Gender Expansive Youth Research Articles

"Being here, you could actually be yourself": Trans and gender expansive youth's experiences of affirmation within LGBTQ+ community-based organizations.

Across the United States, polarizing politics have contributed to the increased stigmatization of transgender (trans) and gender expansive (TGE) youth, reinforcing health inequities for this population. Although lesbian, gay, bisexual, transgender, queer, and/or questioning (LGBTQ+) youth centers have often served as places of refuge for young people across the gender spectrum, literature has yet to show how practices and strategies used in these settings promote TGE affirmation. This qualitative study explores youth and staff experiences within these settings; identifies the services, policies, and environments needed to support TGE community members; and ultimately calls for the expansion of the limited research on TGE experience and affirmation across such spaces. Using data collected in a larger study on affirming practices for LGBTQ+ youth, this article presents findings from in-depth, semistructured focus groups and interviews with TGE (n = 12) youth and staff (n = 12) across four LGBTQ+ community-based organizations in two large urban centers. Study findings show these organizations provide TGE affirmation through language, programming, and atmospheres of openness to identity exploration. Essential to these offerings are organizational policy mandates, such as correct pronoun usage and TGE-specific programming. Youth often juxtapose their experiences of affirmation within LGBTQ+ spaces with experiences of invalidation from the cisheteronormative cultures within their school or home environments. Implications for future practice and research include administering ongoing training on TGE-affirming language and developing comprehensive accountability measures (e.g., TGE-inclusive community guidelines). Institutions with these systems in place are well-equipped to contribute to the fight for trans liberation. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Technology-Based Interventions, with a Stepped Care Approach, for Reducing Sexual Risk Behaviors and Increasing PrEP Initiation Among Transgender and Gender Expansive Youth and Young Adults

Technology-Based Interventions, with a Stepped Care Approach, for Reducing Sexual Risk Behaviors and Increasing PrEP Initiation Among Transgender and Gender Expansive Youth and Young Adults

Losing, gaining, or staying the same: how do different weight change attempts relate to muscle dysmorphia and eating disorder symptoms across genders?

ABSTRACT Adolescents and young adults are at heightened risk for eating disorder (ED) and muscle dysmorphia (MD) symptoms; yet, these symptoms and their relationships to harmful behaviors may also vary by gender. Thus, this study examined: 1) the prevalence of attempts to lose, gain, or maintain the same weight across gender identities, 2) purposes of weight change attempts, and 3) relationships between weight change attempts and ED and MD symptoms across cisgender men, women, and transgender and gender expansive (TGE) youth. 940 adolescents and young adults (57.4% cisgender women, 33.8% cisgender men, 8.8% TGE) completed questionnaires about weight change attempts, ED and MD symptoms. Women and TGE individuals attempted to lose weight more often than men, while men attempted to gain weight more often. All genders endorsed weight loss and gain attempts for different purposes. Weight loss attempts related to ED symptoms and appearance intolerance, whereas weight gain attempts related to MD symptoms across genders. In women, all weight change attempts related to greater functional impairment due to exercise. Findings highlight the need for tailored interventions to address desires to change one’s body and underscore the harmful effects of weight change attempts across genders.

Invisible Resistance: BIPOC Girls and Gender-expansive Youth in Foster Care Resisting School Push Out

This article explores that girls and gender-expansive youth who are Black, Indigenous, and people of color (BIPOC) in foster care resist oppression in schools. Research demonstrates that this population is disproportionately impacted by systemic oppression which contributes to poor academic outcomes. The child welfare system, largely operating on gendered and racialized stereotypes, targets women of color, resulting in higher rates of foster care involvement for girls and gender-expansive youth. In schools, the same stereotypes are used as reasons to surveil and punish youth, channeling them into juvenile detention. However, BIPOC girls and gender-expansive youth in foster care are rendered invisible in school discipline literature. This paper, adapted from my dissertation, utilizes observations in K-12 education to explore youth resistance to hegemonic power structures in school, and illuminates the importance of leveraging positionality when supporting youth. While my research is ongoing, this piece demonstrates that youth in foster care are made to protect themselves in school in ways that are deemed unacceptable, and subsequently criminalized. Ultimately, this work indicates the need for both school reform and structural social change to disrupt the school-to-prison pipeline.

Special Issue: Health Outcomes of Gender-Affirming Care Among Transgender and Gender Expansive Youth: Deadline for Manuscript Submission: September 17, 2024.

Special Issue: Health Outcomes of Gender-Affirming Care Among Transgender and Gender Expansive Youth: Deadline for Manuscript Submission: September 17, 2024.

A Quantitative Investigation of Black and Latina Adolescent Girls’ Experiences of Gendered Racial Microaggressions, Familial Racial Socialization, and Critical Action

As Black and Latina adolescent girls experience race and gender discrimination, they may turn to their families to explore their beliefs about and responses to systemic injustice and oppression. Familial racial socialization is a likely entry point for critical action (like community activism), linking ethnic–racial identity and critical consciousness in youth development. We used hierarchical linear regression to investigate whether familial racial socialization moderated the relationship between experiences of gendered racism and community activism. We analyzed survey data for 315 Black (n = 158) and Latina/Afro-Latina (n = 157) girls (n = 282) and gender expansive youth (age 13–17) from the southern United States. We found that girls who received more familial socialization and were more frequently stereotyped as being angry participated in more low-risk and formal political activism. Also, Black and Latina girls who were more frequently stereotyped as angry and received more messages about racism from their families engaged in more high-risk activism, while girls who were more frequently perceived as angry and received less racial socialization engaged in less high-risk activism. We discuss the implications of our results for families, educators, and scholars who support Black and Latina girls’ sociopolitical development.

Parental Gender Affirmation Model: A culturally informed framework

Benefits of parental gender-affirming behaviors on the mental health and well-being of the broader gender-expansive youth population have been extensively documented. However, the nature and impact of these behaviors have not been explored by centering Black and Latine transgender/non-binary youth (BLTY). This article offers a new framework called the “Parental Gender Affirmation Model.” This framework conceptualizes parental gender-affirming behaviors toward BLTY through the lenses of intersectional stigma and cultural gender norms and uses the Theory of Planned Behavior and Modified Gender Affirmation Model as foundational frameworks. We analyzed qualitative data from 43 interviews with BLTY, parents of BLTY, and Black and Latine transgender/non-binary young adults from California in the United States to develop the framework. The “Parental Gender Affirmation Model” starts with behavioral antecedents and ends with impacts of these behaviors on BLTY's well-being. This framework will inform the development of critically needed, culturally-informed interventions to support parental gender affirmation of BLTY.

170. Co-Designing an Online Healthy Relationship Tool With a Nationally Representative Advisory Board of Transgender and Gender Expansive Youth

170. Co-Designing an Online Healthy Relationship Tool With a Nationally Representative Advisory Board of Transgender and Gender Expansive Youth

18. Recommendations for Promoting the Gender Affirmation of Black and Latine Gender Expansive Youth

18. Recommendations for Promoting the Gender Affirmation of Black and Latine Gender Expansive Youth

97. “They Just Like us for Who We Are”: The Impact of Peer Relationships on Black and Latine Gender-Expansive Youth

97. “They Just Like us for Who We Are”: The Impact of Peer Relationships on Black and Latine Gender-Expansive Youth

Agents of scientific uncertainty: Conflicts over evidence and expertise in gender-affirming care bans for minors

Globally, as medical and mental health associations increasingly have expressed support for the gender-affirming care model for trans and gender expansive youth, this model has been paradoxically banned across the United States. Ban proponents have deemed the science behind gender-affirming care to be dangerously uncertain. Examining the first gender-affirming care ban for minors, Arkansas's Save Adolescents from Experimentation (SAFE) Act of 2021, we addressed the following two questions: 1) who are the scientists, clinicians, and political organizations that promote SAFE and similar bans?; and 2) what are the scientific arguments they make to defend SAFE in federal court? First, we developed a typology of the various “agents of scientific uncertainty” behind these bans, drawing on literature from the sociology and history of science and medicine as well as the political economy of scientific doubt. Second, we created and qualitatively analyzed a dataset featuring 375 unique citations referenced throughout federal litigation over SAFE to identify these agents of scientific uncertainty's arguments. We sorted these arguments into eight categories, which reveal how agents distorted scientific evidence and exaggerated real uncertainties and risks in gender-affirming care. This case study establishes a frame for understanding the growing prevalence and legal impact of scientific arguments against gender-affirming care.

Two-Year Follow-Up Study of Health-Related Quality of Life Among Transgender and Gender Expansive Youth Receiving Gender-Affirming Care.

To examine changes in health-related quality of life (HRQOL), this 2-year follow-up study reassessed the HRQOL of transgender and gender expansive (TG/GE) young people enrolled in a patient registry at the Gender Wellness Center (GWC) in upstate New York. Registry patients had to have a gender-affirming care follow-up visit at the GWC within a 2 year window (+6 months) of their baseline survey to complete follow-up. Youth <18 years of age completed the Child Health Questionnaire-Child Form 87 (CHQ-CF87); youth >18 years of age completed the Short Form-36v2 (SF-36v2). We analyzed change from baseline to follow-up for 11 CHQ-CF87 subscales and 8 SF-36v2 subscales. We compared follow-up HRQOL results to U.S. population standards. We abstracted receipt of gender-affirming care from GWC electronic medical records. Among the 173 patients who completed HRQOL assessments at baseline, 108 completed follow-up (62% response rate) from May 2019 to March 2022. The mean age for those completing the CHQ-CF87 was 14.6±2.2 years (range 10-17) and for the SF-36v2 was 19.7±2.3 years (range 18-24). CHQ-CF87 Behavior and Role/Social Physical Functioning subscale scores improved significantly among youth 8-17 years of age from baseline. Follow-up SF-36v2 scores for patients 18-24 years of age did not change significantly. Follow-up HRQOL mental health scores remained statistically significantly lower than U.S. population standards for both age groups. Two year follow-up HRQOL data from TG/GE youth receiving gender-affirming care improved in two domains, but did not change among young adults (>18 years of age). Mental health remains suboptimal compared to national standards.

Combating Scientific Disinformation on Gender-Affirming Care.

Scientific disinformation is false and misleading information that is used intentionally by legal and political actors to sway public opinion and oppose facts. In recent years, disinformation has become a tool for authorities to limit gender-affirming health care (GAC) for transgender and gender-expansive youth who experience gender dysphoria. Existing modes of expert intervention in health policy may not be sufficient to match the pace of these quickly unfolding health care bans. A cross-disciplinary team of academics in medicine, psychology, and law assembled to challenge scientific disinformation on GAC with 2 rapid-response rebuttal reports. Reports were produced in 3 to 10 weeks after the passage of GAC bans in Texas, Alabama, and Florida in 2022. They were posted online to facilitate dissemination and engage litigators, judges, policy experts, advocates, parents, and others. The team's efforts complemented public statements by medical societies and lawsuits brought by national LGBTQ litigators. The team's reports were cited in legal challenges to GAC bans in Texas, Alabama, and Florida. The team also filed amicus briefs for direct consideration by the courts and public comments to health care agencies in Florida. The reports received coverage in local and national media outlets in broadcast and print media. This advocacy case study describes the process used to challenge disinformation about GAC with rapid-response rebuttal reports, as well as the impact of this work and associated challenges. In an increasingly polarized political climate, this process may be adapted to other areas of health policy in which scientific disinformation takes root.

“I’m More than Just My Gender”: The Experiences of Today’s Transgender and Gender Expansive Youth

“I’m More than Just My Gender”: The Experiences of Today’s Transgender and Gender Expansive Youth

Latinx and Asian American Transgender and Gender-Expansive Youth’s Experiences with Parental Ambivalent Support and Coping Processes

Parental acceptance and rejection have been found to impact transgender and gender-expansive (TGE) youth well-being; however, these constructs have typically been studied within a binary framework. Emerging research indicates that acceptance and rejection are not mutually exclusive experiences, and in fact, many TGE youth are in family environments characterized by ambivalent, inconsistent, or ambiguous support from parents. The current study adds to this literature by exploring types of parental ambivalence that Latinx and Asian American TGE youth experience and the coping processes they use in response to ambivalence. Participants included 12 Latinx and Asian American TGE youth (14 – 25 years). Data were collected via semi-structured interviews. Emergent themes related to parental ambivalent support included: (1) situationally dependent use of pronouns; (2) lack of support for gender-affirming healthcare; and (3) provision of unreliable support. Youth coping included: (1) avoidance, (2) acceptance, (3) employing active internal coping strategies, and (4) employing active external coping strategies. Findings contribute to growing evidence that accentuates the need to move beyond the family acceptance – rejection framework binary and understand that acceptance and rejection often co-occur in the lives of Latinx and Asian American TGE youth. Implications for practitioners, researchers, and families are discussed.

The Impact of Oppression and Contextual Factors on Transgender and Gender Expansive Youth

The Impact of Oppression and Contextual Factors on Transgender and Gender Expansive Youth

How Transgender and Gender Expansive Youth Cope with Oppression: Making Sense of Experiences and Resiliency Factors

How Transgender and Gender Expansive Youth Cope with Oppression: Making Sense of Experiences and Resiliency Factors

Gender identity services must better integrate members of transgender people's social networks in care

Gender identity services must better integrate members of transgender people's social networks in care

A Closer Look: Examination of Suicide Risk Screening Results and Outcomes for Minoritized Youth in Subspecialty Pediatrics.

To describe a sample of minoritized youth who screened positive for suicide risk within medical subspecialty pediatrics, compared to non-minoritized youth and describe the screening outcomes of these youth. This retrospective chart review from October 2018 to April 2021 used electronic medical record data from an academic pediatric medical subspecialty clinic that screens universally for suicide risk for all patients ages 9 and up. Chart reviews were conducted for 237 minoritized youth (operationalized as identifying as non-White or Hispanic/Latinx, identifying as a gender minority, and having a preferred language other than English) who screened positive for suicide risk. Descriptive statistics include need for escalation to an emergency room, connection to mental health care, receival of a mental health referral, and attendance at follow-up visits. Minoritized youth were more likely to screen positive and report a history of suicide attempt when compared to non-minoritized peers. Youth identifying as gender expansive had significant elevation in suicide risk. The majority of youth in this sample were already connected to mental health care, with youth preferring a language other than English being the least likely to be connected. Findings indicate heightened suicide risk for minoritized youth, with gender expansive youth having particularly elevated suicide risk. A need to support youth with a preferred language other than English in getting connected to mental health care was also revealed.

“An Institution Can Have Good Intentions and Still Be Atrocious": Transgender and Gender Expansive Experiences in Social Work Education

Educational settings have been found to be challenging arenas for transgender and gender expansive (TGE) youth and young adults due to misgendering, lack of affirming bathrooms, systemic exclusion (e.g., legal names and lack of inclusive gender identity demographic options), and frequent silence or avoidance related to TGE issues. Though studies of TGE adult experiences in higher education are emerging, most explore disaffirming experiences. Social work education focuses on diversity, equity, and inclusion, along with how to promote social justice, which suggests more affirming environments for TGE individuals. However, little is known about the experiences of TGE students and even less about faculty in social work education. To help fill this gap, the researchers interviewed 23 TGE social work students and faculty to explore their experiences of gender-related affirmation and challenges in social work educational programs. The findings from a thematic analysis identified examples of affirming and disaffirming experiences and recommendations for improving gender affirmation and inclusion in social work programs. Social work is in a strategic position to serve the needs and impact the social welfare of TGE individuals, starting with educational settings.