Transgender and Gender Nonconforming Youths' Public Facilities Use and Psychological Well-Being: A Mixed-Method Study

Abstract

Purpose: In this study, we explored experiences and feelings of safety in public facilities in relation to psychological well-being among transgender and gender nonconforming (TGNC) youth in the Midwest in the summer of 2016, in the context of ongoing legislative proposals and regulations regarding school and public bathroom use in the United States.Methods: We used a mixed-method approach, with (1) a self-administered, paper-and-pencil survey of 120 TGNC youth, focusing on differences of self-esteem, resilience, quality of life (QoL), perceived stigma, feelings of safety, and experiences of public facility use and (2) two focus group interviews (n=9) in which TGNC youth discussed individual perceptions, attitudes, and experiences of bathroom use outside participants' homes. The samples consisted predominantly of individuals assigned female at birth and currently of trans-masculine identity.Results: TGNC youth in our sample who reported that they had felt unsafe in bathrooms due to appearance or gender identity had significantly lower levels of resilience (mean(felt safe)=125.7 vs. mean(felt unsafe)=116.1; p=0.03, Cohen's d=0.44) and QoL (mean(felt safe)=59.1 vs. mean(felt unsafe)=51.9; p=0.04, Cohen's d=0.39), compared to those who felt safe. Meanwhile, feeling unsafe in bathrooms was associated with a greater level of perceived LGBT stigma (mean(felt safe)=2.3 vs. mean(felt unsafe)=2.6; p=0.03, Cohen's d=0.41) and problematic anxiety in the past year (χ2 (1)=4.06; p=0.04). Individuals in the focus groups provided specific examples of their experiences of and concerns about locker room or bathroom use in public facilities, and on the impact of school bathroom-related policies and legislation on them.Conclusion: Perceptions of safety related to bathroom use are related to psychological well-being among TGNC youth. Our predominantly trans-masculine youth sample indicated that choice of bathroom and locker room use is important and that antiharassment policies need to support students' use of their choice of bathrooms. This is particularly important information given debate of so-called bathroom bills, which attempt to restrict public bathroom use for TGNC youth, creating less choice and more stress and fear among these individuals.

Learning from Transmasculine Experiences with Health Care: Tangible Inlets for Reducing Health Disparities Through Patient–Provider Relationships

“…[34][35][36][37][38][39][40][41][42][43] Researchers are beginning to include TGD individuals in studies exploring the mental and physical health effects of minority stress and weathering. 5,34,35,44 Our data illustrate how minority stressors and weathering ensue through patient-provider interactions, offering tangible inlets to reduce health disparities. For example, consistent with NTDS 5 findings, our participants described having to repeatedly educate providers steeped in ciscentric, binary views.…”

Understanding the Mental Health of Transgender and Nonbinary Youth

“…Furthermore, as most youth spend a substantial amount of their time in schools, the finding that victimization and perceived discrimination contribute to these disparities suggests that schools should enact anti-discrimination and anti-bullying policies inclusive of protections for LGBTQ youth [11]. Such policies should specifically address the needs and concerns of transgender and nonbinary youth, such as allowing youth to use the bathroom that corresponds with their gender identity and their chosen name, in addition to requiring that school officials respect their pronouns, all of which have been found to improve health outcomes [27,28].…”

WITHDRAWN: Pride Camp: Pilot Study of an Intervention to Develop Resilience and Self-Esteem Among LGBTQ Youth

“…The 2015 Youth Risk Behavior Survey (YRBS), (31) reported that among self-identi ed sexual minority students, 34% of them were bullied on school property and 28% were bullied electronically. In a sample of 120 TGN youth in Weinhardt et al, (32) about 46% reported that they experienced discrimination in bathrooms and 56% felt unsafe using bathrooms in public due to their appearance or gender identity. Additionally, studies have found that LGBTQ youth were three times more likely to drop out of high school compared to the general population.…”