‘If they didn’t support me, I most likely wouldn’t be here’: Transgender young people and their parents negotiating medical treatment in Australia

Riggs, Damien W.; Bartholomaeus, Clare; Sansfaçon, Annie Pullen

doi:10.1080/15532739.2019.1692751

Cited by 47 publications

(66 citation statements)

References 16 publications

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“…It seems, however, that it is still difficult to be a trans youth; becoming aware and understanding themselves and facing the fear of coming out remains a developmental challenge. Where access to care is limited, multiple levels of oppression overlap, it leads to poor quality of life for trans youth, as is in our sample (see forthcoming Medico et al) and this confirm previous literature (Owen-Smith et al, 2018; Riggs et al, 2019).…”

Section: Resultssupporting

confidence: 91%

Pathways to gender affirmation in trans youth: A qualitative and participative study with youth and their parents

Médico¹,

Sansfaçon²,

Zufferey³

et al. 2020

Clin Child Psychol Psychiatry

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How trans youth realize about their gender identity and come out to their significant others is under-researched and very few studies include both youth and parental perspectives. This study was developed in Switzerland, a country where families with trans youth are just beginning to break invisibility. The research protocol draws on grounded theory methodology, is participative and developed in collaboration with a local trans NGO and a pan Canadian project. We conducted 20 semi-structured interviews with 10 trans youth and their caregivers/parents (10 interview). At least three developmental pathways seem to emerge: a) the affirmed children who affirm themselves very early, (b) the silent children who spend their childhood in a state of internal tension without being able to position themselves and (c) the neutral children who become aware of their gender difference at puberty following a childhood in which gender was not problematic. In all cases puberty is a crossroads, lived painfully with significant manifestations of both social and body dysphoria. A better understanding of the process of gender development in trans children and youth will help improve our interventions to better serve young people and their families, and help them overcome the different levels of oppressions they face.

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Section: Resultssupporting

confidence: 91%

Pathways to gender affirmation in trans youth: A qualitative and participative study with youth and their parents

Médico¹,

Sansfaçon²,

Zufferey³

et al. 2020

Clin Child Psychol Psychiatry

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“…Finally, it appeared that gender clinics rarely provided recommendations for affirming and knowledgeable healthcare professionals and services outside the clinics, and it was usually up to parents to seek out the additional services needed. Specifically, we note that, at least in our sample, the work of negotiating referrals and linked up care was primarily the responsibility of mothers, constituting a specific form of emotional labour (see Riggs et al, 2020). While, as we note below, some parents appreciated the support provided by gender clinics, this does not necessarily mitigate the emotional labour involved.…”

Section: Discussionmentioning

confidence: 79%

“…An inductive thematic analysis was undertaken of the data, focusing on mentions of healthcare professionals. Other areas of the interviews, including experiences of the receipt of puberty blockers or hormones, are the focus of another article (Riggs et al, 2020). The analytic process was informed by Braun and Clarke (2006): (1) becoming familiar with the data, (2) generating codes, (3) identifying themes, (4) reviewing themes, (5) refining specifics of the themes, and (6) selecting extracts that best illustrate the themes identified.…”

Section: Analytic Approachmentioning

confidence: 99%

“…Trans affirming clinical care is defined as an approach that treats gender diversity as an aspect of human gender expression, and seeks to validate transgender people's experiences of their gender (Chang, Singh, & dickey, 2018). In terms of strengths, professionals who are supportive, knowledgeable, and, respectfulincluding by using correct names and pronounsare experienced as affirming (Corliss, Belzer, Forbes, & Wilson, 2007;Guss et al, 2019;Riggs, Bartholomaeus, & Pullen Sansfaçon, 2020;Strauss et al, 2017). Experiences of such affirming responses have been related to high levels of satisfaction among young people and their families attending paediatric gender clinics (Inwards-Breland et al, 2019;Pullen Sansfaçon et al, 2019;Tollit, Feldman, McKie, & Telfer, 2019).…”

Section: Introductionmentioning

confidence: 99%

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Expanding and improving trans affirming care in Australia: experiences with healthcare professionals among transgender young people and their parents

Bartholomaeus

Riggs

Sansfaçon

2020

Health Sociology Review

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Access to medical care is significant for many transgender young people and their families, which involves interactions with healthcare professionals. While a trans affirming model is used across Australian paediatric gender clinics, this does not automatically mean that all transgender young people and their parents experience the care they receive as affirming. This article considers the experiences and views of transgender young people (aged 11-17) and their parents in relation to healthcare professionals inside and outside of gender clinics in Australia. Ten qualitative interviews were conducted with parent-child dyads in two Australian states. Key themes relating to healthcare professionals were: differing levels of healthcare professional knowledge and affirmation, quality of service is dependent on individual healthcare professionals, and lack of connected services and referral pathways. The discussion explores specific issues arising from the findings that suggest implications for training for healthcare professionals so as to be better equipped to provide trans affirming clinical care.

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“…12 In addition, although a cause-effect relationship has not been established, an association between later presentation to GAMC and worse mental health among genderincongruent youth has been identified. 2 Barriers to GAMC 13,14 as well as the care-seeking experiences [15][16][17] and decision-making processes 18,19 of gender-incongruent youth have been described. However, the important questions of whether genderincongruent youth who present for GAMC at older ages have different care-seeking experiences or face different barriers than youth who present younger have not been addressed.…”

mentioning

confidence: 99%

Factors Associated With Age of Presentation to Gender-Affirming Medical Care

Sorbara

Ngo²,

Palmert

2021

Pediatrics

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BACKGROUND: Gender-incongruent youth may present to gender-affirming medical care (GAMC) later in adolescence and puberty when hormone blockers provide less benefit. Factors influencing age of presentation to GAMC have not been described. METHODS:A sequential mixed methods study. Participants were categorized on the basis of age at presentation to GAMC. Youth presenting at $15 years comprised the older-presenting youth, whereas those presenting at ,15 years comprised the younger-presenting youth. Caregivers were categorized on the basis of the youth's age of presentation. Twenty-four individuals were interviewed, 6 youth and 6 caregivers from each age category. Thematic analysis identified themes related to timing of presentation to GAMC. Themes differentially endorsed between older and younger youth or between caregivers of older and younger youth were used to design a questionnaire distributed to 193 youths and 187 caregivers. Responses were compared between age groups for youths and caregivers.RESULTS: Five themes differed between age groups: validity of gender identity, gender journey barriers, influential networks, perceptions of medical therapy, and health care system interactions. Questionnaires were completed by 121 youths and 121 caregivers. Compared with younger-presenting youth, older-presenting youth recognized gender incongruence at older ages, were less likely to have caregivers who helped them access care or LGBTQ1 (lesbian, gay, bisexual, transgender, queer) family members, more often endorsed familial religious affiliations, and experienced greater youth-caregiver disagreement around importance of GAMC.CONCLUSIONS: Family environment appears to be a key determinant of when youth present to GAMC. Whether this association occurs through affecting transgender identity formation and recognition requires further study.WHAT'S KNOWN ON THIS SUBJECT: Gender-incongruent youth face barriers to gender-affirming care and often present to care later in adolescence and puberty when hormone blockers provide less benefit. Factors influencing age of presentation to care have not been described.WHAT THIS STUDY ADDS: With this mixed methods study, we identified family-related differences between youth who presented to gender-affirming care at older versus younger ages. Our findings suggest family environment is an important determinant of the age at which genderincongruent youth present to care.

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‘If they didn’t support me, I most likely wouldn’t be here’: Transgender young people and their parents negotiating medical treatment in Australia

Cited by 47 publications

References 16 publications

Pathways to gender affirmation in trans youth: A qualitative and participative study with youth and their parents

Pathways to gender affirmation in trans youth: A qualitative and participative study with youth and their parents

Expanding and improving trans affirming care in Australia: experiences with healthcare professionals among transgender young people and their parents

Factors Associated With Age of Presentation to Gender-Affirming Medical Care

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