An Intersectional Approach to Therapy with Transgender Adolescents and Their Families

Golden, Rachel Lynn; Oransky, Matthew

doi:10.1007/s10508-018-1354-9

Cited by 30 publications

(14 citation statements)

References 48 publications

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“…42,43 Providers should carefully tailor their interventions to ensure their care is validating of TGAs' gender identity while limiting rejection and fostering acceptance by family members. 44,45 TGAs are more likely to report childhood abuse than heterosexual CGAs, and risk for psychological abuse is highest among TGAs assigned female at birth. Clinicians should be aware that higher levels of abuse could contribute to disproportionate mental health problems among TGAs, and future research should examine how childhood abuse contributes to higher levels of mental health problems among TGAs over time.…”

Section: Figurementioning

confidence: 99%

Disparities in Childhood Abuse Between Transgender and Cisgender Adolescents

et al. 2021

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BACKGROUND AND OBJECTIVES: Transgender adolescents (TGAs) exhibit disproportionate levels of mental health problems compared with cisgender adolescents (CGAs), but psychosocial processes underlying mental health disparities among TGAs remain understudied. We examined self-reported childhood abuse among TGAs compared with CGAs and risk for abuse within subgroups of TGAs in a nationwide sample of US adolescents.METHODS: Adolescents aged 14 to 18 completed a cross-sectional online survey (n 5 1836, including 1055 TGAs, 340 heterosexual CGAs, and 433 sexual minority CGAs). Participants reported gender assigned at birth and current gender identity (categorized as the following: cisgender males, cisgender females, transgender males, transgender females, nonbinary adolescents assigned female at birth, nonbinary adolescents assigned male at birth, and questioning gender identity). Lifetime reports of psychological, physical, and sexual abuse were measured.RESULTS: Seventy-three percent of TGAs reported psychological abuse, 39% reported physical abuse, and 19% reported sexual abuse. Compared with heterosexual CGAs, TGAs had higher odds of psychological abuse (odds ratio [OR] 5 1.84), physical abuse (OR 5 1.61), and sexual abuse (OR 5 2.04). Within separate subgroup analyses, transgender males and nonbinary adolescents assigned female at birth had higher odds of reporting psychological abuse than CGAs.CONCLUSIONS: In a nationwide online sample of US adolescents, TGAs had elevated rates of psychological, physical, and sexual abuse compared with heterosexual CGAs. Risk for psychological abuse was highest among TGAs assigned female at birth. In the future, researchers should examine how more frequent experiences of abuse during childhood could contribute to disproportionate mental health problems observed within this population.

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Section: Figurementioning

confidence: 99%

Disparities in Childhood Abuse Between Transgender and Cisgender Adolescents

et al. 2021

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“…Transgender or gender minority adolescents are those whose gender identity or gender expression is not aligned with the gender they were assigned at birth (American Psychological Association, 2019). Some gender minority youth identify with a binary gender identity, including adolescents identified as female at birth whose gender identity is male (transmales) and those identified male at birth whose gender identity is female (transfemales); other youth do not identify with a binary gender identity and use labels that connote a nonbinary or genderqueer identity which is not exclusively male or female (Goldberg, 2017;Golden & Oransky, 2019;Steinmetz, 2014). Nonbinary and genderqueer individuals may have gender identities which contain both masculine and feminine components (e.g., androgynous), may move between genders in a fluid way (e.g., genderfluid), or may not identify with any particular gender (e.g., agender) (Richards et al, 2016).…”

Section: Introductionmentioning

confidence: 99%

The Gender Minority Youth Study: Overview of Methods and Social Media Recruitment of a Nationwide Sample of U.S. Cisgender and Transgender Adolescents

2020

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Recent research has documented significant mental health disparities for transgender adolescents. However, the extant literature is hindered by vague operationalizations of gender identity and limited measurement of trans-specific stressors. In this article, we (1) introduce and describe the Gender Minority Youth (GMY) Study, a large-scale study of transgender youth disparities; and (2) provide evidence of the feasibility of using social media to recruit a diverse sample of U.S. transgender and cisgender youth. Facebook and Instagram advertisements targeted 14-18-year-old adolescents to complete an online survey. Participants (N = 3318) self-reported gender assigned at birth and current gender identity, mental health symptoms, and transgender-specific stressors and milestones. Adolescents included 1369 cisgender (n = 982 cisgender female; n = 387 cisgender male), 1938 transgender (n = 986 transgender male; n = 132 transgender female; n = 639 nonbinary assigned female at birth; n = 84 nonbinary assigned male at birth; n = 84 questioning gender identity assigned female at birth; n = 13 questioning gender identity assigned male at birth), and 11 intersex youth. The GMY Study is the first nationwide sample of U.S. adolescents recruited specifically for a study of mental health disparities between transgender and cisgender youth. We demonstrate the feasibility of using social media advertisements and a waiver of parental permission to recruit a large sample of adolescents, including subsamples of gender minority youth. We remedied limitations in the existing literature by including appropriate measures of gender assigned at birth, current gender identity, and detailed questions about transgender-specific stressors and transition milestones.

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“…In summary, the findings from the current study suggest that gender dysphoria in children arises in association with developmental pathways-reflected in at-risk patterns of attachment and high rates of unresolved loss and trauma-that are shaped by disruptions to family stability and cohesion, ACEs (including maltreatment), and SES (Golden and Oransky, 2019;Meyer-Bahlburg, 2019;Alonso-Zaldivar, 2020). Alongside other studies and perspectives (Bechard et al, 2017;Giovanardi et al, 2018;Churcher Clarke and Spiliadis, 2019;de Graaf and Carmichael, 2019;D'Angelo, 2020), this study confirms the importance of conceptualizing gender dysphoria by using a broad lens that takes into account the multiple factors that contribute to the child's distress, difficulties with adaptation, multimorbidity, and loss of health and well-being.…”

Section: Discussionmentioning

confidence: 71%

Attachment Patterns in Children and Adolescents With Gender Dysphoria

et al. 2021

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The current study examines patterns of attachment/self-protective strategies and rates of unresolved loss/trauma in children and adolescents presenting to a multidisciplinary gender service. Fifty-seven children and adolescents (8.42–15.92 years; 24 birth-assigned males and 33 birth-assigned females) presenting with gender dysphoria participated in structured attachment interviews coded using dynamic-maturational model (DMM) discourse analysis. The children with gender dysphoria were compared to age- and sex-matched children from the community (non-clinical group) and a group of school-age children with mixed psychiatric disorders (mixed psychiatric group). Information about adverse childhood experiences (ACEs), mental health diagnoses, and global level of functioning was also collected. In contrast to children in the non-clinical group, who were classified primarily into the normative attachment patterns (A1-2, B1-5, and C1-2) and who had low rates of unresolved loss/trauma, children with gender dysphoria were mostly classified into the high-risk attachment patterns (A3-4, A5-6, C3-4, C5-6, and A/C) (χ2 = 52.66; p < 0.001) and had a high rate of unresolved loss/trauma (χ2 = 18.64; p < 0.001). Comorbid psychiatric diagnoses (n = 50; 87.7%) and a history of self-harm, suicidal ideation, or symptoms of distress were also common. Global level of functioning was impaired (range 25–95/100; mean = 54.88; SD = 15.40; median = 55.00). There were no differences between children with gender dysphoria and children with mixed psychiatric disorders on attachment patterns (χ2 = 2.43; p = 0.30) and rates of unresolved loss and trauma (χ2 = 0.70; p = 0.40). Post hoc analyses showed that lower SES, family constellation (a non-traditional family unit), ACEs—including maltreatment (physical abuse, sexual abuse, emotional abuse, neglect, and exposure to domestic violence)—increased the likelihood of the child being classified into a high risk attachment pattern. Akin to children with other forms of psychological distress, children with gender dysphoria present in the context of multiple interacting risk factors that include at-risk attachment, unresolved loss/trauma, family conflict and loss of family cohesion, and exposure to multiple ACEs.

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An Intersectional Approach to Therapy with Transgender Adolescents and Their Families

Cited by 30 publications

References 48 publications

Disparities in Childhood Abuse Between Transgender and Cisgender Adolescents

Disparities in Childhood Abuse Between Transgender and Cisgender Adolescents

The Gender Minority Youth Study: Overview of Methods and Social Media Recruitment of a Nationwide Sample of U.S. Cisgender and Transgender Adolescents

Attachment Patterns in Children and Adolescents With Gender Dysphoria

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