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Family Support & Rejection

Family Support & Rejection
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Risk and protective factors for self-harm in a population-based sample of transgender youth


Authors: Taliaferro L.A., McMorris B.J., Rider G.N., Eisenberg M.E.
Date of publication: 2019
Journal: Archives of Suicide Research: Official Journal of the International Academy for Suicide Research

Summary: This US study used information from 1,635 gender diverse students (Grades 9 and 11). It sought to understand the factors that impact upon non-suicidal self-injury (NSSI) (i.e. self-harming acts) and suicide attempts (SA) by gender diverse young people. Students were divided into 3 groups (no self-harm, non-suicidal self-injury (NSSI) only, and NSSI and suicide attempt (NSSI + SA)). The researchers ran analyses that tested the associations between risk factors, protective factors, and health-risk behaviours to self-harm. Over half (51.6%) of gender diverse young people in the study reported past-year self-harm behaviour.

Factors that consistently distinguished young people who reported self-harm from those who reported no self-harm included reports of a mental health problem, depression, running away from home, and substance use. Factors that distinguished the NSSI + SA group from the NSSI only group were reports of a mental health problem, physical or sexual abuse, relationship violence, bullying victimization, less parent connectedness (i.e. how much a child feels they can talk to their parent/s about their problems, how much a child feels their parent/s care about them), lower grades, lower levels of perceived school safety, and running away from home. The two strongest factors protecting against the likelihood that gender diverse young people would engage in NSSI and also attempt suicide were parent connectedness and school safety. This study showed that being connected to parents reduced the risk of a suicide attempt in gender diverse young people.

You can read the full study here

Family rejection as a predictor of suicide attempts and substance misuse among transgender and gender nonconforming adults


Authors: Klein, A. & Golub, S.A.
Date of publication: 2016
Journal: LGBT Health

Summary: This US study looked at associations between family rejection and risk of suicide attempts and substance (alcohol and drug) misuse among a large national sample of 3458 transgender and gender nonconforming adults. The researchers ran analyses that looked at these health risks by the level of reported family rejection (low/moderate/high). Overall, 42.3% of participants reported a suicide attempt and 26.3% reported misusing drugs or alcohol to cope with transgender-related discrimination. After controlling for other significant factors such as age, income, education etc, family rejection was associated with increased chance of suicide attempts and substance misuse. Chances increased significantly with increasing levels of family rejection, such that the risk of attempting suicide more than tripled for those adults who experienced a high level of family rejection. The risk for alcohol or drug abuse also rose much higher.

You can read a summary of the study only here

Mental health of transgender children who are supported in their identities


Authors: Olson, K. R., Durwood, L., DeMeules, M., & McLaughlin, K. A.
Date of publication: 2016
Journal: Pediatrics

Summary: This US study examined the mental health (depression and anxiety levels) of 73 gender diverse children aged 3 to 12 years who had socially transitioned (i.e. were supported to live openly as the gender they identified with). The researchers compared their mental health with two other groups: Non-gender diverse children aged 3 to 12 years and the siblings of the gender diverse study participants. Their parents completed measures of anxiety and depression for all children.

The researchers found that the gender diverse children showed no difference in levels of depression and only slightly higher levels of anxiety than that of average children in the population. When they compared the gender diverse children’s mental health to that of the other groups in the study, they found again that there was no difference in depression levels and only marginally higher anxiety levels. The researchers concluded that when gender diverse children are supported to live openly, they have similar mental health outcomes to their cisgender (i.e., not gender diverse) peers.

You can read the full study here

Mental health and resilience in transgender individuals: What type of support makes a difference?


Authors: Puckett, J. A., Matsuno, E., Dyar, C., Mustanski, B., & Newcomb, M. E.
Date of publication: 2019
Journal: Journal of Family Psychology

Summary: This US study looked at different types of social support and how they influence individuals’ mental health and resilience. The study sample included 695 trans adults and the researchers looked at family support, support from friends, and connectedness to a trans community. Over half of participants reported moderate to severe levels of anxious and depressive symptoms. The researchers found that participants fell into four groups, with one group reporting lower levels of depression and anxiety and higher resilience compared to the other three groups. This group also reported high levels of family support and community connectedness. Overall family support was most strongly linked to better mental health and resilience compared to support from friends or connectedness to the trans community.

You can read the full study here

Parental support and mental health among transgender adolescents


Authors: Simons, L., Schrager, S. M., Clark, L. F., Belzer, M., & Olson, J
Date of publication: 2013
Journal: Journal of Adolescent Health

Summary: This US study used a survey to investigate the relationships among parental support, quality of life, and depression in trans teenagers using a sample of 66 young people who were accessing gender-affirming healthcare. Parental support was defined as parental help, advice, and confidante support. The researchers found that parental support was significantly associated with higher life satisfaction, lower perceived burden of being trans, and fewer depressive symptoms.

You can read the study summary only here

Impacts of strong parental support for trans youth


Authors: Travers, R., Bauer, G. & Pyne, J.
Date of publication: 2012
Report: TransPULSE

Summary: This Canadian study used a survey to report on the health impacts of parental support for 433 trans young people aged 16 to 24 years. The researchers found clear associations between the support that trans young people experience from their parents and numerous health outcomes. The most significant differences indicated that trans young people who have strong parental support for their gender identity and expression report higher life satisfaction, higher self-esteem, better mental health including less depression and fewer suicide attempts, and adequate housing compared to those without strong parental support.

Of note, the researchers found that 57% of participants who reported experiencing parental rejection had attempted suicide in comparison to 4% who reported experiences of parental acceptance. These findings draw a direct relationship between strong parental support and the reduction of significant risk factors for trans young people.

You can read the full study here

Perspectives of transgender youth on parental support: Qualitative findings from the resilience and transgender youth study


Authors: Andrzejewski, J., Pampati, S., Steiner, R. J., Boyce, L., & Johns, M. M.
Date of publication: 2021
Journal: Health Education & Behavior

Summary: In this US study 33 trans young people aged 16 to 25 years were interviewed about their experiences of parental support. The researchers found participants identified numerous ways (emotional, instrumental, informational, and appraisal) in which parents demonstrated their support generally (e.g., expressions of love, housing, advice, and affirmation). Parental support that related directly to their young person’s gender identity was more limited however (e.g., use of chosen name and pronoun). Young people spoke about the importance of having parents provide support specific to their gender identity such as emotional support at the time of their coming out, willingness to listen to the young person’s experience of gender, use of chosen names and pronouns, and support for social, legal and/or medical gender affirmation.

You can read the full study here

Knowledge is power: Trans young people’s perceptions of parental reactions to their gender identity, and perceived barriers and facilitators to parental support


Authors: Morgan, H., Raab, D., Lin, A., Strauss, P., & Perry, Y.
Date of publication: 2023
Journal: LGBTQ+ Family: An Interdisciplinary Journal

Summary: This Australian study aimed to better understand how gender diverse young people view parental reactions to disclosure of their gender identity and what they consider to be barriers to, and enablers of, parental support. The researchers interviewed 14 young people aged 14 to 23 years who described a range of initial parental reactions ranging from rejection to unconditional support. They reported parents demonstrated many different feelings and emotions including shock, grief, anxiety and uncertainty, denial and ambivalence. They reported that their fathers or father figures tended to struggle more with understanding and supporting their gender identity. When young people experienced unsupportive reactions they described strong, negative impacts on their mental health and sense of being comfortable or safe at home. Positively, most participants said that their parents became more supportive over time in these cases. Positive reactions from parents related to expressions of unconditional love, efforts to support their child’s gender identity, and concern related to just wanting their child to be happy. Young people identified several barriers to their parents understanding and showing support which included a lack of knowledge of gender diversity and parents feeling a sense of stigma at being the parent of a gender diverse child, feeling isolated or being afraid for their child and their future. Non-binary young people felt that their parents experienced even more difficulty due to a greater lack of information and resources for parents of non-binary children.

Enablers for increasing parental understanding and support related to quick and easy access to good-quality information, being able to connect with peers such as other parents of gender diverse children, and exposure to positive representation of gender diversity such as stories of gender diverse adults. Young people also identified that when parents learned about the impact of not supporting their child’s gender identity, particularly the negative mental health impacts, they were better able to support their child.

You can read a summary of the study only here

Disordered eating behaviors among transgender youth


Authors: Watson, R. J., Veale, J. F., & Saewyc, E. M.
Date of publication: 2017
Journal: The International Journal of Eating Disorders

Summary: This Canadian study looked at the relationship between disordered eating and risk and protective factors for trans young people using health survey information from 923 participants aged 14-25 years. The researchers found high rates of eating disorders in this group. Nearly half of the 14-18 year olds and more than a third of the 19-25 year olds engaged in behaviours such as binge eating, fasting and using pills, laxatives or vomiting to lose weight. Binge eating and fasting were the most common behaviours, with both behaviours reported by around 35-45% of the participants. Vomiting was reported by almost 1 in 5 of the 14-18 year olds. When compared with figures from a similar study looking at eating disorders in the general youth population, the researchers found that 27% of young people reported binge eating (compared with 42% in this study by Watson and colleagues) and 5% reported vomiting to lose weight (compared with 18% in this study by Watson and colleagues).

The researchers found that enacted stigma (the higher rates of harassment and discrimination that trans young people face) was linked to a higher chance of reported past year binge eating and fasting or vomiting to lose weight. Importantly, they found several factors protected against disordered eating including family connectedness, school connectedness, caring friends, and social support. When participants reported having these factors in their life, they also reported lower chances of past year disordered eating. For 14-18 year olds, family connectedness was particularly linked with the lowest chance of disordered eating.

You can read the full study here

Affirmation-support, parental conflict, and mental health outcomes of transgender and gender diverse youth


Authors: Belmont, N., Cronin, T.J., & Pepping, C.A.
Date of publication: 2023
Journal: International Journal of Transgender Health

Summary: This Australian study surveyed 63 parents of gender diverse young people (aged 11 to 17 years) to (1) investigate parental reports of affirmation of their children, with a focus on parental support and barriers to affirmation, and (2) test whether parental support and aspects of the co-parenting relationship predicted young people's mental health outcomes.

The researchers found almost 90% of young people had had their gender socially affirmed according to parents' reports, though fewer had taken steps to legally or medically affirm their gender.

Parental support for affirmation was generally very high, and parents reported that co-parenting conflict was generally low although discrepancies between parents were greatest for medical affirmation.

Parent support for affirmation was a strong predictor of lower child depressive symptoms and they found that parental conflict did not have a significant link to children's mental health outcomes.

The researchers concluded that parental support for gender affirmation is important.

You can read the full study here