Coming Out to Doctors, Coming Out to "Everyone": Understanding the Average Sequence of Transgender Identity Disclosures Using Social Media Data.

Oliver L Haimson,Tiffany C Veinot

doi:10.1089/trgh.2019.0045

Abstract

Purpose: Gender transition is a complex life change, and transgender identity disclosures are pivotal moments that delineate the gender transition process. The purpose of this study was to quantify the average sequence in which transgender people disclose their transgender identity to different people in their lives, such as medical professionals, family members, and online networks, and to understand the emotional implications of these disclosures.Methods: We used mixed methods to identify 362 transgender identity disclosure social media posts within 41,066 total posts from 240 Tumblr transition blogs (online spaces in which transgender people document gender transitions). We manually assigned each disclosure post an audience category, and then calculated the average sequence in which people in this sample disclosed their transgender identity to different audiences.Results: Health professionals, such as physicians and therapists, were on average some of the very first people to whom transgender Tumblr bloggers disclosed their transgender identity. Such disclosures were often anxiety provoking and emotionally difficult, whether intentional or involuntary. Next, they often disclosed to friends, followed by close family (e.g., parents and siblings) and then extended family (e.g., grandparents). Mass disclosures to large portions of a person's network, such as on one's Facebook profile, usually came late in the disclosure process.Conclusion: Gender transition is a staged process that includes a series of disclosures to different audiences that follows an average sequence. Because health care providers (e.g., physicians and therapists) who work with transgender patients are often some of the very first people to whom transgender people in our sample disclosed, providers must practice extra sensitivity when responding to such disclosures.

Highlights

The dominant narrative of gender transition imagines an unambiguous, specific moment in which one’s gender switches.[1]
The purpose of this study was to quantify the average sequence in which transgender people disclose their transgender identity to different people in their lives, such as medical professionals, family members, and online networks, and to understand the emotional implications of these disclosures
Disclosures to acquaintances and strangers took place throughout gender transition and beyond. Bloggers often explained these as unplanned disclosures that happened as they ran into such people throughout the course of their transitions and lives. Despite this average sequence that we present, transgender identity disclosures can come in any order depending upon personal circumstances

Summary

Introduction

The dominant narrative of gender transition imagines an unambiguous, specific moment in which one’s gender switches.[1] transition is a process rather than a moment; it involves transgender identity disclosures to different people in one’s life, some marking pivotal moments of change.[2]. People balance their desires for a lived gender that matches their internal gender with considerations of available resources, coping abilities, and potential consequences of transition.[3] Models of transgender identity transition have proposed five steps of coming out[4] and 14 stages of identity development.[5] transition can be framed as a series of ‘‘milestones’’ reflecting diversity in transition goals,[6] some of which involve disclosures. Previous works offer important details regarding the temporal dynamics of transgender identity disclosure,[7] we lack thorough empirical understanding of the average sequence of audiences to whom

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Methods

Results

Discussion

Conclusion