Young Trans Research Articles

The Umbilical1

AbstractTraditional psychoanalytic approaches view excessive parental, social or relational involvement in human development as an opportunity for linking complex gender and identity experiences. The analyst's unconscious bias might present them with an opportunity for interpretation that might resemble something akin to conversion therapy. All of which leaves the patient feeling alienated thereby confirming their exiled Self. Early relational trauma affects every gender and sexual identity. In turn each traumatic situation, from inappropriate interference to traumatic abuse, affects how an individual forms and experiences relationships. Gender and sexual identity are fluid agencies of the Self within all human development. For people who are non‐normative when it comes to their gender, identity or sexuality, evidence of early relational trauma should not unthinkingly be treated alongside mental health struggles. This clinical paper explores the once‐weekly analytic work with a young trans man who was exiled and lived in a dysregulated state of mind from his early relational trauma. This paper uses images from the artist Louise Bourgeois to explore the early development of projective identification and to propose that this becomes a way of exiling unwanted feelings into the Other with the hope of finding a place of belonging as if through a psychic umbilical.

“Grasping on a spider web of hope”: Psychological challenges and impact of waiting to access UK gender dysphoria Clinics on young adults

Background Young transgender adults report higher levels of mental health difficulties compared to the general population. These difficulties reportedly improve following gender-affirming care and transition. However, gender-dysphoric people wait up to 5+ years in the UK to access gender-affirming treatment. Aims The study aimed to qualitatively explore the psychological challenges and impact of waiting to access UK Gender Dysphoria Clinics (GDCs) for young trans adults. Methods Recruitment via two GDCs resulted in a sample of 10 participants (aged 17–26) who had been waiting at least 12 months for assessment. Qualitative semi-structured interviews were conducted online or by phone with four men, four women, and two gender nonconforming people. Data were analyzed through Interpretive Phenomenological Analysis (IPA). Results Challenges and impact of waiting were represented within eight themes. Five psychosocial challenges included "Grasping on a spider web of hope that’s about to snap,” “People are uneducated and they don’t understand,” “Society or whatever made me second guess myself,” “I’m too autistic for that shit’, and “It sounded like the phone was just being left all day every day.” Mental health impacts of waiting were captured in the themes “(Gender) Dysphoria attacks” and “If it doesn’t go well by 30, I’m gonna kill myself.” A final theme, “I’m going to just go on with me life,” focused on healthy and less-adaptive coping strategies. Conclusion Waiting to access GDCs is a fragile and vulnerable time; experiences of discrimination, stigma, transphobia, and uncertainty during the waiting period appear to increase feelings of hopelessness and diminish mental health. Focusing on social transitioning was reported by most participants as a coping strategy for waiting. Findings highlight the importance of reducing waiting times for GDCs and offering psychosocial support during the wait.

The gender congruences and life satisfaction scale for transgender and gender-diverse youth (GCLS-Y): a validation study with samples from the UK and US

Background There are currently no good quality psychometric tools available to assess multi-dimensional outcomes for trans and gender diverse youth. A tool is needed to develop a stronger evidence base regarding the evaluation of gender-affirming healthcare for the population. Aim The current study aimed to adapt and validate the Gender Congruence and Life Satisfaction Scale for young trans and gender diverse people (GCLS-Y) with young trans and gender diverse people aged 14-19 living in the United Kingdom (UK) and the United States (US). Method Initially, the GCLS-Y was adapted through expert consultation and discussion with trans and gender diverse youth to ensure it is meaningful and relevant. A survey that included the GCLS-Y and other psychometric measures that assessed gender incongruence, mental health and wellbeing to determine convergent validity and social desirability to examine discriminant validity was completed by 307 trans and gender diverse youth (n = 175 in the US and n = 132 in the UK). Findings Exploratory Factor Analysis supported a 5-factor model that was assessed as conceptually accurate. The final version of the GCLS-Y included 38 items with the following subscales: Psychosocial Implications of Gender Distress, Incongruence and Dysphoria related to Chest, Incongruence and Distress related to Genitalia, Social Perceptions of Gender, and Life Satisfaction. The measure was also found to be valid and reliable. Conclusions The GCLS-Y is a psychometrically sound tool that can be used to assess multidimensional outcomes among trans and gender diverse youth (14-19 years) related to mental health and wellbeing, gender incongruence and distress, and social experiences of gender. The tool can support the development of evidence-based policy, which has implications for legislation, healthcare funding, and broader societal attitudes.

The privacy and visibility paradox: trans students’ experiences of toilets and changing rooms in UK secondary schools

ABSTRACT Trans people’s use of single-sex toilet facilities has become the subject of public attention, academic debate and research in recent years. One common solution is to offer transgender students access to an alternative toilet or changing space, such as an accessible toilet. However, in this paper, I critically engage with the suggestion that alternative toilets and changing spaces afford trans students more privacy than single-sex facilities. Drawing on research with teachers and young trans people in the UK, I illustrate that alternative toilets and changing spaces further compromise rather than secure their privacy as long as the broader environment in which they are situated is organized in a cisnormative way. This does not mean that trans students should be required to use single-sex facilities, but rather, I call for critical conversations around how far alternative facilities offer privacy for trans students in practice.

Valuing Trans Lives After Suicide: Rituals of Commemoration in Digital Social Media Culture

In 2014, a trans teenager named Leelah Alcorn posted a suicide letter to her public Tumblr account. Almost a decade later, in 2023, Eden Knight, another young trans woman, posted a suicide letter to her public Twitter account. Both suicide letters went viral and inspired memorial hashtags on the platforms where they initially circulated. In this article, I identify similarities between the cases, conceptualizing both as rituals of commemoration aimed toward restoring value to trans lives lost too soon. My analysis shows how ordinary users leverage the connective affordances embedded within popular social media platforms to sustain structured, value-laden acts of remembrance and mourning. In doing so, I elucidate four stages of the ritual process: (1) sharing suicide letters, (2) enshrining selfies, (3) modulating memories, and (4) casting blame. Ultimately, I argue that trans-led rituals of commemoration can function as justice-oriented tactics of resistance against engrained systems of oppression that perpetuate disproportionally high rates of early death within trans communities.

Exploring young trans people's everyday experiences of ‘out‐of‐placeness’ and socio‐bodily dysphoria

AbstractThis paper examines how young trans people come to be positioned as, and subsequently feel, ‘out‐of‐place’ in certain everyday spaces, particularly in the socio‐political context of the contemporary UK. Through the stories of young trans people aged 14–25 collected via participatory research, I question what it feels like to be young and trans and to experience and embody such dislocating feelings as ‘out‐of‐placeness’ and socio‐bodily dysphoria, and what toll repeatedly experiencing such embodied emotions exacts on young trans people, their bodies, and life trajectories. To do so, the experience of misgendering and deadnaming, others' hostile gazes, and what I refer to as socio‐bodily dysphoria, are introduced as examples of common modes of cisnormativity and ‘out‐of‐placeness’ experienced by participants. I build on Sara Ahmed's work on the socio‐spatial positioning and experience of non‐conforming or disruptive bodies to examine how trans youth and marginalised folk more generally become ‘out‐of‐place’ and experience ‘out‐of‐placeness’ in everyday space‐times that are not affectively, socially, or materially structured to expect their bodily presence, facilitate their participation, or enable their active agency, particularly on gendered terms. Importantly, a central contribution of the article involves articulating a spatial conceptualisation of socio‐bodily dysphoria. In sum, I develop geographical analyses of young trans people's everyday encounters and crucially build geographical understandings of the emergence and fixity of socio‐bodily dysphoria and everyday marginality through the voices and stories of trans youth.

“Ever since I knew I was trans I knew I wanted hormone therapy”: a qualitative exploration into the journey of Australian trans individuals accessing feminizing gender-affirming hormone therapy

Background:For many trans folks, gender-affirming hormone therapy (GAHT) is a desired affirming procedure that has been linked with positive health outcomes, however literature has had little focus on the journeys of trans people as they access GAHT.Aim:To understand trans people’s journey of accessing GAHT to delineate supports necessary to better engage trans individuals into gender-affirming care.Method:This study conducted semi-structured interviews with a sample of 15 Australian trans adults who participated in a larger study investigating the effects of a cyproterone acetate titration protocol.Findings:A four-factor thematic structure was created from the data. Theme one describes early cognizance of being trans and the pivotal moments in their trans realization. The second theme explores the rapid engagement with community to begin accessing information and affirming healthcare, including GAHT. The third theme explores barriers to engaging in GAHT and theme four reflects on advice participants have for other trans people who are considering GAHT.Conclusion:Findings from this study emphasize the importance of providing support to young trans people to help reconcile their gender identity and assist them to engage into care as early as possible. It also highlights the key role that community plays in providing links to affirming information and providers of GAHT – but also emphasizes the importance of considering how to engage with community who may be missed. The experience of accessing GAHT is personal and contextual, but signaling of affirming safe spaces and access to salient information may be key strategies to better support trans people choosing to access GAHT.

Young people’s attitudes to Pre-Exposure Prophylaxis for HIV Prevention – a qualitative exploratory study

Abstract Introduction Young people aged 18-24 years old are a key demographic target for eliminating human immunodeficiency virus (HIV) transmission globally. Pre-exposure prophylaxis (PrEP), a prevention medication which reduces HIV transmission, is emerging as a key tool to reduce HIV transmission. Despite largely good uptake by gay and bisexual men who have sex with men, hesitancy to use PrEP has been observed in other socio-cultural groups, such as young people, heterosexuals, people from ethnic minority backgrounds and females. Aim The aim of this study was to explore young peoples’ perceptions and attitudes to using PrEP. Methods A convenience sample of young people were recruited from England aged between 18 and 24 using a social media invitation posted by two authors which include details about the study with a registration link. Data was collected using semi-structured one-to-one interviews with graphic elicitation about current experiences of HIV care, awareness of using PrEP and decision making about accessing PrEP. Thematic analysis was used to identify codes and themes to describe participants’ experiences. Institutional ethical approval was obtained. Results Twenty-four young people took part. The sample was 58% female, 100% cisgendered, 54% had or were completing undergraduate study, 58% were straight, 58% had previously had a HIV test, 17% had previously used PrEP and a broad range of ethnicity were included. Key findings found young people had good levels of knowledge about HIV but had a poor understanding of using PrEP. In this information vacuum, negative stigma and stereotypes about HIV were transferred to using PrEP, which were reinforced by information on social media, television, and film - such as an association between using PrEP and being a promiscuous, white, gay males. In addition, young people from ethnic ethnicity communities appeared to have particularly negative attitudes to PrEP use, compared to ethnic majority counterparts. This meant the young people in our study were unable to make decisions about when to access and use PrEP. Discussion/Conclusion The findings indicate an information vacuum for young people regarding PrEP. A strength of the study is that theoretical data saturation was reached. A limitation of the study is that participants were all cisgendered and therefore the experiences of young trans people were not accounted for. Further work is needed to explore what information young people need, when and how this can be delivered to support informed decision-making about using PrEP. Pharmacists have a key role in supporting sexual health and further work should explore community pharmacies readiness to provide this information to young people.

The experiential nature of dysphoria: formulating a new conceptual framework following a qualitative study exploring the lives of seven young trans men

Background ‘Gender dysphoria’ is commonly used to describe feelings of psychological discomfort, unease, anxiety, or distress in trans individuals. Whilst the past decade has shown a significant rise in research on the experiences of trans individuals in society, the amount of literature dedicated to the experiences of trans men has been much more limited, and particularly research focused on the experiences of young trans men. As such, the range and scope of dysphoric experiences will not have been fully captured and there will be gaps in both general and clinical understanding and conceptualization. Aims To provide a deeper insight into the dysphoric experiences of young trans men, and to use this insight, in conjunction with the wider body of literature, to formulate an original framework to conceptualize the experiential nature of dysphoria. Method Semi-structured interviews were carried out with seven white British trans men aged 18–29 living in England and Wales. Data was analyzed using Braun and Clarke’s (2020) six stage reflexive thematic analysis. Results Several themes were drawn out of the data which underpinned the creation of a new conceptual framework for the experiential nature of dysphoria: the psychological nature of dysphoria which focuses on issues such as the notion of identity and desire to ‘pass’; the corporeal nature of dysphoria which focuses on the techniques and methods used to modify physical appearance; and the structural nature of dysphoria which outlines the way that societal structures influence and affect dysphoria through waiting times and financial costs. Conclusion As well as providing a deeper insight of the dysphoric experiences of young trans men, its significance lies in a new conceptual framework that can aid future studies and understanding.

Young trans people's experiences of leisure and mental health: Belonging, creativity, and navigation

There is a lack of research on young trans people's everyday leisure. This article analyses how leisure, defined within a broad spatial context beyond sport and physical activity, is perceived and experienced by trans youth in relation to their mental health and wellbeing. We draw upon theoretical concepts of cisnormativity and spatiality to our analysis of sixteen interviews with young trans people (16-25 years old) in Sweden. Three themes emerged. The first refers to how both queer- and non-queer-specific leisure spaces connect people with similar (and different) experiences regarding queer and trans identities and shows how these identities can shift in importance. The second highlights how creative spaces (e.g., theatre, cosplay) can offer opportunities to carve out a leisured space to explore different gender identity/ies and expressions that are often crucial and life changing. The final theme illustrates how leisure is avoided, postponed, waited for, and reclaimed by trans youth. Excluding mechanisms such as transphobia, cisnormativity, and the lack of access to gender-confirming care can hinder young people's leisure participation. Our analysis illustrates the complex connections between leisure and mental health among young people with trans experiences. Leisure can be a source of discomfort and distress but also of belongingness and affirmation of one's identity. Finding and accessing strengthening leisure spaces demands emotional investment, engagement, and navigation.

Shared care and gender identity support in Primary Care: The perspectives and experiences of parents/carers of young trans people.

This article addresses the complex issues surrounding trans youths' shared care perceived by parents in primary care settings in the UK. The analyses in this article draws on qualitative data derived from an online survey of 153 parents with trans children. Through the conceptual framework of healthcare assemblages, findings suggest that quality shared care for trans youth is based upon transient service relationships inherent in their healthcare-primary care, gender identity services, endocrinologists, and Adolescent Mental Health Services (CAHMS)-and, as such, this complexity must be understood better by GPs in order for quality shared care to be administered. We explored various blockages to quality shared care within primary care surgeries that produced limit situations, such as lack of knowledge, training, or experience with trans healthcare. One other key factor was that there were strong external forces that were limiting trans youths' quality shared care in the form of abject depictions from beyond the consultation, which all produced negative effects. Despite these blockages, we also demonstrate how and where quality shared care is received. For instance, we show that continuity of care or treatment after an initial diagnosis or assessment contributes to quality shared care as too does personalized care to those youths receiving it. Overall, this research provides insights into the complex perceptions of parents about what quality shared care is and ought to be for trans youth.

Parents Health Care Experiences of a Child or Adolescent with Gender Incongruence and Gender Dysphoria: A Qualitative Study

In general, little is known about the experiences of parents of a transgender child or adolescent when seeking health care services. In addition, there is little research on how parents interact with their child in the health care system. International studies show high vulnerability and psychological distress among those children and adolescents who assign themselves to a gender other than the one assigned at birth. Parental support represents a protective factor related to mental health. The aim of this study is to investigate parental interaction processes in medical-psychological treatment settings. For this purpose, guided qualitative interviews were conducted throughout Germany with twelve fathers and mothers of transgender children/adolescents. Most parents faced a number of challenges and barriers to their children's health care. A lack of knowledge and insecurities on the part of the health care practitioners up to psychopathologization of identity were ascertainable. At the same time, accepting, affectionate and supportive encounters were evident from the reports. Furthermore, it was found that the parents took an essential protective and supportive stance towards their children in the treatments. For improved health care, sensitization and education regarding gender variance in childhood and adolescence is necessary for health care practitioners in the health care system. The study can contribute to expanding the scientific discourse on life biographies of young trans* people and their parents.

Exhaustion, Exhausting Temporalities, and Young Trans People’s Everyday Lives in the UK

In this article, young trans people share their experiences of exhaustion and exhausting temporalities. Drawing on participatory research with young trans people aged fourteen to twenty-five in London and Scotland, I trace forces implicated in the spatial and bodily emergence and fixity of exhaustion in young trans people’s lives to the sociomaterialities, embodied practices, and architectures of many everyday spaces, alongside societal hostilities, as a set of forces that often (attempt to) erode their agency and contribute to their “out-of-placeness.” I also undertake a queer reconceptualizing of the condition that emphasizes the specificities of the bodies, subject positions, and spatial interactions of exhausted people. Crucially, this reconceptualization recognizes that experiencing and embodying exhaustion can, perhaps paradoxically, initiate and make possible myriad potentialities, complicating academic work that positions exhaustion as the removal of possibility. The article reflects on the radical flourishing of trans youth lives, spaces, solidarities, and euphoric experiences by exploring participants’ (re)making of resilient, resistive, and restorative subjectivities, embodiments, and spatialities within exhaustion’s spatial and temporal pervasiveness. By illuminating exhaustion’s nonlinear, messy, and prolonged temporalities, I observe that such temporalities constitute a function of lived exhaustion while paradoxically providing conditions for such empowering, expansive, and often queer and transspecific potentialities.

Fertility Preservation and Parenthood: Perspectives of Trans and Non-Binary Youth and Parents in Portugal

(1) Background: Fertility preservation allows for trans and non-binary individuals to achieve parenthood using their own gametes. Considering that preservation of gametes can be performed at increasingly earlier ages, it is important to analyze both the attitudes of trans and non-binary youth and their parents towards available family formation options, including fertility preservation. We aimed to explore attitudes toward parenthood and fertility among trans and non-binary youth and parents of trans and non-binary youth. (2) Methods: A questionnaire about fertility attitudes was administered to 33 adolescents and young adults and 27 parents. (3) Results: Trans and non-binary youth showed little interest in resorting to fertility preservation, and both parents and youth mentioned the lack of knowledge about this procedure as the main reason for not performing it. Parents were overall supportive of their children’s decisions, including the choice of different pathways to parenthood other than biological reproduction. (4) Discussion: Health providers should ensure that young trans and non-binary persons and their parents are aware of family formation options, including fertility preservation along with its impact in future genetic parenthood.

#Ownvoices, Disruptive Platforms, and Reader Reception in Young Adult Publishing

The concept of #ownvoices writing has gained traction in contemporary publishing as both a genre of reader interest and a focus for debates about authors’ rights to write cross-culturally. This paper examines tensions the #ownvoices movement reveals between the commissioning, publishing, and critical reception of a book, using debate about Craig Silvey’s Honeybee, an Australian novel focalized through a young trans protagonist but written by a straight male author. Drawing on the theory of recognition, it analyzes author and publisher media interviews, social media, and literary reviews in mainstream publications, which are given context through with selected interviews with Australian publishers. Misrepresentation and appropriation are concerns for many readers, while judgements about aesthetic quality vary. Structures within the book industries limit the economic representation of diverse creators which, in turn, has implications for the diversity of experience represented in young adult fiction and its literary quality.

‘It’s a giant faux pas’: exploring young trans people’s beliefs about deadnaming and the term deadname

Deadname is a term used to describe the name a trans person is given at birth and is a taboo topic in many trans communities. Research highlights the importance of using the chosen name of a trans person and the complex relationship young trans people have to their name(s). Drawing on interviews with young trans people in Canada and Australia, we explore the narratives they share about their relationship to their name given at birth. Through a theoretical framework that recognizes the importance of complex and even contradictory narratives in young trans people’s lives, we examine their narratives about their relationship to their name given at birth. We find that more nuance is needed to understand the significance of the words ‘deadname’ and ‘deadnaming’ in young trans people’s lives. We can all better support young trans people by recognizing they have diverse experiences and relationships to their name given at birth. We consider what this looks like when applied to educational and medical spaces.

Waiting for and in gender-confirming healthcare in Sweden: An analysis of young trans people’s experiences

ABSTRACT The role of waiting and temporality has been explored in relation to gender-confirming healthcare for adults. However, young people's experiences have been lacking, both in previous research and in the public debates on young trans people's access to gender-confirming medical procedures. This paper explores young trans people's experiences of waiting for and in gender-confirming healthcare in the Swedish context. The analysis draws on 16 semi-structured interviews with young trans people (16-25 years old). The analysis was done using thematic analysis and conceptual work on 'waiting' and 'youth'. The participants described waiting as one of the most challenging aspects of their encounters with the gender-confirming healthcare, and the findings also show that this waiting has consequences for youth's mental health and social life. Social workers can have an important role in providing psychosocial support in times of waiting.

Family nonsupport of young trans people, experiences of legal problems, and access to the legal system

This paper explores the connections between parental nonsupport of a young person’s trans or gender diverse identity and young trans people’s experiences of justiciable legal problems 1 as well as access to the legal system to address these issues. Qualitative youth data were drawn from the TRANSforming JUSTICE: Trans Legal Needs Assessment Ontario (TFJ) study. The narratives of 16 young trans people (16–29 years) were analyzed to identify parental factors in relation to encountering legal problems and accessing the legal system. Five themes emerged: parental nonsupport of gender identity, identity documentation issues, accessing medical care, employment legal problems, and housing legal problems. Results indicate that parental nonsupport of a young person’s trans or gender diverse identity may render a young person more vulnerable to experiencing justiciable legal problems and may also create barriers to accessing the legal system to address these issues.

Transidentité et préservation de gamètes : apports à la réflexion des parcours médicaux d’affirmation de genre chez les adolescents et jeunes adultes

BackgroundAt 12 years old, transgender youth who have engaged in a medical gender affirming intervention are concerned to have information about fertility risk prior to starting a treatment. MethodWe introduce a care organization proposed by our center, based on literature data. In order to illustrate some clinical situations, three case reports are presented. FindingsFertility preservation counseling with young trans people have several aims: to adjust to the capacity of the youth to take into consideration current and future fertility issues; to negotiate the exchanges between parents and the youth; and to reduce the effects of the influence by professionals on the decision. PerspectiveThese factors invite a development of counselling in fertility preservation for transgender minors, as well as for cisgender people.

Biographical ruptures by the COVID-19 pandemic on adolescent and young trans men and transmasculine people: demands for nursing

Resumo Objetivo: compreender as rupturas biográficas causadas pela pandemia da COVID-19 sobre adolescentes e jovens homens trans e pessoas transmasculinas no contexto do Brasil. Método: estudo qualitativo - survey on-line, multicêntrico. Participaram 97 homens trans e 22 pessoas transmasculinas, autoidentificados, que responderam formulário semiestruturado em duas etapas. Os dados foram submetidos à Análise de Conteúdo Temática Reflexiva. Realizou-se a interpretação com base sociológica, a partir do conceito de ruptura biográfica. Resultados: derivadas cinco categorias: interrupção da hormonização, cirurgias e acompanhamento especializado; desconfortos precipitados pela ruptura das características masculinas, autoimagem, autopercepção e identidade; vulnerabilidade a partir das perdas de familiares e pessoas significativas, emprego e fragilização das redes de apoio; emergência de problemas psicoemocionais, como perda do sentido da vida; demandas para o cuidado de enfermagem e valorização da vida de adolescentes e jovens transmasculinos no pós-pandemia. Conclusão: as rupturas biográficas provocadas pela pandemia ameaçaram as identidades de homens trans e pessoas transmasculinas de adolescentes e jovens, produziram degradação e descontinuidade das biografias, conduzindo-os à perda de sentido da vida. Profissionais de enfermagem podem ser estratégicos e essenciais na superação das ameaças, intervindo antecipadamente.