Gender Expansive Children Research Articles

Trans-cending Parenthood: Lived Experiences of Parents Raising Transgender and Gender Expansive Children

This Interpretative Phenomenological Analysis (IPA) study, informed by the application of queer theory, examined eleven parents’ narratives about raising Transgender and Gender Expansive (TGE) children. The subjective experiences of these parents’ transcendence into parenting a TGE child informed one superordinate theme, the impact of living in a conventional society on the unique parenting experiences of raising TGE children. Evoked by the superordinate theme, the subtheme socio-cultural-political influences, encompasses preconceived ideas and assumptions experienced by each parent as they navigate raising a TGE child within a conventional society. Other subthemes include internalizing cishet norms and safety concerns, cishet language and cognitions on gender, and protective feelings and reactions to family and community judgments which demonstrate the multiple realities of each participant. The final subtheme, peer-led play support group, embodies these parents’ involvement in an affirming space. This data, and the meaning made from it, align with the realities of each participant and their experiences as a collective to inform this paper, which concludes with implications for supporting parents of TGE children and considerations for future research.

Parental perspectives on fertility preservation for their trans and gender-expansive children: Reflections on complexities of autonomy, support, and societal realities

Introduction Navigating fertility preservation poses unique challenges for young transgender and gender expansive (TGE) youths, who must balance short-term concerns like delaying gender-affirming hormonal treatment (GAHT) with long-term considerations of potential infertility. Parents play a crucial role in supporting their TGE children through their gender affirmation journey, which includes discussions about fertility preservation. Aim This study aimed to explore parental feelings and attitudes toward the fertility preservation of their TGE children, acknowledging the diverse perspectives shaped by societal, legal, and personal factors. Methods The study involved 82 parents who completed an online-distributed questionnaire. Participants were parents of TGE youths aged between six and twenty-five years old. The mixed-methods study utilized a tailored questionnaire comprising both open-ended and closed-ended questions. Results Descriptive analysis revealed that a significant majority of parents were aware of the effects of GAHT on fertility, with 65.3% expressing a desire for their children to have their own children in the future. However, parents shared that only 14.5% of children underwent a fertility preservation pathway, while 68.1% did not, citing barriers such as lack of services, cost, and procedural distress. Qualitative analysis identified four main themes: (1) Emotional response, (2) Parental expectations, (3) Parent-Child relationship, and (4) Structural barriers. Discussion Overall, the study underscores the multifaceted nature of parental experiences regarding fertility preservation for TGE individuals, emphasizing the importance of addressing societal norms, personal expectations, and structural barriers to ensure equitable access to reproductive healthcare services.

Teachers’ Strategies for Supporting Transgender and/or Gender-Expansive Elementary School Students

This qualitative study examines elementary teachers’ strategies for supporting trans and/or gender-expansive elementary students. The findings come from observations and interviews with a purposive sample of 31 teachers from five elementary schools with principals whom parents characterized as supporting their transgender and/or gender-expansive children. Findings indicate that elementary teachers used three broad strategies to support transgender and/or gender-expansive students. Teachers decreased gendered practices, increased discussions about gender, and affirmed children’s gender identity and expression. The consistency of teachers’ efforts to support trans and/or gender-expansive students was challenged by entrenched habits and their beliefs about the relevance of supportive practices. The study results contribute to the nascent knowledge base on educational practices that may improve the conditions for transgender and/or gender-expansive elementary school students.

Preliminary Factor Structure of the Parental Attitudes of Gender Expansiveness Scale for Parents (PAGES-P).

Parental acceptance and support are associated with positive psychosocial outcomes among transgender and gender expansive (TGE) adolescents. Understanding the degree of parental acceptance and support of gender identity and expression is an important component of gender affirmative pediatric assessment and can inform intervention. Although there are reliable measures assessing general family support, there are no existing parent self-report measures assessing acceptance and support of their gender expansive children. The present study examines the factor structure of the Parental Attitudes of Gender Expansiveness Scale for Parents (PAGES-P). Participants included 739 parents who completed the PAGES-P as standard-of-care during their child's gender health clinic visit within a children's hospital in the Midwestern United States. Principal Component Analysis (PCA) was used to identify subscales reflected in the PAGES-P. PCA yielded four subscales reflecting the following domains: (1) support and affirmation, (2) guilt and loss, (3) gender concealment, and (4) pride. This study provides preliminary evidence of the factor structure of the PAGES-P. The resulting subscales lend insight into the thoughts and behaviors of parents of TGE youth and can inform clinical practice to facilitate parental support and promote overall well-being in TGE youth.

Beyond diagnosis: Prepubescent gender expansive children on the margins of clinical measures

AbstractFew clinical measures are available for use with transgender and gender‐expansive (TGE) prepubescent children. This qualitative study includes 65 TGE children, ages 4–12, with 21 identifying as boys, 34 as girls, and 10 as nonbinary. Race/ethnicity reported by parents: 72.3% White, 7.7% Asian, 6.2% Hispanic/Latinx, 4.6% multiple races, 3.1% Black/African American, 1.5% American Indian or Alaskan Native, and 4.6% were missing race/ethnicity data. Children's responses to clinical measures identified these themes: dysphoria, identity statements, gender statements, contentment with self, and anticipatory statements. Findings highlight the need to develop clinical measures that center children's voices, are inclusive of all gender identities, and go beyond diagnostic criteria to better reflect and understand the meaning children make of gender‐related experiences.

COVID-19 and Transgender and Gender Expansive Children and Youth.

The coronavirus disease 2019 pandemic has put strains on transgender and gender expansive (TGE) children and youth, with increased rates of anxiety and depression, lower access to medical and mental health services, and greater exposure to unaccepting home environments. At the same time, for some of these young people, particularly those with supportive living situations, sheltering in place and online schooling has afforded them the opportunity to freely explore and consolidate their gender, protected from the strains of socially induced anxieties, and anticipated or experienced negative, hostile messages from their surrounding environment (ie, school or public meeting places). Culling from emerging data on the psychosocial effects of the pandemic on TGE children and youth, an argument is made for an understanding of these young people's experiences as both stress-inducing and resilience-building, each existing in dialectic tension with the other. Providers are called on to hold both in mind to fortify the biopsychosocial well-being of transgender and gender expansive children and youth. [Pediatr Ann. 2021;50(9):e366-e370.].

Gender-Affirmative Eating Disorder Care: Clinical Considerations for Transgender and Gender Expansive Children and Youth.

Transgender and gender expansive (TGE) children and youth suffer staggering rates of discrimination and are at higher risk of developing eating disorder symptoms and behaviors than cisgender youth. This article presents an overview of current research on identified risk factors for the development of eating disorders for TGE children and youth; provides clinical considerations for professionals in providing gender-affirming, collaborative eating disorder care; outlines specific concepts for staff training and for developing gender-affirming systems of care including policies and practices; and identifies numerous resources for TGE children and youth and their families. The clinical considerations and suggested practices reflect current research and clinical practice. Both the gender-affirmative clinical field and the eating disorder field are constantly evolving, and the recommendations and resources will need ongoing updates to reflect developments in these fields. [Pediatr Ann. 2021;50(9):e371-e378.].

Responding to Children’s Diverse Gender Expression: Validation of a Parent-Report Measure of Gender-Related Conditional Regard

Epidemiological studies suggest that more youth are identifying as gender expansive (e.g., transgender, gender nonconforming) than ever before. However, due to stressors like discrimination, gender minorities remain at significantly higher risk for mental and physical health problems than their cisgender peers. While initial research has shown that parental support of youth’s minority gender identities may be protective, further research is needed regarding specific parenting practices and their impact on children. We propose that parental conditional regard — the selective provision of warmth and esteem when children’s behavior conforms to parental standards or values — may be a critical component of parenting behaviors that predicts maladaptation in gender expansive children. Across three studies involving parents of cisgender and gender expansive children ages 3-15 (Study 1: N = 601, community sample; Study 2: N = 793, parents of gender expansive and cisgender children; Study 3, same sample as in Study 1), we describe the development of a novel measure of parental conditional regard for gender expression and test its validity and reliability. Finally, we demonstrate that conditional regard for gender expression is distinct from existing conditional regard measures, and is uniquely associated with children’s psychopathology.

Book Review: The gender affirmative model: An interdisciplinary approach to supporting transgender and gender expansive children

Book Review: The gender affirmative model: An interdisciplinary approach to supporting transgender and gender expansive children

Psychological Functioning, Parenting Stress, and Parental Support among Clinic-Referred Prepubertal Gender Expansive Children.

The purpose of this study is to describe psychological functioning, parenting stress, and parental support of gender expansiveness in prepubertal gender expansive children presenting to a specialized pediatric gender clinic and examine relations between parenting factors and child psychological functioning. Standard-of-care questionnaires were completed by parents of all children presenting for services. Data from prepubertal children (i.e., Tanner stage 1 of pubertal development) seen between August 2013 and April 2018 were extracted from patient charts. Data were analyzed from 71 youth ages three to 11, including 20% (n=14) ages five and younger. Fourteen percent of the sample (n=10) met diagnostic cutoff criteria for Generalized Anxiety Disorder and 20% (n=14) for Oppositional Defiant Disorder. Caregivers reported varying levels of support of their child's gender expansiveness (female caregivers: M=78.85, SD=8.68, range=56-90; male caregivers: M=77.32, SD=10.37, range=53-90), and only 3% (n=2) of caregivers endorsed parenting stress levels in the high range. Parenting stress significantly predicted higher symptom counts across all eight diagnoses. Unexpectedly, higher levels of parental support predicted more symptoms of Major Depressive Disorder and Dysthymia. Parenting stress was a significant moderator of relations between gender-nonconformity and ADHD Hyperactive-Impulsive Type and Conduct Disorder symptoms-higher levels of gender nonconformity was associated with higher symptom counts at moderate and high levels of parenting stress (but not at low levels of parenting stress). Clinical interventions aimed at reducing parenting stress among caregivers of gender expansive children may have a positive effect on children's psychological functioning.

The Arc of Justice: Examining Policies and Laws to Advance the Human Rights of Transgender and Gender Expansive Children

The role of the social worker in the achievement of human rights is to assist individuals in their struggle for dignity and their attainment of their full potential. Ethical social work ensures just laws and practices that allow all persons to live without discrimination. The purpose of this paper is to present the practice and policy implications of the last five years of court cases regarding transgender and gender expansive (TGE) children and school systems in the USA. This paper outlines the legal justifications for revisions to the current procedures and policies of interacting with TGE children, including use of restrooms consistent with gender identity (RCGI). These recommended guidelines are designed to prevent ongoing human rights violations and create pathways for TGE children to live their lives congruently with their gender identity. Basic human rights for the TGE individual include policy improvements involving restrooms, locker rooms, showers, overnight accommodation, affirmed name, and identification for the child welfare, mental health, educational, medical, juvenile justice, and law enforcement systems.

199. Communication of Acceptance And Support In Families Who Have Gender-Variant Youth

Transgender and gender expansive youth benefit from gender affirming care and support. Without this, these youth can have significant negative physical and behavioral health outcomes. In addition, prior research has found that familial acceptance and support are important protective factors; however, there are no data on how parents of transgender and gender expansive youth can communicate or demonstrate support and acceptance. Therefore, the goal of this study was to explore the ways parents show support and acceptance of their transgender and gender expansive children. Between February 2018 and August 2018, patients aged 14-20 years at the Gender & Sexuality Development Clinic at Children’s Hospital of Philadelphia were recruited. During the study visit, eligible participants provided informed consent/assent and we conducted in-depth semi-structured interviews; adolescents and parents completed separate individual interviews. Interview questions addressed several domains, including growing up in their home, relationships with parents, and their coming out process. Interviews were recorded and transcribed. Data were coded and analyzed in NVivo using Grounded Theory. To date, 5 parent-adolescent dyads interviews (4 transgender male and 1 transgender female) have been interviewed. Three major themes emerged from interviews; primarily from the youth interviews. Participants discussed collaboration, referring to the youth and the parent working as a team towards the goal of affirming the youth’s gender identity (e.g. “she asked me about my name and she helped me through the process”). Participants also described the environment, which related to perceptions that the family environment was characterized by tolerance and openness and was perceived by youth as facilitating their coming-out process (e.g. “I was raised in a fairly gender neutral household”). Participants also highlighted the importance of self-efficacy, specifically noting that being accepted at home enhances the youth’s self-efficacy and promotes advocacy and leadership in their school and community (e.g. “getting that experience has taught me more people could accept me”). Additionally, youth provided definitions for acceptance and support. Acceptance was described as a deeper experience between parent and youth. Youth feel validated when their gender identity is not discussed because it is a part of who they are (e.g., “she talks with me about being a woman, just casual conversations about me being a woman and my, now, second puberty”). Support was defined as practical and concrete, such as when parents used the correct pronouns, sought out medical services, and researched to learn more about what being transgender entails. These interviews yielded important insights into the experiences gender identity support and acceptance among transgender youth and their caregivers. Youth reported that it was empowering to feel part of a team (with their parent) working towards the common goal of affirming their gender identity. Better understanding of these relationships and how support and acceptance are defined by youth will be critical in identifying ways parents can demonstrate and communicate support and acceptance in order to promote the health and well-being of transgender and gender expansive youth.

Supporting transgender and gender-expansive children in school

As transgender people have received greater visibility and acceptance, as well as increased legal protections, educators have begun to examine their school policies and practices with an eye toward legal compliance and a desire to be welcoming to all students. Melinda Mangin shares insights from interviews with educators who have sought to improve their policies and practices on the district, school, and classroom level. Providing support requires educators to learn about the differences between sex, gender, and sexuality; to be proactive in creating inclusive policies before issues arise; and to work closely with parents and students to understand their needs.

The gender facilitative school: Advocating authenticity for gender expansive children in pre-adolescence

This article presents a framework for Gender Facilitative Schools advocating safe schools for transgender, gender expansive, and questioning children. This framework was constructed on the bases of a qualitative study of a transgender student with experiences in both gender restrictive and gender facilitative elementary schools and supporting literature. It addresses climate, language and narratives, curricular and extracurricular inclusion, professional development and partnership, and policy that can be used for improving schools.

Gender justice/gender through the eyes of children: a Photovoice project with elementary school gender expansive and LGBTQ-parented children and their allies

How do children experience gender? What are the roles of schools, adults and allies in supporting gender inclusion in a world of gendered categories? Despite a growing public discourse on gender and shifts toward fluid understandings of gender in US popular culture and educational institutions, the voices of transgender and gender expansive children remain on the margins. In Spring 2017, fourteen elementary school children in a school in Northern California, USA, who are gender expansive, transgender and in LGBTQ parented families and their allies documented their understandings and experiences of gender in their lives and in the school using Photovoice methodology. Visual and narrative findings traced three related themes of gendered meanings, gendered spaces and gendered allies. This paper asks how we can build more inclusive school environments in which children can come into their fully gendered selves. By documenting meanings and experiences of gender, children illustrate the infinite possibilities of gender and create pathways to institutional and social change for inclusive educational environments. The paper addresses the role of gender justice in light of persistent injustices rendered in and through gendered states to support movements for educational and social change.