Gender Nonconforming Adolescents Research Articles

Nonconforming gender expression and associated problematic smartphone and internet use among Chinese adolescents.

Gender nonconformity (GNC), which refers to an individual's expression of gender that does not align with the socially prescribed norms for their biological sex, may be associated with adverse behavioral problems, such as problematic smartphone use (PSU) and problematic internet use (PIU). This study examined the associations between GNC and PSU and GNC and PIU among Chinese adolescents. This cross-sectional study utilized data from the 2021 School-based Chinese Adolescents Health Survey, recruiting 23,054 eligible adolescents aged 11 to 21, with an average age of 14.9 (SD: 1.7) years from 504 classes in 84 public high schools across 7 cities in China. Gender nonconformity, PSU/PIU, and demographics were measured. Mixed-effect linear regression models were performed. Among the participants (51.0% male), 5.3% reported high GNC and 26.9% reported moderate GNC. After adjusting for covariates, high GNC was significantly and positively associated with PSU (Β = 1.11, 95% CI = 0.49-1.72) and PIU severity (Β = 2.16, 95% CI = 1.40-2.93). Stratified analyses indicated that the associations between GNC and PSU differed between males andfemales, with a significant association observed only among male students (Β = 1.91, 95% CI=0.97-2.86). GNC is positively associated with the severity of PSU and PIU among Chinese adolescents, with male gender-nonconforming adolescents being more vulnerable to PSU. These results highlight the importance of implementing education on gender expression diversityin schools to create an inclusive school environment, which may potentially help prevent PSU and PIU among gender-nonconforming adolescents.

A Systematic Review of Inflammatory Bowel Disease Epidemiology and Health Outcomes in Sexual and Gender Minority Individuals

A Systematic Review of Inflammatory Bowel Disease Epidemiology and Health Outcomes in Sexual and Gender Minority Individuals

Revisiting gendered parenting of adolescents: understanding its effects on psychosocial development

Introduction: Today’s adolescents are growing up in a unique sociocultural climate in which gender issues are highly prominent. Alongside new ways of understanding gender identity, there are persistent gender disparities in social, health and mental health outcomes despite increasingly egalitarian views and a significant public focus on sexual assault and gender-based violence. Given gender-differentiated outcomes emerge during adolescence, it is critical to revisit factors influencing adolescent gender development. It has been argued that gendered parenting, reflected in differences in parenting attitudes and behaviors directed towards boys and girls, influences gender development. While numerous studies have examined gendered parenting with children, there has been no previous synthesis of gendered parenting of adolescents. Method: The current narrative review presents an overview of research into gendered parenting of adolescents, including parental modelling, gendered environments, and specific parenting practices, and draws together the available research on how it impacts adolescents. Gendered parenting is also examined in the context of LGBTQI + and gender non-conforming adolescents. Results: There is limited research investigating the presence of gendered parenting of adolescents, and even less assessing its impact on adolescent psychosocial outcomes. The available literature suggests that there may be effects of gendered parenting on adolescents, particularly on their gender role attitudes and gender-typed behaviors. Conclusions: Future work is needed to better understand how gendered parenting of adolescents manifests in the family home. In addition, research is needed to examine the longitudinal impact of gendered parenting, particularly within non-traditional families, and across a range of sociocultural contexts.

38.7 Retrospective Study of Characteristics of Transgender and Gender-Nonconforming Adolescents Admitted to an Inpatient Psychiatric Unit Compared to Cis-Gender Adolescent Inpatients

The number of transgender and gender-nonconforming (TGNC) youth presenting to outpatient medical services has increased. Alarmingly, TGNC youth are at greater risk for depression, suicide attempts, completed suicide, self-injurious behaviors, and substance abuse compared to cisgender adolescents. This research suggests that understanding factors that influence the development of TGNC adolescents is important. Few studies have targeted TGNC youth admitted to a psychiatric unit. This can be a critical experience in the youth's treatment trajectory. The purpose of this study is to examine characteristics, treatment histories, and trauma histories of adolescent inpatient TGNC psychiatric patients compared with cisgender inpatients. A retrospective chart review was done on all adolescent admissions to a university inpatient psychiatric unit in 2012 and 2017 (n = 432; mean age 15 years old). Data abstracted from the medical record included age, ethnicity, sex assigned at birth, gender identity, sexual preference, trauma history, bullying experiences, psychiatric diagnoses, psychiatric treatment, family psychiatric history, rural vs urban home environment, and religious preference. χ2 and Fischer’s exact tests were used to examine associations between these data points. For both years, 53.8% of nonbinary adolescents reported psychiatric comorbidity, 30.8% experiencing bullying, 30.8% history of suicide attempts, and 61.5% histories of self-harm behavior. There was a positive association between nonbinary and comorbidity (p = 0.019), being bullied (p = 0.006), suicide attempt (p = 0.009), self-harm (p = 0.000), aggression (p = 0.004), and legal issues (p = 0.011). The results were consistent between the 2 years and significantly greater than the cisgender inpatients. Many adolescents who identify as transgender or who are questioning their identity exhibit concerning mental health consequences. Understanding characteristics of adolescents who enter psychiatric inpatient facilities may help educate community-based providers to better understand the unique needs of this group. The inpatient unit experience could potentially impact these youth moving forward in their treatment, and it is important for the treatment team to be aware of their vulnerabilities.

Effects of the COVID19 Pandemic on Transgender and Gender Non-Conforming Adolescents’ Mental Health

We assessed the effects of the COVID19 lockdown on the mental health of transgender and gender non-conforming (TGN) youth (n = 18) vs cisgender youth (29 males; 29 females). Coronavirus Health Impact Survey (CRISIS) and Emotion Regulation Questionnaire were used in an online study. No group differences were found in demographic variables and exposure to COVID19. Negative emotions/feeling increased for all groups. Cisgender youth reported using more adaptive emotion regulation strategies than TGN youth. While the lockdown similarly affected TGN and cisgender youth, the former showed elevated levels of symptomatology and fewer adaptive emotional regulation strategies.

School-Based Nurse Practitioners' Perceptions of the Health Care Needs of Transgender and Gender Nonconforming Adolescents.

School-based nurse practitioners (NPs) can reduce health disparities for transgender and gender nonconforming (TGNC) adolescents. However, research is limited regarding their understanding of TGNC health. This study aimed to explore school-based NPs' perceptions of the health needs of TGNC adolescents. A qualitative, descriptive analysis utilizing a demographic survey and semi-structured interview questionnaire was conducted. School-based NPs (N = 6) were recruited via the New York School-Based Health Alliance listserv and through clinical networking. An essentialist, reflexive approach utilizing inductive thematic analysis was utilized. Four key themes and an overarching theme were identified. The overarching theme was the following: School-based NPs are primary resources-or "point people"-for TGNC adolescents seeking support, safety, and accessibility to health care. Findings identified the need for improvements in the areas of TGNC advocacy and education.

Recommendations for Transgender and Gender Nonconforming Adolescents and Young Adults With Inflammatory Bowel Disease.

Transgender and gender nonconforming (TGNC) individuals have a different gender identity than the sex they were assigned at birth. Despite an increase in provider awareness of TGNC health over the past decade, no original research or societal guidelines exist on TGNC patients with inflammatory bowel disease (IBD). We review TGNC IBD cases in the University of California, San Francisco (UCSF) Pediatric IBD Program and in the literature. We then provide some recommendations for the provision of high-quality care to the TGNC IBD population, divided into 3 categories: medications, anatomy, and mental health.

Predictors of sexual victimisation and suicidal ideation among transgender and gender-nonconforming adolescents

ABSTRACT To better understand the well-being of transgender and gender-nonconforming (TGNC) adolescents, this study examined the relations among bias-based peer victimisation, sexual harassment, parental support, school belonging, sexual violence, and suicidal ideation in a sample of a total of 16,292 high school students from the U.S (TGNC n= 610) Midwest. Students completed self-report measures: 22% of TGNC adolescents reported being forced to take part in sexual activity, and 33% reported being sexually harassed. Tests of the individual parameters revealed four variables that differentiated between those who reported sexual victimisation and those who did not. Results indicated that sexual harassment victimisation, bias-based peer victimisation, problematic drug use, and female sex assigned at birth predicted sexual victimisation. Suicidal ideation was predicted by sexual victimisation, sexual harassment victimisation, bias-based peer victimisation, and problematic drug use. Greater parental support and school belonging were associated with less suicidal ideation. Practitioners, teachers, and school administrators should be sure to intervene in instances of transphobic victimisation and sexual harassment that occur in their classrooms and schools in order to address adverse outcomes for TGNC adolescents.

Socially Assigned Gender Nonconformity and School Violence Experience Among Transgender and Cisgender Adolescents.

Although literature documents the experiences of socially assigned gender nonconformity (SAGNC) by minority sexual orientation (i.e., lesbian, gay, and bisexual [LGB]), examination of the role of gender expression on school violence outcomes in the presence of sexual orientation and gender identity is not well understood. This study describes SAGNC among a representative sample of adolescents, accounting for sexual orientation and gender identity (e.g., transgender). A secondary data analysis was conducted using Youth Risk Behavior Survey data from Los Angeles Unified School District high schools in 2013 (N = 1,496). The prevalence of school violence by self-reported SAGNC and gender identity was obtained. Associations between SAGNC and school violence were examined using multivariate logistic regression adjusted for mischievous response bias. Two hundred ninety-one (19.5%) adolescents reported SAGNC. Having missed school due to a safety concern and being bullied in the past year were more common among socially assigned gender nonconforming adolescents than those who conformed to gender expression expectations. Socially assigned gender nonconforming adolescents, regardless of sexual orientation or gender identity, are at greater risk of missed school due to safety concerns, and bullying, as compared with those who conform to norms of gender expression. Future research should measure SAGNC, sexual orientation, gender identity, and expression with larger representative samples of school populations across contexts (urban and rural), and inclusive of structural factors (e.g., school climate) to guide the development of prevention efforts.

51.3 The Influence of On- and Offline Peer Support on Peer Victimization for Transgender and Gender-Nonconforming Adolescents

51.3 The Influence of On- and Offline Peer Support on Peer Victimization for Transgender and Gender-Nonconforming Adolescents

Disparities for LGBTQ and Gender Nonconforming Adolescents.

To identify patterns of childhood adversity in a sample of adolescents and assess disparities in these experiences for lesbian, gay, bisexual, transgender, and questioning adolescents and by level of gender nonconformity. By using the cross-sectional, statewide, anonymous 2016 Minnesota Student Survey, 81 885 students were included in the current study (50.59% male; mean age = 15.51). Participants were enrolled in grades 9 and 11 in a total of 348 schools. Four patterns of childhood adversity were identified with sex-stratified latent class analyses (entropy = 0.833 males; 0.833 females), ranging from relatively low levels of abuse (85.3% males; 80.1% females) to polyvictimization (0.84% males; 1.98% females). A regression analysis showed that compared with heterosexual adolescents, gay, lesbian, bisexual, and questioning adolescents were more likely to be classified into profiles characterized by polyvictimization (odds ratio [OR] 1.81-7.53) and psychological and/or physical abuse (OR 1.29-3.12), than no or low adversity. Similarly, compared with nontransgender adolescents, transgender adolescents were more likely to be classified into profiles characterized by patterns of polyvictimization (OR 1.49-2.91) and psychological and/or physical abuse (OR 1.23-1.96). A higher level of gender nonconformity predicted a higher likelihood of being classified into each adversity profile compared with the no or low adversity profile (OR 1.14-1.45). Sexual minority adolescents and adolescents with high levels of gender nonconformity are vulnerable to experience adversity. The disparities for lesbian, gay, bisexual, transgender, and questioning adolescents and adolescents with high gender nonconformity highlight the variation in patterns of childhood adversity that these youth are at risk of experiencing. The findings reveal the need for further research on the benefits and harm of screening for childhood adversity by physicians and pediatricians.

Fertility Knowledge and Preferences Among Transgender and Gender Non-Conforming Adolescents

Gender-affirming medical therapy, such as cross-hormone therapy and sexual reconstructive surgery, may impair fertility. Many transgender and gender non-conforming (TGNC) patients initiate these therapies in adolescence, well before they may have considered their effects on future reproduction. The goal of the current study is to characterize the reproductive knowledge, concerns, and preferences among TGNC adolescents seen at a specialty gender clinic of a large academic medical center.

Attitudes Toward Fertility and Reproductive Health Among Transgender and Gender-Nonconforming Adolescents

PurposeLittle is known about the reproductive desires of transgender and gender-nonconforming (TGNC) adolescents who may seek gender-affirming medical care that leads to infertility. The current study addressed this gap by examining attitudes toward fertility and family formation in a diverse sample of TGNC youth. MethodAn online survey about sexual/reproductive health in sexual and gender minority (SGM) adolescents ages 14–17 years was conducted from September to October 2016. ResultsA total of 156 TGNC adolescents (Mage = 16.1 years; 83.3% assigned female at birth; 58.3% youth of color) responded. Overall, 70.5% of TGNC adolescents were interested in adoption and 35.9% in biological parenthood; more gender-nonconforming youth (43.8%) than transgender youth (25.8%) expressed interest in biological fertility. Discussions with health-care providers about fertility and reproductive health were uncommon—only 20.5% of youth had discussed fertility in general and only 13.5% had discussed effects of hormones on fertility. However, 60.9% of respondents were interested in learning more about their fertility and family building options. Key themes emerging from qualitative comments included concerns related to fertility/reproductive health (e.g., stigma of SGM parenthood, effect of gender-affirming treatments on fertility), and the need for additional reproductive health information both tailored to their individual experience and for SGM individuals more generally. DiscussionTGNC adolescents expressed interest in multiple family building options, including adoption and biological parenthood, and identified a need for more information about these options. Thus, clinicians working with adolescents should be aware of the unique fertility and reproductive health needs of TGNC youth.

7 - Youth and Provider Perspectives on Improving Health Care Experiences for Transgender and Gender Nonconforming Adolescents: A Mixed Methods Study

7 - Youth and Provider Perspectives on Improving Health Care Experiences for Transgender and Gender Nonconforming Adolescents: A Mixed Methods Study

92 - Exploring Multidisciplinary Treatment Approaches for Gender Non-Conforming Adolescents with Eating Disorders: A Case Series

92 - Exploring Multidisciplinary Treatment Approaches for Gender Non-Conforming Adolescents with Eating Disorders: A Case Series

52.5 THE ROLE OF FAMILY THERAPY IN CHILDREN AND ADOLESCENTS WITH GENDER DYSPHORIA AND PSYCHIATRIC PROBLEMS

Although there is growing literature and increasing awareness about the transgender experience, there is a need for continued discussion on the role of family and parent–child relationships in the development and support of transgender and gender-nonconforming adolescents. The adjustment process for families of these youth can also present challenges for parents experiencing feelings of denial, grief, blame, disappointment, loss, shame, confusion, and anxiety. Indeed, given that approximately 59 percent of transgender youth face negative reactions when coming out to their families, parental/familial involvement in the treatment of youth with gender dysphoria is highly warranted.

Transgender and gender nonconforming adolescent care: psychosocial and medical considerations.

Transgender individuals display incongruence between their assigned birth sex and their current gender identity, and may identify as male, female, or being elsewhere on the gender spectrum. Gender nonconformity describes an individual whose gender identity, role, or expression is not typical for individuals in a given assigned sex category. This update highlights recent literature pertaining to the psychosocial and medical care of transgender and gender nonconforming (TGN) adolescents with applications for the general practitioner. The psychological risks and outcomes of TGN adolescents are being more widely recognized. Moreover, there is increasing evidence that social and medical gender transition reduces gender dysphoria, defined as distress that accompanies the incongruence between one's birth sex and identified gender. Unfortunately, lack of education about TGN adolescents in medical training persists. Recent literature highlights increased health risks in TGN adolescents and improved outcomes following gender dysphoria treatment. It is important for clinicians to become familiar with the range of treatment options and referral resources available to TGN adolescents in order to provide optimal and welcoming care to all adolescents.

Homophobic Name-Calling Among Secondary School Students and Its Implications for Mental Health

Although homophobic verbal victimization has been associated with negative mental health outcomes, little actually is known about its general prevalence and relationship to mental health among adolescents. In addition, the relationship of homophobic name-calling to mental health in gender non-conforming adolescents is not well understood. This study examined the relationship between homophobic verbal victimization and mental health in adolescents, accounting for their sexual orientation and level of gender non-conformity. Survey data was collected from 513 adolescents (ages 11-17) who attended eight schools in and around Amsterdam, the Netherlands; 56.7 % of the participating adolescents were female and 11.1 % reported same-sex attractions. As hypothesized, male adolescents and those with same-sex attractions were more likely to report victimization from homophobic name-calling than were their female and non-same-sex attracted peers. Contrary to expectations, homophobic name-calling was not independently associated with psychological distress after controlling for gender, sexual attractions, gender non-conformity, and other negative treatment by peers. The hypothesis that homophobic name-calling would be more strongly associated with psychological distress in male, same-sex attracted, and gender non-conforming adolescents was also not supported. The results suggest that same-sex attracted and gender non-conforming youth are particularly vulnerable to homophobic name-calling, in the Netherlands as in other contexts, but also that other forms of peer victimization may be more strongly related to mental health.