Romantic Relationships in Transgender Adolescents: A Qualitative Study

Abstract

BACKGROUND: Identity formation and exploration of interpersonal relationships are important tasks that occur during adolescence. Transgender, gender diverse, and gender-nonconforming (TGNC) individuals must face these developmental milestones in the context of their transgender identity. Our aim with this article is to describe adolescents' history and experiences with romantic partners. METHODS:We conducted phenomenological, qualitative semistructured interviews with transgender adolescents. Questions were focused on romantic experiences, thoughts, and perceptions. All interviews were coded by 2 members of the research team, with disagreements resolved by discussion and, if needed, with a third member of the research team. Thematic analysis was used to analyze the data, as well as descriptive categorization.RESULTS: In total, 30 adolescents (18 transmasculine and 12 transfeminine) between the ages of 15 and 20 years were interviewed. Themes included (1) engagement in romantic relationships, (2) disclosure of gender identity and romantic relationships, (3) experience with abusive relationships, and (4) perceived impact of gender-affirming hormone care on romantic experiences.CONCLUSIONS: TGNC adolescents are engaged in romantic experiences before and during social and/or medical transitioning and are cultivating relationships through both proximal peers and online connections. There is perceived benefit of gender-affirming hormone care on romantic experiences. Risk of transphobia in romantic relationships impacts the approach that transgender adolescents take toward romance and influences decisions of identity disclosure. TGNC adolescents have experience with relationship abuse in different forms. Providers can incorporate these findings in their approach to counseling and screening when caring for TGNC youth.WHAT'S KNOWN ON THIS SUBJECT: Adolescence is a time of exploration of romantic relationships and actualization of identity. Transgender, gender diverse, and gender-nonconforming (TGNC) youth represent a growing clinical population for pediatricians. TGNC youth before hormone therapy have less romantic experience than their cis-gender peers.WHAT THIS STUDY ADDS: TGNC adolescents engage in romantic relationships with youth of many gender identities, navigate transphobia in dating applications and in person, experience abusive relationships, and struggle with the decision for identity disclosure.

Patterns of online relationship seeking among transgender and gender diverse adolescents: Advice for others and common inquiries.

“…Although sexual and gender minority (SGM) adolescents may be just as likely to be in romantic and sexual relationships (Bruce et al, 2012; Dehaan et al, 2013; Diamond & Lucas, 2004; Macapagal et al, 2019), research has focused on cisgender sexual minority (SM) adolescents (Collins et al, 2009; Korchmaros et al, 2015; Macapagal et al, 2019; Phillips et al, 2014). To date, only one study qualitatively examined transgender and gender diverse (TGD) adolescents’ experiences with in-person romantic relationships (Araya et al, 2021). SGM adolescents may often seek partners online (Korchmaros et al, 2015; Macapagal et al, 2019; Macapagal et al, 2018), yet little is known about TGD adolescents’ needs and their experiences in doing so.…”

A Systematic Review of Psychosocial Functioning Changes after Gender-Affirming Hormone Therapy among Transgender People

“…Qualitative evidence for changes in psychosocial functioning among transmasculine people came from only one study (Araya et al, 2021). In this study, transmasculine participants described increased confidence and assertiveness, but also concern over increased difficulty controlling anger and reduced emotional openness.…”

“…We identified only five (16%) qualitative studies, including four semi-structured interviews and one mixed-methods report (for the mixed-methods study, Mohamed & Hunter, 2018, only the qualitative element was pertinent to the objectives of this review). The qualitative research identified (k = 5) predominantly involved transfeminine (i.e., transitioning to a female gender identity) experiences (Araya et al, 2021;Giovanardi, 2019;Mohamed & Hunter, 2018;Riggs et al, 2020;Rosenberg et al, 2019), with only two studies (Araya et al, 2021;Riggs et al, 2020) including transmasculine (i.e., transitioning to a male gender identity) participants. In the following sections we briefly summarize results related to changes in psychosocial functioning from the qualitative literature, organized by the experiences of transfeminine and transmasculine people.…”

“…Overall, the qualitative literature tended to support positive changes in well-being among transfeminine people after starting gender-affirming hormone therapy, although often with the qualification that improvements in well-being were attributed to satisfaction with changes in appearance rather than to direct effects of hormones on psychosocial states (Giovanardi, 2019;Mohamed & Hunter, 2018;Rosenberg et al, 2019). More specifically, in addition to reductions in distress (Rosenberg et al, 2019), participants reported improvements in self-image and selfacceptance (Araya et al, 2021;Mohamed & Hunter, 2018;Riggs et al, 2020) and less selfmonitoring (Rosenberg et al, 2019) after beginning gender-affirming hormone therapy. There were also indications of changes in emotional functioning, generally experienced as positive and related to greater emotional range and freedom-of-expression (Mohamed & Hunter, 2018;Rosenberg et al, 2019), but sometimes noted as negative and related to mood swings and emotional imbalance (Giovanardi, 2019;Mohamed & Hunter, 2018).…”

“…There were also indications of changes in emotional functioning, generally experienced as positive and related to greater emotional range and freedom-of-expression (Mohamed & Hunter, 2018;Rosenberg et al, 2019), but sometimes noted as negative and related to mood swings and emotional imbalance (Giovanardi, 2019;Mohamed & Hunter, 2018). Finally, improvements in interpersonal functioning and the quality of relationships were commonly reported after beginning gender-affirming hormone therapy (Araya et al, 2021;Giovanardi, 2019;Mohamed & Hunter, 2018), but again these were also largely attributed to changes in satisfaction with appearance rather than direct effects of hormones (Giovanardi, 2019;Mohamed & Hunter, 2018). While a desire for changes to appearance is a core aspect of seeking gender-affirming hormone therapy for many transgender people (Sansfaçon et al, 2019), understanding this as a separate pathway (i.e., a psychological one) can help to isolate any potential biological pathway through which hormones might affect psychosocial functioning.…”