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Katz-Wise SL, Sarda V, Line EC, Marchwinski B, Budge SL, Godwin EG, Moore LM, Ehrensaft D, Rosal MC, Thomson KA. Longitudinal Family Functioning and Mental Health in Transgender and Nonbinary Youth and Their Families. JOURNAL OF CHILD AND FAMILY STUDIES 2024; 33:1321-1335. [PMID: 39220671 PMCID: PMC11361712 DOI: 10.1007/s10826-023-02738-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 11/22/2023] [Indexed: 09/04/2024]
Abstract
This study examined concordance of family members' perspectives of family functioning and mental health across two years in families with transgender and/or nonbinary youth (TNBY). Participants were 89 family members (30 TNBY, age 13-17 years; 44 cisgender caregivers; 15 cisgender siblings, age 14-24 years) from 30 families from the U.S. New England region. Family members completed an online survey every 6-8 months for 5 waves between December 2015 and Feb 2019. Surveys assessed family functioning (quality of communication, satisfaction with family) and the following mental health-related outcomes: depression and anxiety symptoms, non-suicidal self-injury, suicidality, self-esteem, and resilience. Analyses tested concordance of family functioning and mental health across family members. Reports of family functioning changed over time, and family members were not consistently concordant in their reports of family functioning. Caregivers perceived a higher quality family communication than TNBY at all waves and higher than siblings at some waves. Perceptions of family satisfaction did not show a clear pattern between family member types across waves. The greatest concordance of perceived family functioning was between caregivers and siblings and between TNBY and siblings. Across all waves, TNBY reported more severe depression and anxiety symptoms than their caregivers and siblings, and more non-suicidal self-injury than their siblings. Compared to siblings, TNBY reported higher self-esteem, but less resilience. This study highlights opportunities for intervention in clinical work with TNBY and their families. Providers working with families with TNBY should use family systems approaches to support the mental health of all family members.
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Affiliation(s)
- Sabra L Katz-Wise
- Division of Adolescent/Young Adult Medicine, Boston Children's Hospital, Boston, MA, USA
- Department of Pediatrics, Harvard Medical School, Boston, MA, USA
- Department of Social and Behavioral Sciences, Harvard T. H. Chan School of Public Health, Boston, MA, USA
| | - Vishnudas Sarda
- Division of Adolescent/Young Adult Medicine, Boston Children's Hospital, Boston, MA, USA
| | - Emmett C Line
- Division of Adolescent/Young Adult Medicine, Boston Children's Hospital, Boston, MA, USA
- Teachers College, Columbia University, New York, NY, USA
| | - Breana Marchwinski
- Division of Adolescent/Young Adult Medicine, Boston Children's Hospital, Boston, MA, USA
| | - Stephanie L Budge
- Department of Counseling Psychology, University of Wisconsin - Madison, Madison, WI, USA
| | - Eli G Godwin
- Division of Adolescent/Young Adult Medicine, Boston Children's Hospital, Boston, MA, USA
| | - Lb M Moore
- Division of Adolescent/Young Adult Medicine, Boston Children's Hospital, Boston, MA, USA
| | - Diane Ehrensaft
- Department of Pediatrics, University of California San Francisco School of Medicine, San Francisco, CA, USA
| | - Milagros C Rosal
- Department of Population and Quantitative Sciences, University of Massachusetts Chan Medical School, Worcester, MA, USA
| | - Katharine A Thomson
- Department of Psychology, BC Children's Hospital, Vancouver, BC, Canada
- Department of Psychiatry, University of British Columbia, Vancouver, BC, Canada
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Pletta DR, Austin SB, Chen JT, Radix AE, Keuroghlian AS, Hughto JMW, Reisner SL. Lower levels of social support are associated with risk for future suicide attempts in a clinical sample of transgender and gender diverse adults. Soc Psychiatry Psychiatr Epidemiol 2024:10.1007/s00127-023-02606-w. [PMID: 38182830 DOI: 10.1007/s00127-023-02606-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/11/2023] [Accepted: 12/11/2023] [Indexed: 01/07/2024]
Abstract
PURPOSE Transgender and gender diverse (TGD) adults are disproportionately affected by suicide. Social support and connection to the broader TGD community may help lower TGD adults' odds of having a suicide attempt (SA). The current study examined whether baseline levels of social support and community connectedness were associated with TGD adult's prospective odds of having a SA over 12 months of follow-up. METHODS Longitudinal data for the current study came from a patient cohort of TGD adults enrolled in the LEGACY Project. Descriptive statistics and an attrition analysis were used to examine characteristics of the cohort and missingness over time. Logistic generalized estimating equation models were used to examine factors associated with patients' odds of having a past 6-month SA at 6- or 12-month follow-up. RESULTS During the 12-month follow-up period, a total of 26 patients (3.1%; N = 830) reported having a SA. The 6-month incidence of SAs was approximately 2% at both 6- and 12-months of follow-up (6 months: N = 830; 12 months: N = 495). Baseline factors associated with increased odds of a future SA included gender identity (transfeminine vs. transmasculine: adjusted odds ratio [aOR] = 3.73, 95% confidence interval [CI] = 1.26-11.08; nonbinary vs. transmasculine: aOR = 3.09, 95% CI = 1.03-9.21), having a prior SA (aOR = 6.44, 95% CI = 2.63-15.79), and having moderate vs. high perceived social support (aOR = 4.25, 95% CI = 1.65-10.90). CONCLUSION Lower levels of social support are associated with risk for future suicide attempts among TGD adults. Findings may inform screening practices for future suicide risk and the development of interventions to improve mental health outcomes for TGD adults.
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Affiliation(s)
- David R Pletta
- Department of Behavioral and Social Sciences, Brown University School of Public Health, 121 S. Main St., Providence, RI, 02903, USA.
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, MA, USA.
- The Fenway Institute, Fenway Health, Boston, MA, USA.
| | - S Bryn Austin
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, MA, USA
- Division of Adolescent and Young Adult Medicine, Boston Children's Hospital, Boston, MA, USA
| | - Jarvis T Chen
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Asa E Radix
- Callen-Lorde Community Health Center, New York City, NY, USA
| | - Alex S Keuroghlian
- The Fenway Institute, Fenway Health, Boston, MA, USA
- Department of Psychiatry, Harvard Medical School, Boston, MA, USA
- Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA
| | - Jaclyn M W Hughto
- Department of Behavioral and Social Sciences, Brown University School of Public Health, 121 S. Main St., Providence, RI, 02903, USA
- The Fenway Institute, Fenway Health, Boston, MA, USA
- Department of Epidemiology, Brown University School of Public Health, Providence, RI, USA
| | - Sari L Reisner
- The Fenway Institute, Fenway Health, Boston, MA, USA
- Division of Endocrinology, Diabetes, and Hypertension, Brigham and Women's Hospital, Boston, MA, USA
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
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Fish JN, Russell ST. The paradox of progress for sexual and gender diverse youth. Curr Opin Psychol 2022; 48:101498. [PMID: 36401907 DOI: 10.1016/j.copsyc.2022.101498] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2022] [Revised: 09/27/2022] [Accepted: 10/18/2022] [Indexed: 01/28/2023]
Abstract
In this essay, we explore diversity in sexual and gender identities, with a focus on implications of the current politicized moment for lesbian, gay, bisexual, transgender, queer, or questioning youth. As youth come out at younger ages, their personal identity development collides with the adolescence period characterized by peer influence, stigma, and possible victimization. We consider the changing and diverse experiences of coming out in adolescence for sexual and gender diverse youth. The current social and political moment offers possibilities for new identities, yet anti-LGBTQ + legislative and policy actions have crucial implications for health and wellbeing for youth.
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Affiliation(s)
- Jessica N Fish
- Department of Family Science, University of Maryland, 4200 Valley Drive, Suite 2242, College Park, MD 20742, USA
| | - Stephen T Russell
- Department of Human Development and Family Sciences, The University of Texas at Austin, 108 E Dean Keeton St, Austin, TX 78712, USA.
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Riskind RG, Tornello SL. “I Think It’s Too Early to Know”: Gender Identity Labels and Gender Expression of Young Children With Nonbinary or Binary Transgender Parents. Front Psychol 2022; 13:916088. [PMID: 36059766 PMCID: PMC9430650 DOI: 10.3389/fpsyg.2022.916088] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2022] [Accepted: 06/23/2022] [Indexed: 11/13/2022] Open
Abstract
Little is known about gender expression among children with transgender parents. In the United States, we surveyed 64 nonbinary or binary transgender parents of children aged 18 to 71 months. Most parents reported a marginalized sexual identity and a White racial identity. Many declined to label their child’s gender identity, and this was particularly true among those with younger children. Scores indicated that, on average, children’s play was conventionally gendered. However, scores indicated significantly more gender-expansive play in the present sample than in normed samples, particularly among children assigned male at birth. Findings support transfamily theory (McGuire et al., 2016) and illustrate differences among families with nonbinary and binary transgender parents.
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Affiliation(s)
- Rachel G. Riskind
- Department of Psychology, Guilford College, Greensboro, NC, United States
- *Correspondence: Rachel G. Riskind,
| | - Samantha L. Tornello
- Department of Human Development and Family Studies, Pennsylvania State University, University Park, PA, United States
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