Affirmative practice with transgender and gender nonconforming youth: Expanding the model.

Abstract

Affirmative care with transgender and gender nonconforming (TGNC) children and adolescents is a new framework under which many mental health clinicians now practice. It rests on a premise that appreciates diverse gender expressions and identities within society, and encourages the highest potential for individuals to follow their own paths to positive emotional well-being. Scientific understanding of the phenomenology of gender development in children and adolescents is scarce, and the gaps in knowledge limit evidence-based practice when working with these youths. Interventions span many domains within the physical and mental health realms, calling for providers to navigate differing interdisciplinary perspectives when optimizing assessment and treatment goals. In addition, interventions differ according to developmental stage, and newer approaches and treatments have become more popular within the last decade. For children, the concept of social gender transition has remained controversial, as relatively historical approaches (discouraging cross-gender behavior) have become outdated and more recent methods (supporting gender transition) have gained backing. Fully reversible pubertal suppression has been introduced for TGNC adolescents as a means of buying time for exploration without the pressures of irreversible pubertal advancement. Given the current deficits in scientific understanding of genderidentity development in youth, the affirmative provider often faces decisions that are challenging, complex, and unclear. This paper describes the theoretical approaches to TGNC youth across development, provides a brief overview of the current research, and offers providers a way to conceptualize and provide care that can be both supportive and scientifically driven when done in a thoughtful, balanced way.

The Experiences of Sexual Minority Mothers with Trans* Children

“…Further, clinicians have observed that the anxiety and distress exhibited by many trans* children dissipates immediately after the children are allowed to freely express their gender identities (Ehrensaft, ; Hill, Menvielle, Sica, & Johnson, ). Thus, leading clinicians specializing in gender (e.g., Edwards‐Leeper, Leibowitz, & Sangganjanavanich, ; Hidalgo et al, ) advise parents to be supportive and to follow their children's lead, as developmentally appropriate, as children explore and express their “true gender selves” (Ehrensaft, , p. 341).…”

A Review of Evidence Based Treatments for Transgender Youth Diagnosed with Social Anxiety Disorder

“…Edwards-Leeper and Leibowitz expand on both the APA and WPATH sets of guidelines for affirmative therapy. 40 They especially go into depth regarding TGNC children and adolescents, stating that supporting them can look different from supporting adults. This is because they are still developing their sense of identity and have more pressing family/social concerns than adults do, since they are in constant contact with their family and peers at school and home.…”

Sexual Orientation, Gender Identity, and Adoption Law

“…Another hypothesis is that perhaps processes of identity development related to adoption for these children who present as TGNC also uniquely contribute to shaping their gender identity in ways that may be distinct from those for children who are not adopted (Miller, 2016;Schumer et al, 2017). Regardless, it is clear that, for children who are adopted and who are TGNC, support and affirmation are critical to their health and well-being (APA, 2015b; Edwards-Leeper, Leibowitz, & Sangganjanavanich, 2016;Farr & Grotevant, 2019).…”