Binary Gender Identity Research Articles

High Rates of PrEP Eligibility but Low Rates of PrEP Access Among a National Sample of Transmasculine Individuals

Transmasculine individuals have been largely ignored in HIV prevention research, and there is a lack of data regarding this population's eligibility for and utilization of HIV pre-exposure prophylaxis (PrEP). National online survey conducted in the United States. Between May and July 2017, we surveyed 1808 transmasculine individuals (aged 18-60 years; 30% people of color and/or Latinx), asking questions about sexual behavior and receipt of sexual health care, including PrEP. We examined the number of individuals who would meet eligibility criteria for PrEP and then used log-linked Poisson regression with robust variance estimation to examine predictors of PrEP eligibility. Almost one-quarter of the sample (n = 439; 24.3%) met one or more criterion for PrEP eligibility. PrEP eligibility did not differ by age, race/ethnicity, education, or binary gender identity. PrEP eligibility was lower among heterosexual-identified and higher income participants, and was higher among participants who were in open relationships and reported substance use. Among PrEP-eligible individuals, 64.9% had received an HIV test in the past year, 33.9% had received PrEP information from a provider, and 10.9% (n = 48) had received a PrEP prescription. PrEP-eligible individuals who had received a PrEP prescription were more likely to have a binary gender identity, identify as gay, and be taking testosterone. A substantial proportion of transmasculine individuals meet PrEP eligibility criteria, but few are receiving adequate PrEP services. Enhanced efforts should be made by providers, programs, and systems to assess HIV-related risk in transmasculine patients and engage them in comprehensive sexual health care.

Beyond Binary Gender Identities: Gender Identity Justice in Schools and Communities

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The contraceptive and reproductive history and planning goals of trans-masculine adults: a mixed-methods study

ObjectivesThis study aims to identify factors associated with the reproductive planning of trans-masculine adults. Study designBetween 2015 and 2016, providers enrolled 150 trans-masculine adults in a sexual health study assessing sociodemographics, social support, gender affirmation, sexual partnering, and reproductive history and planning. A brief clinical interview assessed contraceptive use and concerns. Bivariate and multivariable logistic regression analyses examined associations between participant characteristics and three outcomes: current contraceptive use, lifetime pregnancy history and reproductive planning. ResultsOverall, 37.3% are currently using contraceptives; 5.3% have been pregnant; and 20.0% plan to have biological children (9.3% plan to become pregnant; 12.0% plan to use their oocytes with a surrogate). Participants are less likely to use contraceptives if they are students vs. not, have socially affirmed their gender vs. not and have a partner vs. are single. Greater number of sexual partners is associated with the increased odds of contraceptive use. Further, as social support increases, the odds of having been pregnant decreases. Participants with a nonbinary gender identity are more likely to want to become pregnant than those with a binary gender identity, whereas those who have socially affirmed their gender are less likely to want to become pregnant than those who had not. Finally, participants of color more commonly planned to use their oocytes with a surrogate than white participants. ConclusionSociodemographic, gender affirmation, social support and sexual partner factors are associated with contraceptive use and reproductive history among trans-masculine patients. ImplicationsHealthcare providers must be aware of the diverse reproductive histories and pregnancy goals of trans-masculine individuals in order to provide comprehensive reproductive healthcare counseling and provision. More research is needed to better understand contraception and reproduction desires in trans-masculine individuals.

Beyond Binary Gender Identities: Using the Fictional to Create Nonfictional Gendered Lives*

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Greta Gerwig's Gestures: Agamben in the Land of Stardom

In a brief essay, “For an Ethics of the Cinema”, Giorgio Agamben names the film star as the twentieth century figure representing an elision of what is individual and what is collective. It is impossible, he argues, to separate the actor from the character in the thorough commodification of the star, drawing examples from classical Hollywood cinema. Yet consideration of contemporary film provides for a different account of stardom in which the common language of performance is seen to be an inheritance to be inhabited critically and citationally by the star. This article brings Agamben's cinema essays on ethics and gesture respectively into dialogue with Greta Gerwig's emphatically gestural style of performance, a style that belongs to what Erin Manning has named the minor gesture. Incomplete and imperfect performances of heterosexual femininity, Gerwig's gestures are incisive in their revelation precisely of binary gender identity as the major, the defining and delimiting paradigm of adulthood that her characters consistently resist.

Beyond Binary Gender Identities: Boxed In before Three Years Old*

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Beyond Binary Gender Identities: Welcoming Discussions of Gender Identity in Public Schools

A theater arts teacher discovered that her students and colleagues were more accepting than she expected when she came out as transgender.

The Destruction of the Heterosexual Family? The Discourse of Opponents of the Gender Mainstreaming Educational Curriculum in Baden-Württemberg, Germany

The implementation of gender mainstreaming principles in the educational curriculum of the German Federal state Baden-Wurttemberg has caused protests that have gained significant attention in media. Using discourse analysis this article investigates how the media discourse of opponents constructs risks and dangers of gender mainstreaming. It will be shown that opponents perceive gender mainstreaming as a governmental hidden agenda aimed at destroying the heterosexual families by questioning the assumed “natural order” of hetero-normativity and patriarchy as the ruling ideology in public schools. Implying that harmful knowledge about Lesbian, Gay, Bisexual, Transsexual, Transgender, Intersex, Queer (LGBTTIQ) ways of life would disturb the binary gender identity of pupils and sexualize them prematurely, gender mainstreaming is understood as the core mechanism to accomplish this hidden agenda implemented through the disciplinary power of schools. Referring to biological and religious arguments the opponents’ discourse is based on sexualizing non-heteronormative life by intermingling categories of gender and sexuality. Therefore, our findings imply that in order to support gender mainstreaming in society a greater public awareness for the difference between gender and sexuality is needed, so that bias of defining LGBTTIQ life through sexual practices becomes obvious to the audience of this discourse.

Risk and protective factors for mental health morbidity in a community sample of female-to-male trans-masculine adults

BackgroundTrans-masculine (TM) individuals, who are assigned female sex at birth and identify along the masculine gender spectrum, face mental health disparities relative to cisgender people. Limited research has sought to explore the multi-level risk and protective factors associated with mental health morbidity for TM populations.MethodsBetween August 2015–September 2016, 150 TM adults were enrolled in a one-time biobehavioral health study. A survey assessed socio-demographics, past 12-month everyday discrimination, lifetime intimate partner violence (IPV), resilience (using the Brief Resilience Scale), and other factors. Bivariate and multivariable logistic regression analyses examined associations between participant characteristics and four mental health statuses: post-traumatic stress disorder (PTSD), depression, anxiety, and non-suicidal self-injury (NSSI).ResultsIn this sample (76.7% had a binary gender identity, i.e., man or transgender man; 74.7% were white, 70.0% were under age 30 years), 42.2% had PTSD based on past 30-day symptoms; 25.7% had depression based on past 7-day symptoms; 31.1% had anxiety based on past 7-day symptoms; and 31.3% had engaged in NSSI within the past 12-months. Results from multivariable models: 1) PTSD: unemployment, lifetime IPV and past 12-month discrimination were each associated with increased odds of PTSD, while having a partner was associated with the reduced odds of PTSD. 2) Depression: lower educational attainment and past 12-month discrimination were each associated with the increased odds of depression, while greater resilience was associated with the reduced odds of depression. 3) Anxiety: low annual household income and past 12-month discrimination were each associated with the increased odds of anxiety, while resilience was associated with the reduced odds of anxiety. 4) NSSI: past 12-month discrimination was associated with the increased odds of past 12-month NSSI, while higher age and greater resilience was associated with the reduced odds of NSSI (all p-values < 0.05).ConclusionsUnemployment, low income, limited education, everyday discrimination, and violence were risk factors for poor mental health, while being in a relationship, higher age, and personal resilience were protective against mental health morbidity. Findings highlight the need for interventions to address the individual, interpersonal, and societal factors that may be driving poor mental health in this population.

Beyond Binary Gender Identities: Youth Researchers Wrestling with Gender and Sexuality

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Social and psychological heterogeneity among binary transgender, non-binary transgender and cisgender individuals

ABSTRACTResearchers have identified important psychosocial distinctions between three emergent gender categories: cisgender, binary transgender and non-binary transgender. The present study further examines such heterogeneous experiences and explores the methodological implications for research of the transgender community. Participants were 153 cisgender, 201 binary transgender and 164 non-binary transgender American adults who completed questionnaires on the topics of life satisfaction, gender determinism and perceived social support. Results demonstrate that non-binary transgender participants report lower gender determinism than both cisgender and binary transgender participants. Furthermore, correlations between significant other support and life satisfaction were higher in cisgender participants than either binary or non-binary transgender participants, whereas the correlation between friend support and life satisfaction was higher in both cisgender and binary transgender participants than in non-binary transgender participants. These results threaten the methodological coherence of studying a unitary ‘transgender community’, and suggest that some meaningful group differences can be attributed to one of two dimensions of gender variance: cisgender versus transgender identity, or binary versus non-binary gender identity. Future survey research should further explore the methodology of assessing non-binary identity and transgender identity using separate items.

Beyond Binary Gender Identities: Not the Girl Everyone Sees: A Transgender Teen’s Experiences in a Faith-Based School

Judith Dunkerly-Bean and Camden Ross—parent and child—share their perspectives on how Camden, who is transgender, navigates a duplicitous existence in a Christian private school.

Beyond Binary Gender Identities: The Last Man

David Lee Carlson shares a moving moment about the recent death of his father, whom he calls “the last man.” This naming is both a paradox and a metaphor for Carlson’s keeping who he was from the man who raised him.

Gender Fluidity Reflected in Contemporary Society

ABSTRACTThis article briefly outlines and explores the concept of gender fluidity expressed by genderqueer persons that offers an alternative to our customary binary gender identities. This development allows for the possibility of the expression of nonconforming gender neutrality as the stereotypical heteronormative gender expectations are slowly being eroded. A few examples of contemporary gender fluid persons are included. Gender fluidity is also conceptualized from an analytical psychology perspective with reference to androgynous archetypal energies referred to by Jung as “The Original Man that is usually hermaphroditic.”

Non-binary and binary transgender youth: Comparison of mental health, self-harm, suicidality, substance use and victimization experiences

ABSTRACT Background: Little research has compared the mental health and victimization experiences of non-binary youth depending on their sex assigned at birth (SAAB), or compared these two groups with binary transgender youth.Aims: To compare mental health, self-harm and suicidality, substance use and victimization experiences between non-binary and binary transgender young adults, both male assigned at birth (MAAB) and female assigned at birth (FAAB).Methods: Online survey data from 677 participants from the “Youth Chances” community study of 16 to 25 year olds in the United Kingdom was analyzed, comparing across binary participants (transgender females (n = 105) and transgender males (n = 210)) and non-binary participants (MAAB (n = 93) and FAAB (n = 269)).Results: Female SAAB participants (binary and non-binary) were more likely to report a current mental health condition and history of self-harm than male SAAB participants (binary and non-binary). Similarly, female SAAB participants (binary and non-binary) were more likely to report childhood sexual abuse than male SAAB participants (binary and non-binary); the reverse pattern was found for lifetime physical assault relating to being LGBTQ. Non-binary MAAB participants were less likely than the other groups to report past suicide attempts and previous help-seeking for depression/anxiety. Binary participants reported lower life satisfaction than non-binary participants. For all four groups, mental health problems, self-harm, suicidality, alcohol use and victimization experiences were generally higher than that of youth in general population studies.Conclusions: These findings highlight the importance of considering both non-binary versus binary gender identity and SAAB in relation to mental health problems, self-harm, suicidality and substance use in transgender youth. The roles of sexual abuse, other abuse and discrimination in contributing to increased rates of mental illness and self-harm in non-binary and binary transgender individuals, particularly those who were assigned female at birth, relative to those assigned male, require investigation.

Non-binary/Genderqueer Identities: a Critical Review of the Literature

The goal of this paper is to give current understanding of non-binary/genderqueer identities, non-binary mental health trends and identity development, unique experiences of non-binary individuals, and recommendations for clinicians and researchers. About one third of individuals who identify as transgender primarily identify as non-binary. Recent studies found that non-binary people are at higher risk for suicide, experience more psychological distress, and experience higher levels of depression and anxiety. New studies on identity development of non-binary individuals provide explicit and fluid understandings of gender identity development outside of male/female, man/woman, and boy/girl. Overall, little research is focused on non-binary individuals even though non-binary people make up a significant portion of the transgender community and experience even greater negative mental health risks. Non-binary people face several challenges in a society that is structured around binary gender identities. We encourage psychologists to challenge the dominant binary assumption about gender and create environments that include and affirm non-binary individuals.

Er tiden inde til et skifte fra genus till genus*?

The article discusses naming in academic feminism, suggesting that institutionalising naming practices should take into account the multiplicity and diversity of what bears the name Gender Studies by attaching an asterisk: Gender* Studies. The idea is borrowed from Transgender Studies and politics which sometimes use an asterisk, “trans*” to spell out the problems of fixed and essentialising, binary gender identities. The asterisk signals an opening towards multiple expressions of gender diversity and dissidence. The timeliness of a parallel shift from gender to gender* in institutionalising discourses on Gender Studies is argued through a series of examples of historical and current key discussions in the field, which, sensu strictu, cannot be contained within the framework of something defined as studies of a delimited, ”proper” object, called ”gender”. The historical part is introduced through the author’s personal history as an academic feminist activist who has taken part in the building up of “Gender Studies” institutions in Denmark, Sweden and on a broader European basis since the 1980s. The contemporary part introduces examples of current key discussions within the field which share the problem that they can be contained within the framework of Gender Studies only when this term is understood in a broad umbrella like fashion. The discussions referred to are among others transgender critiques of cisnormativity, feminist intersectionality debates and feminist technoscience studies studying other phenomena than “gender”. Against the background of these and other examples, it is argued that adding an asterisk to “Gender*” in ”Gender Studies” could signal excess and diversity, aptly addressing what Judith Butler (1993) conceptualised as the “constitutive impossibility” of finding non-exclusive names.

Family Rejection as a Predictor of Suicide Attempts and Substance Misuse Among Transgender and Gender Nonconforming Adults.

We examined associations between family rejection and risk of suicide attempts and substance misuse among a national sample of transgender and gender nonconforming adults. Data were drawn from the National Transgender Discrimination Survey (N = 6456). This secondary analysis was restricted to 3458 individuals who self-identified as transgender or gender nonconforming and provided complete data on study variables. We used multivariable logistic regression to examine health risks by level of reported family rejection (low/moderate/high), controlling for relevant sociodemographic characteristics. Overall, 42.3% of the sample reported a suicide attempt and 26.3% reported misusing drugs or alcohol to cope with transgender-related discrimination. After controlling for age, race/ethnicity, sex assigned at birth, binary gender identity, income, education, and employment status, family rejection was associated with increased odds of both behaviors. Odds increased significantly with increasing levels of family rejection. Family rejection related to gender identity is an understudied interpersonal stressor that may negatively affect health outcomes for transgender and gender nonconforming individuals. A better understanding of the role of close relationships in both risk and resilience for transgender individuals is critical in the development of effective public health interventions for this community.

The subversive potential of queer pornography

This paper addresses the question of what potential queer pornography has to subvert hegemonic discourses of gender and sexuality. In particular, it engages in the analysis of transitivity and metaphor in an example of queer written online pornography and links this textual analysis to a discussion of the role of text distribution and consumption in realising any subversive potential. The analysis shows that in terms of participant representation, the text reinforces rather than challenges hegemonic discourses of gender and sexuality: Although the main protagonists are both ambiguously sexed, patterns of transitivity and use of metaphor construct largely binary gender identities for them, allocating sexual activity to the first-person narrator while casting the Other as passively desiring. In terms of its distribution and consumption, however, the text maintains its subversive potential as it sexualises a public online space and can turn offline public space into a sexual place.

“Strange and Otherwise Unaccountable Actions”

Despite recognizing that gender identity is a complex compromise formation, psychotherapists struggle to tolerate gender variance. We still tend to favor binary gender identities and clear developmental lines, rather than embracing a stance of subversive curiosity about the variability and fluidity of gender in our patients. When gender identity is fluid or ambiguous, countertransferential affective disturbances can arise that meld states of abjection and excitement, challenging theoretical constructs and threatening therapeutic neutrality. Case material from the treatment of a female-to-male trans person is presented from the perspective of the transference-countertransference matrix.