The importance of child voice in trans health research: a critical review of research on social transition and well-being in trans children

Abstract

Background Trans healthcare has traditionally been dominated by the perspectives of cis clinicians, with trans and service user voices side-lined. The voices and perspectives of trans children are rarely centered in clinical literature, with potential consequences for the design, delivery and evaluation of pediatric trans healthcare services. Aim This article examines literature on the association between social transition and mental health in trans children, exploring the inclusion or exclusion of child reported data. Methods Modern research studies on the relationship between social transition and well-being in trans children are examined, investigating what data sources underpin each analysis. A recent clinician authored article on the relationship between social transition and mental health is then reviewed in greater depth. This article is evaluated, drawing attention to data limitations and reflecting on the implications of the study’s approach to data. Results Data limitations related to social transition are identified, exploring the omission of trans child perspectives on 1) social transition 2) name change and 3) ease of social transition. Mental health data limitations are reviewed considering 4) the combination of research with clinical assessments. Additional limitations relate to the absence of 5) child or family perspectives on mental health 6) data on euphoria and 7) data on gender minority stress. Discussion The reviewed article’s approach to data is critiqued, highlighting the limitations of a reliance on clinician reported measures and the consequences of the exclusion of child reported measures. The article calls for greater prioritization of child and service user perspectives in healthcare research.