Gender Diverse Young People Research Articles

Systematic review of ethical/methodological issues in transgender youth participative research

Abstract Background Understanding the experiences of transgender and gender-diverse (TGD) youth is essential for developing appropriate support services. However, studies focusing on TGD youth under 18 outside clinical settings are scarce, limiting effective support development. The requirement for parental consent in participatory research poses ethical and logistical challenges, impacting the safety, well-being, and privacy of adolescent participants. This dynamic complicates the balance between adolescents’ rights to autonomy and privacy and parental duties to protect their children. This review aims to illuminate the ethical and methodological challenges in participatory research with TGD youth. Methods A systematic review of bibliometric databases from 2006 to 2022 was conducted, focusing on transgender and gender non-conforming identities, adolescence, qualitative and participatory research methods, and consent issues. This review was registered with PROSPERO in November 2022 (CRD42022368360). Results Of 3,794 articles initially identified, 291 met the inclusion criteria, and 48 were extensively reviewed. Research with TGD youth commonly faces ethical tensions including parental inclusion in the consent process, safeguarding participant safety and privacy, ensuring confidentiality, and creating environments that allow TGD youth to express themselves and feel empowered. Methodological challenges include engaging public and stakeholders, recruiting participants, data collection, and maintaining research integrity. Conclusion & Implications The literature on participatory research with young transgender and gender-diverse individuals reveals intricate and often conflicting issues related to consent procedures, power dynamics, and the researcher’s role. These findings are applicable in various legal and geographical contexts, providing insights that can guide practices globally. Key messages • Research reveals ethical dilemmas in participatory research with transgender young people, highlighting difficulties around consent and the need for tailored support. • Understanding the complexities of research ethics enables better support for transgender and gender-diverse young people during research.

Sexuality and Gender Diversity Among Adolescents in Australia, 2019-2021

Sexuality- and gender-diverse (SGD) young people experience substantial health disparities relative to cisgender heterosexual peers. Little is known about SGD adolescents younger than 15 years. To describe SGD prevalence and associated factors in a population-representative cohort of younger adolescents in Australia. This prospective cohort study was part of the Future Proofing Study, with enrollment of year 8 students at 134 Australian secondary schools from 2019 to 2021 and annual follow-ups for 5 years. Data were analyzed from June 20, 2023, to June 6, 2024. Outcomes of interest were baseline self-reported gender and sexuality identities, individual characteristics, and mental health and disability diagnoses, as well as school characteristics. Among 6388 participants, median (IQR) age was 13.9 (13.6-15.8), with a range of 10.7 to 17.5 years. Most participants attended school in a major city (76.0%), were born in Australia (91.4%), and spoke English at home (93.7%). Approximately half (3122 participants; 48.9% [95% CI, 45.2%-59.0%]) identified as female or girls, and 46.5% (2973 participants; 95% CI, 39.8%-53.4%) identified as male or boys. The overall proportion of transgender identity was 3.3% (95% CI, 2.7%-3.9%), with 23 participants (0.4%) identifying as transgender boys, 10 participants (0.2%) identifying as transgender girls, 117 participants (1.8%) identifying as transgender nonbinary, and 59 participants (0.9%) identifying as another transgender identity. The overall proportion of sexuality diversity was 12.0% (95% CI, 10.4%-13.8%). The proportion of cisgender participants who were sexuality-diverse (13.0% [95% CI, 11.4%-14.8%] of girls and 4.7% [95% CI, 3.7%-5.9%] of boys) was lower than the proportion among gender-diverse participants, which ranged from 30.0% (95% CI, 9.3%-64.1%) of transgender girls to 91.5% (95% CI, 81.3%-96.4%) of those with another diverse gender identity. Gender diversity and sexuality diversity were strongly associated (odds ratio [OR], 66.24; 95% CI, 38.23-114.80), and both were negatively associated with age (gender diversity: OR per 1-year older, 0.61; 95% CI, 0.49-0.76; sexuality diversity: OR per 1-year older, 0.78; 95% CI, 0.65-0.93) and positively with mental health diagnosis (gender diversity: OR, 2.41; 95% CI, 1.79-3.24; sexuality diversity: OR, 2.50; 95% CI, 2.10-2.98), and disability diagnosis (gender diversity: OR, 2.39; 95% CI, 1.68-3.40; sexuality diversity: OR, 1.96; 95% CI, 1.64-2.36). While there were significant associations between individual and school characteristics and responses to gender and sexuality identity items, patterns of association differed, with no consistent association with economic disadvantage. This cohort study of young adolescents found higher rates of SGD than among samples of older adolescents. The significant associations with younger age, poorer mental health, and disability underscored the urgent need for inclusive programs to promote a safe and welcoming environment in schools, health care settings, and communities.

Stories of absence: Experiences of parental and familial rejection among gender-diverse children and young people.

Previous research has demonstrated the positive associations with parental support with better mental health outcomes in gender-diverse young people. However, less is known about what happens within a family structure if an unsupportive parent or family member leaves the family unit and sees the child only on the condition that they present in a way that conforms to their birth gender. This paper will focus on the first interviews with nine families within the wider sample of 39 families in the LOGIC-Q (Longitudinal Outcomes of Gender Identity in Children - qualitative) study who reported they had experienced rejection by a parent or family member after the young person had disclosed their gender non-conformity. These families' narratives are examined through two themes: How rejection impacts visitation, and Moving past the loss of rejection. The families all spoke about how they had adapted to the loss of their family members. They described how any negative impact would have been worse had they stayed living together, or were in contact with, the rejecting family member. Here, it becomes important then to understand the context of why a gender-diverse young person may choose to no longer see a parent or family member.

Affirming schools, population-level data, and holistic public health are key to addressing mental ill-health and substance use disparities among gender and sexuality diverse young people in Australia and Aotearoa New Zealand

Affirming schools, population-level data, and holistic public health are key to addressing mental ill-health and substance use disparities among gender and sexuality diverse young people in Australia and Aotearoa New Zealand

Rethinking ‘Healthy Masculinity’ Training From a Queer Boys+ Perspective

ABSTRACT Contemporary discourses on feminism’s role in Australian boys’ lives focus on how feminism might guide strategies that train boys to resist negative or ‘toxic’ performances of masculinity and instead encourage them to strive for a ‘healthy’ or ‘positive’ masculinity. In this article, I question whether training young people to attach themselves to a particular masculinity is aligned with a commitment to queer politics or serves the interests of boys, particularly queer boys or gender-diverse young people. I begin by tracing unsettled contests over masculinity's ontological foundations, including the roles of biology, identification, ‘gendered’ traits, and affective attachments. Through the method of autoethnography, I then explore issues that arise in the logic and implementation of common desires to train boys into ‘healthy’ men. I argue that, drawing on a queer liberation tradition, feminism can be an invitation to solidarity and freedom as well as a ‘way out’ or ‘refuge’ from the regulatory policing of gender norms associated with boyhood. I suggest a detachment or disaffection with masculinity does not have to lead to an identity crisis and can instead be part of a feminist killjoy survival kit [Ahmed, Sara. 2017. Living a Feminist Life. Durham: Duke University Press].

Contextualising Experiences of Co-Occurring Mental Ill-Health and Substance Use Among Trans, Non-Binary, and Gender Diverse Young People: Implications for Tailored Harm Reduction Approaches.

Though significant research highlights higher rates of mental ill-health and substance use among trans, non-binary and gender diverse (henceforth 'trans') young people, little research has considered patterns, contextual characteristics, and correlates of co-occurring experiences of mental ill-health and substance use among trans young people. Using data from the Trans Pathways study, we used prevalence ratios and age- and gender-adjusted logistic regression models to examine prevalence and differences of co-occurring substance use (past six-month cigarette use, alcohol use, and other drug use) and contextual characteristics of substance use (past six-month solitary alcohol and/or drug use, substance use for coping) by mental ill-health (depression disorder, anxiety disorder, past 12-month self-harm thoughtsand behaviours,suicidal thoughts, planning, and attempt/s). Age- and gender-adjusted models assessed associations between co-occurring depressive and anxiety disorders and recent cigarette, alcohol, and other drug use (six co-occurring items total) and 18 interpersonal stressors. Significantly increased odds of smoking or recentuse of cannabis or sedatives was observed among trans young people reporting depressive disorder, anxiety disorder (aORs ranging 1.8-3.1). Trans young people who reported recent smoking or use of cannabis, inhalants, or sedatives, had 40% to 80% reduced odds of past 12-month self-harm thoughts, self-harm behaviours,suicidal thoughts, and suicide attempt/s (aORs ranging 0.2-0.6). On the other hand, solitary alcohol and/or other drug use and substance use for coping was significantly associated with increased odds of all mental ill-health outcomes. Issues with school, secure housing, and intimate partner abuse were themost robust correlates of co-occurring mental ill-health and substance use. Trans young people using substances, especially cigarettes, cannabis, and sedatives, often so do with co-occurring experiences of depression and anxiety though limited substance use in more 'social' contexts may confer benefits for preventingself-harm and suicide thoughts and behaviours. Continued research in partnership with trans young people is warranted to conceptualise more nuanced and precise conceptualparameters of trans-affirming substance useharm reduction approaches.

Substance use among trans and gender diverse young people in Australia: Patterns, correlates and motivations.

There is a dire paucity of research into the burden, correlates and motives of substance use among trans young people in Australia. Using data from a national survey of Australian trans young people (N = 859, Mage = 19.4), we estimated prevalence of past 6-month substance use (tobacco, alcohol, cannabis, other drugs) and lifetime substance use disorder diagnoses. Covariate-adjusted multivariate logistic regression models tested associations between substance use types with 18 interpersonal factors. Open-ended responses regarding substance use motives (n = 489) were qualitatively analysed using thematic analysis with an interpretative phenomenological approach. Prevalence of lifetime substance use disorder diagnosis was 13.5% (95% confidence interval [CI] 11.1, 16.1). Alcohol use was most reported (72.4%; 95% CI 68.9, 75.6) followed by tobacco (31.1%; 95% CI 27.7, 34.6) and cannabis (30.6%; 95% CI 27.2, 34.2). Trans women reported highest rates of alcohol and cannabis use; use of other drugs was highest among trans men. Highest risk of substance use was observed among trans youth who experienced discrimination, intimate partner abuse, peer rejection and lack of family support (adjusted odds ratios ranging 1.5 to 3.0). Four multi-levelled themes of substance use motives were identified: circumstantial use, somatic use, feeling better about oneself and one's life, and harm reduction. While substance use among trans young is largely circumstantial, hedonistic and altruistic, facilitating self-exploration, friendship and community connectedness, substance use among trans young people is highly prevalent and may be used to cope with sleep difficulties, depression/anxiety and cisnormativity, including delays and waitlists for accessing gender-affirming care.

Youth justice-involved LGBTIQA+ young people: exploring practitioner and policy perspectives

ABSTRACT A growing body of research explores the intersectional needs and experiences of youth justice (YJ)-involved young people. However, there remains limited research on the experiences of and service responses to justice-involved lesbian, gay, bisexual, transgender, intersex, queer, asexual and other sexually or gender-diverse (LGBTIQA+) young people. This paper contributes practitioner and policy perspectives on the topic, with focus group data from one Australian jurisdiction and a review of jurisdictional YJ policy directions. In relation to LGBTIQA+ young people, the study found that: intersectional factors influence experiences of and engagement with services; pathways to justice-system contact are variable and influenced by several factors; current service responses have several limitations in both statutory and non-statutory settings; young people’s experiences in one service influence their experiences and engagement with other services. These findings are largely unreflected in current state and territory YJ policy direction documents. The findings can inform policy and practice with justice-involved LGBTIQA+ young people in Australia and provide recommendations for future research. IMPLICATIONS: Current limitations to practice with justice-involved LGBTIQA+ young people cannot be addressed fully by individual practitioners or organisations. Identified practice concerns and limitations are largely not reflected in current state and territory YJ policy direction. Further research should explore perspectives of justice-involved LGBTIQA+ young people.

Prevalence, distribution, and inequitable co-occurrence of mental ill-health and substance use among gender and sexuality diverse young people in Australia: epidemiological findings from a population-based cohort study

PurposeTo estimate the prevalence, distribution, and co-occurrence of mental ill-health and substance use among gender and sexuality diverse young people relative to their cisgender and heterosexual peers in Australia using population-level, nationally representative data.MethodsWe utilised Wave 8 (2018) data from the Longitudinal Study of Australian Children (N = 3037, Mage = 18.4) collected via an assessment protocol comprising interviews, direct observations, and assessments (on average 60 min per survey occasion). Weighted prevalence ratios and logistic regression models adjusted for demographic confounders were used to estimate the prevalence and distribution of mental ill-health (psychological distress, past 12-month self-harm thoughts and behaviours, past 12-month suicidal ideation, planning, attempt/s) and substance use outcomes (past 12-month cigarette, alcohol, and marijuana use) across gender identity (trans vs. cisgender), sexuality (gay/lesbian, bisexual, queer [those identifying with an ‘other’ sexuality identity that is not ‘gay’, ‘lesbian’, ‘bisexual’, or ‘heterosexual’] vs. heterosexual) and sexuality diversity status (sexuality diverse vs heterosexual) subgroups. Sex-stratified prevalence rates and accompanying adjusted logistic regression models were also used to assess mental ill-health and substance use disparities by sexuality diversity status. Adjusted multinominal logistic regression models were used to test disparities in co-occurring outcomes by sexuality identity) sexuality status sub-groups, and Fisher’s Exact Test of Independence for co-occurring disparities by gender identity (due to small sample size). All analyses used Wave 8 sample weights and adjusted for postcode-level clustering.ResultsAmong gender and sexuality diverse participants, 59 − 64% reported high or very high levels of psychological distress, 28 − 46% reported past 12-month self-harm ideation or attempts, and 26 − 46% reported past 12-month suicidal ideation, planning, or behaviour. We found significant disparities in high/very high levels of psychological distress, self-harm behaviours and suicidal behaviours among trans participants (adjusted odds ratios (aORs) ranged from 3.5 to 5.5) and sexuality diverse participants (aORs ranged from 3.5 to 3.9), compared with cisgender and heterosexual participants, respectively. Highest disparities in any past 12-month self-harm and suicidal behaviours appeared most pronounced among trans participants and queer participants compared with their cisgender, heterosexual counterparts. Minor differences by sex among sexuality diverse participants were observed for select mental ill-health outcomes. Sexuality diverse participants, and particularly sexuality diverse females, were significantly more likely to report past 12-month cigarette use and past 12-month marijuana use (adjusted odds ratio (aORs) ranging 1.4–1.6). Trans young people were at significantly elevated risk of mental ill-health in co-occurrence with cigarette and marijuana use compared with their cisgender peers (Fisher’s Exact Test of Independence p < 0.05 for all), whereas sexuality diverse young people were at greater risk of co-occurring mental ill-health and cigarette co-use and marijuana co-use, compared with their non-sexuality diverse peers (adjusted multinomial odds ratios (aMORs) ranging 2.2-6.0).ConclusionMental ill-health, substance use, and their co-occurrence disproportionately affects gender and sexuality diverse young people in Australia. Further research should study the longitudinal development of these disparities through adolescence, with close attention to the social, embodied contexts of substance use among LGBTQ + young people with the view to building LGBTQ + affirming models of harm reduction.

Tuned In! An affirmative mindfulness intervention for sexual and gender diverse young people

Sexual and gender diverse youth and young adults (SGDY) experience significant mental health disparities compared to non-SGDY, which is exacerbated by ongoing anti-LGBTQIA + political attacks across the U.S. SGDY lack access to culturally responsive mental health supports and are overlooked in clinical practice/research. Mindfulness is a transformative practice that fosters well-being and provides tools to address the psychological impact of discriminatory experiences. This study investigated feasibility, acceptability, and outcomes of a mindfulness-based intervention (MBI), Tuned In!, co-developed with SGDY to improve mental health and navigate and challenge the current anti-LGBTQIA + sociopolitical context. Participants (n = 56), 16 to 29 yrs., were recruited and participated online. Surveys were administered pre, post-intervention, and at 6-month follow-up. Hierarchical Linear Modeling and Reflexive Thematic Analysis were used to analyze data. Rates of engagement and retention were high. High levels of satisfaction and acceptability, a significant decrease in depression, anxiety, and psychological distress, and a significant increase in sexual self-efficacy, mindfulness, and self-compassion were found, with gains maintained at 6-month follow-up. Qualitative analysis uncovered the following themes: Development of Crucial Coping Skills and Strategies, A Sense of Community Among SGDY, Learning from Peers Through Dialogue. Study results suggest that Tuned In! is a promising intervention to improve SGDY mental health.

Gender fluidity and “other left-wing superstitions”: problem representations in the inquiry report on the NSW Parental Rights Bill

ABSTRACT Policies and other governance initiatives that attempt to limit or prohibit gender diversity inside (and outside of) schools are increasing in frequency. One core discourse that has been deployed to restrict curricular engagements and school policies around gender and sexuality diversity in schools is that of “parental rights”, which seeks to position any discussions of these matters as requiring consent of parents. This paper reviews an inquiry report into proposed legislation that sought to enshrine “parental rights” in education and prohibit the teaching of “gender fluidity” in schools in New South Wales, Australia. Produced in 2021, the inquiry report included inputs from advocacy groups, citizens, and lobbyists alongside substantial contributions from politicians, representing multiple constructions of gender, identity, young people, and schooling. Using Bacchi and Goodwin’s “What is the problem represented to be” framework, this paper analyses the conceptual logic and prominent discourses within the Report. Three key problem constructions dominated: “gender fluidity”, unsafe schools and radical teachers. We argue that the Report engaged in a moral panic of gender diversity as contagious, teachable, and dangerous. The logic of the Report depended upon the imagined but often cited crisis of teacher quality and a subscription to antiquated discourses that frame children as innocent, asexual, and cisgender. Findings demonstrate that the Report silenced the perspectives and experiences of transgender and gender diverse children and adults. Ultimately, the Report reproduced and amplified transphobic discourses that proliferate in international publics that seek to limit and admonish gender diversity and gender diverse young people.

Memories of schooling amongst trans women and sexuality diverse men in Papua New Guinea

ABSTRACT Drawing from a life history study we examine memories and experience of schooling in Papua New Guinea among 45 trans women and sexuality diverse men. While participants reported regulating their expression of gender and sexuality to ‘fit in’ and avoid physical and verbal abuse at school, others felt able and supported to express their gender and sexuality diversity more freely beyond stereotypical norms. Schools provided a varietyof experience for trans and sexuality diverse youth, unsupportive in many ways but supportive in others. The study highlights the importance of examining the impact of colonial discourses driving homophobia and transphobia in diverse settings, and understanding the socio-cultural climates of schools to identify solutions to the discrimination and violence experienced by trans women and sexuality diverse students. Further research into the current experiences of trans, gender and sexuality diverse young people in school would provide a valuable comparative perspective to our retrospective study.

THRIVING IN MOTION – YOUTH MOVES: MOVEMENT FOR TRANS AND GENDER DIVERSE YOUNG FOLK

CASE SETTING Gender diverse young people have lower rates of exercise, and higher rates of mental and physical health challenges, perpetuated by a lack of trans-friendly physical activity providers and environments. Our collaborative project aimed to create and support community-based exercise opportunities for trans and gender diverse young people (15-25yrs) to increase participation and improve their physical and mental health outcomes. Alongside feasibility data from 18 months delivery, two case studies will be presented (23 yrs non-binary individual, presenting with disordered eating and exercise, neurodivergence and mental illness; 18yrs transfeminine presenting with neurodivergence and participation barriers). APPROACH AND TREATMENT Through targeted community collaboration with young people and multidisciplinary support services, a supportive and inclusive structured exercise program was created. Specifically, we delivered and evaluated the feasibility of the exercise program for gender diverse young people; and educated the wider exercise and health community on inclusive exercise practices. RESULTS Forty-six gender diverse young people participated across the delivery of 11 x 8-10 week programs in 5 Perth metro locations, totalling 4518 exercise therapy hours. On average 100% of participants reported a score higher than 3/5 for program enjoyment, 79% of participants reported a score higher than 3/5 for motivation to return. Participants on average increased weekly physical activity participation by 50% since commencing the program, and 100% of participants would recommend the program to other trans peers. REFLECTIONS/LEARNINGS In WA, the absence of exercise opportunities for gender diverse young people prompted our tailored program. We prioritized inclusivity, safety, and participant-specific needs. Our proactive approach included health screenings, upskilling staff, and encouraging a supportive environment. Listening to participant expectations, involving a Youth Advisory Group, and engaging a Youth Engagement Officer proved vital for program success. Our reflections incorporate the significance of tailored, inclusive programs and community involvement in fostering active, safe spaces.

Integrating perspectives of transgender and gender-diverse youth, family members, and professionals to support their health and wellbeing – a mixed-method study protocol

BackgroundThe current literature highlights a strong link between the poor health outcomes of transgender and gender diverse (TGD) individuals and their negative experiences in various areas of life. Most of these publications rely on adults’ memories, lacking a focus on the current experiences and needs of young transgender and gender-diverse individuals. Furthermore, previous studies on support for these young people often solely consider the perspectives of TGD adults or professionals and rarely involve parents’ viewpoints.MethodsThis study will use a mixed sequential method with a participatory approach. Firstly, the qualitative phase will explore the difficulties and needs of TGD (15–20 years old) and of the families and professionals who support them. Results from this part will be used to develop the questionnaire for the quantitative phase, with the help of a community board. Secondly, based on participatory epidemiological research, the quantitative phase will use an intersectional perspective to measure the impact of individual and structural factors on the quality of life and well-being of transgender and gender-diverse young people. Finally, a co-creation phase will be undertaken to formulate recommendations based on the results of the first two phases.DiscussionThis research aims at better understanding the influence of gender identity on the quality of life and health of TGD young people and their families and to identify protective and risk factors that affect their vulnerabilities.Ethics and disseminationThis study has been approved by the Ethics Committee of the Erasme Faculty Hospital (CCB B4062023000140). As this research is participatory and part of a PhD dissertation, we aim to disseminate the results through our partners’ networks and structures locally, and internationally through conferences and peer-reviewed journals.

Towards a critical pedagogy of trans-inclusive education in UK secondary schools

ABSTRACT School systems within the UK are embedded within cultures of normative gender narratives. Such cultures can create difficult environments for gender diverse young people which in turn contribute to poorer academic attainment and long-term health and wellbeing outcomes. In an attempt to understand how to foster better understanding within schools, we drew upon the lived experience of gender diverse young people. Using Interpretative Phenomenological Analysis (IPA), this research explored the experience of six transgender and non-binary young people who reflected on their experience of secondary education in the UK. Drawing on critical pedagogy as a theoretical framework, we found that: unsupportive school environments and relationships led to decreased mental health and feelings of Otherness; gender diversity was a contentious topic not found within curriculums; and teachers had the potential to create and foster positive experiences within a pedagogy of gender diverse affirmative partnership. To facilitate this, there is a need for institutional support allowing teachers to critically interrogate the structural embeddedness of cisgenderism in educational spaces, and within cultures of pathologised self-identified gender identities.

Effect of gender identity on the association between gender dysphoria and suicidality via appearance anxiety among transgender and gender-diverse young people: moderated mediation study.

Gender dysphoria is associated with suicidality among transgender and gender-diverse (TGD) people. Gender dysphoria also results in a stress on appearance. The objectives of this study were to examine: (a) whether appearance anxiety mediates the effect of gender dysphoria on suicidality; and (b) whether gender identity moderates the mediating effect of appearance anxiety. A total of 117 769 college and university students were recruited in this cross-sectional study from Jilin Province, China. After screening based on participants' gender identity, 2352 TGD young people (aged from 15 to 25 years) were divided into three subgroups: female to male (FTM), male to female (MTF) and non-binary. Self-report inventories measured gender dysphoria, suicidality and appearance anxiety. A structural equation model was run to examine the relationships among TGD gender identity, gender dysphoria, appearance anxiety and suicidality. Among TGD young people, gender dysphoria was significantly positively associated with suicidality (β = 0.15, 95% CI = 0.11-0.18, P < 0.001). Appearance anxiety partially mediated the association between gender dysphoria and suicidality (β = 0.07, 95% CI = 0.05-0.08, P < 0.001). Gender identity moderated the mediating effects: compared with individuals with FTM identity, among those with MTF and non-binary identities, gender dysphoria showed stronger positive effects on appearance anxiety, and appearance anxiety showed greater effects in mediating the association between gender dysphoria and suicidality. Among TGD young people, gender dysphoria is significantly associated with suicidality via appearance anxiety, with gender identity moderating the mediating effects. Diverse treatments should consider the heterogeneity of TGD subgroups, with the aim of limiting the tendency of gender dysphoria to trigger appearance anxiety, thus further buffering against the risk of suicide.

Prevalence, severity and risk factors of psychiatric disorders amongst sexual and gender diverse young people during the COVID-19 pandemic: A systematic review.

Before the COVID-19 pandemic, the prevalence and severity of psychiatric disorders among sexual and gender diverse (SGD) young people was greater than in their heterosexual/cisgender peers. We systematically reviewed literature examining the prevalence, severity, and risk factors for psychiatric disorders among SGD young people aged 25 and under during the pandemic. Four databases (MEDLINE, PsycInfo, Scopus and Web of Science) were searched. Eligibility criteria were studies assessing prevalence rates, mean symptomology scores and risk factors of psychiatric disorders using contemporaneous screening measures or diagnosis. Thirteen studies of mixed quality were identified. Most studies indicated SGD young people were at high risk of experiencing several psychiatric disorders including depressive and generalised anxiety disorder compared to the general population. This group also experienced more severe symptomology of various psychiatric disorders compared to their heterosexual/cisgender peers. Risk factors included those specific to the pandemic along with factors that led to greater risk before the pandemic. This systematic review has indicated evidence of heightened risk of psychiatric disorders among SGD young people during the COVID-19 pandemic. It is important for clinicians to acknowledge the needs of SGD young people, working with them to co-develop more inclusive care as they deal with the pandemic's fallout.

A scoping review of trans and gender diverse children and adolescents’ experiences of physical activity, sport, and exercise participation

Increasing young people's physical activity, along with their motivation and confidence to be active, is widely advocated for supporting desirable health outcomes. Trans and gender diverse (henceforth; trans) young people experience significant physical activity-related barriers compared to cisgender (i.e., an individual for whom gender identity and sex presumed at birth are in alignment) peers. This scoping review aimed to synthesise information relating to physical activity, sport, and exercise, as well as participation experiences among trans young people aged 10–25 years. Database searches of CINAHL, Embase, Medline, PsychINFO, and SportDiscus were conducted for publication until August 2023. Broad search terms included exercise, physical activity, sport, transgender, gender diverse, youth, child, and adolescents, with 24 studies identified for full text review. Following title, abstract, and full text review, 12 studies were retained for data extraction. Methodological quality was assessed with scores ranging from 0.14 to 0.95. Eleven studies reported trans young people participated in less physical activity compared to cisgender peers. All 12 studies reported on barriers to exercise participation—resulting from gender-based isolation, exclusion, and rejection in sports or school physical education—that were associated with mental health-related concerns. Findings demonstrate trans young people typically have lower physical activity participation levels, feel less safe while playing sport, and face more barriers to participation than their cisgender peers, resulting in isolation and exclusion. Findings suggest a need to create more inclusive opportunities and harness motivating factors (e.g., gender affirmation, social capital) to assist the adoption of healthy exercise behaviours.

The intersectional social patterning of early-COVID-era digital intimacies among transgender and gender-diverse young adults: effects on peri-pandemic sexual decision-making

Interactive communications technologies facilitate identity formation and socio-sexual connection among transgender and gender-diverse young people. However, within their communities, variations in technology use along ethno-racial, sexual and gendered lines, and as facilitators of sexual resilience during the early COVID-19 pandemic, remain under-studied. Among N = 230 transgender and gender-diverse young adults, surveyed between October 2020 and September 2021, latent class analyses characterised participants by preferred functional affordances, such as finding dates, sex and friends (Model 1), and by simultaneous account-keeping across social, dating and ‘hookup’ apps (Model 2). Werron and Ringel’s typology of pandemic practices characterised qualitative descriptions of sexual decision-making attributed to COVID-19. Both fit indices favoured two-class solutions. Model 1 detected an n = 89, 43% ‘high interactive communications technologies–enabled intimacy’ (versus ‘low technology-enabled intimacy’) class, in which digitally mediated friendships, dates, sexual encounters and gay/lesbian sexualities, predominated. An n = 38, 17% ‘high socio-sexual polymedia’ (versus ‘low polymedia’) class in Model 2 was characterised by simultaneous social media, ‘hookup’ and dating app usage. ‘High’ subgroups saw statistically significant reductions in sexual partners, with the high polymedia class also associated with reductions in HIV testing. Qualitative results contextualised these reductions as, predominantly, ‘responsive’ pandemic practices: reactions to stay-at-home orders.

Minority stressors, traumatic events, and associations with mental health and school climate among gender and sexuality diverse young people in Australia: Findings from a nationally representative cohort study.

Population-level, nationally representative data on the prevalence of minority stressors and traumatic events, mental ill-health effects, and the preventative utility of school climate, among gender and sexuality diverse young people in Australia, is significantly lacking. In this study, we estimated the prevalence and distribution of minority stressors and traumatic events among young people by sexuality identity (gay/lesbian, bisexual, other sexuality, heterosexual), sexuality diversity (sexuality diverse, not sexuality diverse), and gender identity (transgender, cisgender) and assessed associations with mental ill-health and the moderating role of school climate factors. Using Wave 8 (2018) follow-up data from a population-level, nationally representative longitudinal cohort study, the sample comprised 3037 young people aged 17-19 years in Australia. Prevalence ratios for minority stressors and traumatic events were calculated for gender and sexuality diverse categories using logistic regression models. Linear regression models were used to test associations between traumatic events and minority stressors, and mental ill-health. Multivariate linear regression tested school climate factors as effect modifier between minority stressors and mental ill-health among sexuality diverse young people. Rates of traumatic events and minority stressors were highest among bisexual and gay/lesbian young people and were significantly associated with mental ill-health among all gender and sexuality diverse young people. Highest mental ill-health effects were observed among trans young people. Among sexuality diverse young people, positive and negative feelings toward school climate were associated with decreased and increased mental ill-health, respectively. After accounting for sexuality diversity, positive overall school climate appeared protective of mental ill-health effects of sexuality-based discrimination. Minority stressors, traumatic events, and associated mental ill-health are prevalent among gender and sexuality diverse young people in Australia, especially trans, bisexual, and gay/lesbian young people. Promotion of affirmative, safe, and inclusive school climate demonstrates significant promise for the prevention and early intervention of mental ill-health among gender and sexuality diverse young people.