunitario a los jóvenes transexuales conduce a un aumento de la falta de vivienda, la prostitución y el abuso de sustancias. El enfoque intransigente y de amor-duro no conduce a resultados positivos para muchos jóvenes transexuales. Las pruebas médicas de la década anterior sugieren una causa del neurodesarrollo para las identidades transgénero; sin embargo, los estudios sobre la disforia de género de inicio rápido apuntan a causas sociales para el pico de adolescentes que se identifican como transgénero. Mientras que las altas tasas de niños preadolescentes diagnosticados como transgénero desisten de su disforia, algunos estudios han demostrado que los adolescentes que toman bloqueadores hormonales no desisten hasta los veinte años. Se necesitan estudios de seguimiento a más largo plazo para conocer los efectos que tienen los bloqueadores hormonales en el desistimiento cuando se prescriben a tiempo. Los teóricos nominalistas del género han integrado las identidades transgénero en su ideología, según la cual el cuerpo, la mente y el espíritu no están esencialmente unidos. Aunque estas ideologías intentan liberar a los individuos de las restricciones del realismo biológico, esta ideología no ha ofrecido a las personas transgénero una sensación de paz interior. Según un estudio de la Campaña de Derechos Humanos de 2018, los individuos que se identifican como no binarios y otras identidades de género recién nombradas sufren los niveles más altos de depresión, ansiedad e intentos de suicidio. Bajo el paraguas transgénero se encuentran tres grupos de personas: (1) los que tienen disforia de género de inicio temprano, (2) los que tienen disforia de género de inicio rápido y (3) los teóricos del género que forman parte de la 4ª ola del feminismo. Las personas con disforia de género de inicio temprano padecen una condición médica que desiste en un 80% en la adolescencia; el 20% que persiste se beneficia de alguna forma de transformación social en el sexo opuesto. La gran mayoría de las personas que se autodenominan transgénero pertenecen a la segunda categoría, que son principalmente mujeres adolescentes. Al igual que las autolesiones y los trastornos alimentarios, este contagio social alcanza su punto álgido a los diecisiete años, desistiendo en la edad adulta. Los jóvenes autistas están muy afectados. Este grupo busca principalmente una identidad y una comunidad de apoyo. El teórico del género ha aprovechado este caos y ha presentado eficazmente la identidad transgénero como una forma de reinvención. Las personas con disforia de género necesitan apoyo, las que tienen confusión de género necesitan orientación y los teóricos del género necesitan ser desafiados filosóficamente. El realismo tomista ofrece recursos adicionales para los individuos transgénero, que la ciencia secular no puede ofrecer por sí sola. El tomismo abarca todas las disciplinas de la ciencia y las humanidades para presentar una expresión holística de la verdad. La heurística tomista utiliza la ciencia médica y busca restaurar la naturaleza por los medios menos invasivos, al tiempo que depende de las virtudes y la gracia para proporcionar sabiduría y carácter para superar los obstáculos. Este libro sostiene que el uso de una heurística tomista en consonancia con la enseñanza de la Iglesia es mejor que las terapias médicas por sí solas, la terapia de conversión basada en la fe o la adopción de una ideología de teoría de género basada en el nominalismo.
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"I Am Fortunate to Have a Transgender Child": An Investigation into the Barriers and Facilitators to Support among Parents of Trans and Nonbinary Youth "I Am Fortunate to Have a Transgender Child": An Investigation into the Barriers and Facilitators to Support among Parents of Trans and Nonbinary Youth
Article
  • Oct 2021
Research has demonstrated that parental support is a key factor in protecting trans and nonbinary youth from elevated mental health risks including depression and suicide. However, little research has investigated what barriers prevent parents from supporting their child's trans or nonbinary identity or what helps facilitate parental support. A survey of 93 parents of trans and nonbinary youth identified common barriers and facilitators to support via checklists and open-ended questions. Common barriers to support were emotional barriers such as fear of their child being bullied or hurt; lack of knowledge/skills including difficulty adjusting to a new name or pronouns; beliefs and attitudes; and systems barriers such as lack of inclusive policies at their child's school. Common facilitators to support included receiving social support from other families of trans and nonbinary youth, educational and professional resources, communicating with their child, and exposure to trans communities. Additionally, this study examined patterns in barriers and facilitators across parents categorized by level of supportiveness into three groups: supportive, somewhat supportive, and unsupportive. Implications for targeting interventions to increase parental support and future directions for research are discussed.
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Respondent-Driven Sampling II: Deriving Valid Population Estimates From Chain-Referral Samples of Hidden Populations
Article
Full-text available
  • Feb 2002
Researchers studying hidden populations–including injection drug users, men who have sex with men, and the homeless–find that standard probability sampling methods are either inapplicable or prohibitively costly because their subjects lack a sampling frame, have privacy concerns, and constitute a small part of the general population. Therefore, researchers generally employ non-probability methods, including location sampling methods such as targeted sampling, and chain-referral methods such as snowball and respondent-driven sampling. Though nonprobability methods succeed in accessing the hidden populations, they have been insufficient for statistical inference. This paper extends the respondent-driven sampling method to show that when biases associated with chain-referral methods are analyzed in sufficient detail, a statistical theory of the sampling process can be constructed, based on which the sampling process can be redesigned to permit the derivation of indicators that are not biased and have known levels of precision. The results are based on a study of 190 injection drug users in a small Connecticut city.
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“I Don't Think This Is Theoretical; This Is Our Lives”: How Erasure Impacts Health Care for Transgender People
Article
Full-text available
  • Sep 2009
For people who are transgender, transsexual, or transitioned (trans), access to primary, emergency, and transition-related health care is often problematic. Results from Phase I of the Trans PULSE Project, a community-based research project in Ontario, Canada, are presented. Based on qualitative data from focus groups with 85 trans community members, a theoretical framework describing how erasure functions to impact experiences interacting with the health care system was developed. Two key sites of erasure were identified: informational erasure and institutional erasure. How these processes work in a mutually reinforcing manner to erase trans individuals and communities and produce a system in which a trans patient or client is seen as an anomaly is shown. Thus, the impetus often falls on trans individuals to attempt to remedy systematic deficiencies. The concept of cisnormativity is introduced to aid in explaining the pervasiveness of trans erasure. Strategies for change are identified.
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Family Acceptance in Adolescence and the Health of LGBT Young Adults
Article
the role of family acceptance as a protective factor for lesbian, gay, bisexual, and transgender (LGBT) adolescents and young adults has not been established. a quantitative measure with items derived from prior qualitative work retrospectively assessed family accepting behaviors in response to LGBT adolescents' sexual orientation and gender expression and their relationship to mental health, substance abuse, and sexual risk in young adults (N= 245). family acceptance predicts greater self-esteem, social support, and general health status; it also protects against depression, substance abuse, and suicidal ideation and behaviors. family acceptance of LGBT adolescents is associated with positive young adult mental and physical health. Interventions that promote parental and caregiver acceptance of LGBT adolescents are needed to reduce health disparities.
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Family Rejection as a Predictor of Negative Health Outcomes in White and Latino Lesbian, Gay, and Bisexual Young Adults
Article
We examined specific family rejecting reactions to sexual orientation and gender expression during adolescence as predictors of current health problems in a sample of lesbian, gay, and bisexual young adults. On the basis of previously collected in-depth interviews, we developed quantitative scales to assess retrospectively in young adults the frequency of parental and caregiver reactions to a lesbian, gay, or bisexual sexual orientation during adolescence. Our survey instrument also included measures of 9 negative health indicators, including mental health, substance abuse, and sexual risk. The survey was administered to a sample of 224 white and Latino self-identified lesbian, gay, and bisexual young adults, aged 21 to 25, recruited through diverse venues and organizations. Participants completed self-report questionnaires by using either computer-assisted or pencil-and-paper surveys. Higher rates of family rejection were significantly associated with poorer health outcomes. On the basis of odds ratios, lesbian, gay, and bisexual young adults who reported higher levels of family rejection during adolescence were 8.4 times more likely to report having attempted suicide, 5.9 times more likely to report high levels of depression, 3.4 times more likely to use illegal drugs, and 3.4 times more likely to report having engaged in unprotected sexual intercourse compared with peers from families that reported no or low levels of family rejection. Latino men reported the highest number of negative family reactions to their sexual orientation in adolescence. This study establishes a clear link between specific parental and caregiver rejecting behaviors and negative health problems in young lesbian, gay, and bisexual adults. Providers who serve this population should assess and help educate families about the impact of rejecting behaviors. Counseling families, providing anticipatory guidance, and referring families for counseling and support can help make a critical difference in helping decrease risk and increasing well-being for lesbian, gay, and bisexual youth.
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Helping families support their lesbian, gay, bisexual, and transgender (LGBT) children. Washington, DC: National Center for Cultural Competence, Georgetown University Center for Child and Human Development Available at: http://nccc.georgetown
  • Jan 2009
  • C Ryan
Ryan C. Helping families support their lesbian, gay, bisexual, and transgender (LGBT) children. Washington, DC: National Center for Cultural Competence, Georgetown University Center for Child and Human Development, 2009. Available at: http://nccc.georgetown.edu/documents/LGBT_Brief.pdf. tbtsc2012@gmail.com https://www.facebook.com/pages/Trans- Support-Collective/194317560663423
Respondent-Driven Sampling Analysis Tool (RDSAT) Version 6.0.1
  • E Volz
  • C Wejnert
  • I Degani
  • D D Heckathorn
Volz E, Wejnert C, Degani I, Heckathorn DD. Respondent-Driven Sampling Analysis Tool (RDSAT) Version 6.0.1. Ithaca, NY: Cornell University.
Opening the door to inclusion of transgender people: The nine keys to making lesbian, gay, bisexual and transgender organizations fully transgenderinclusive
  • Jan 2008
  • L Mottet
  • J Tanis
Mottet L, Tanis J. Opening the door to inclusion of transgender people: The nine keys to making lesbian, gay, bisexual and transgender organizations fully transgenderinclusive. New York: National Gay and Lesbian Task Force Policy Institute and the National Center for Transgender Equality, 2008.
MSc, for the Trans PULSE team; Lorraine Gale, MSW, for Children's Aid Society of Toronto
  • Kaitlin Bradley
Kaitlin Bradley, MSc, for the Trans PULSE team; Lorraine Gale, MSW, for Children's Aid Society of Toronto; and Maria Papadimitriou, MSc, MPH, for Delisle Youth Services.
The Transgender Child: A Handbook for Families and Professionals
  • Jan 2008
  • Stephanie A Brill
  • Rachel Pepper
Stephanie A. Brill and Rachel Pepper. (2008). The Transgender Child: A Handbook for Families and Professionals. Cleis Press. TransParent Canada http://www.transparentcanada.ca/?file=kop1.php