COMMUNICATION OF ACCEPTANCE AND SUPPORT IN FAMILIES WHO HAVE GENDER-VARIANT YOUTH

• Published in: Journal of adolescent health Vol. 64; no. 2S; p. S101
• Main Authors: Libby, Brock D, Miller, Victoria, Regan, Katelyn, Gruschow, Siobhan, Hawkins, Linda, Dowshen, Nadia
• Format: Journal Article
• Language: English
• Published: New York Elsevier BV 01-02-2019
• Subjects: Acceptance; Advocacy; Caregivers; Child development; Clinical outcomes; Coming out; Communication; Gender identity; Gender-affirming care; Grounded theory; Health services; Health status; Home environment; Informed consent; Leadership; Objectives; Openness; Parents & parenting; Personal relationships; Pronouns; Protective factors; Puberty; Self-efficacy; Sexuality; Teams; Teenagers; Tolerance; Transgender persons
• ISSN: 1054-139X; 1879-1972

Purpose: Transgender and gender expansive youth benefit from gender affirming care and support. Without this, these youth can have significant negative physical and behavioral health outcomes. In addition, prior research has found that familial acceptance and support are important protective factors; however, there are no data on how parents of transgender and gender expansive youth can communicate or demonstrate support and acceptance. Therefore, the goal of this study was to explore the ways parents show support and acceptance of their transgender and gender expansive children. Methods: Between February 2018 and August 2018, patients aged 14-20 years at the Gender & Sexuality Development Clinic at Children's Hospital of Philadelphia were recruited. During the study visit, eligible participants provided informed consent/assent and we conducted in-depth semi-structured interviews; adolescents and parents completed separate individual interviews. Interview questions addressed several domains, including growing up in their home, relationships with parents, and their coming out process. Interviews were recorded and transcribed. Data were coded and analyzed in NVivo using Grounded Theory. Results: To date, 5 parent-adolescent dyads interviews (4 transgender male and 1 transgender female) have been interviewed. Three major themes emerged from interviews; primarily from the youth interviews. Participants discussed collaboration, referring to the youth and the parent working as a team towards the goal of affirming the youth's gender identity (e.g. "she asked me about my name and she helped me through the process"). Participants also described the environment, which related to perceptions that the family environment was characterized by tolerance and openness and was perceived by youth as facilitating their coming-out process (e.g. "I was raised in a fairly gender neutral household"). Participants also highlighted the importance of self-efficacy, specifically noting that being accepted at home enhances the youth's self-efficacy and promotes advocacy and leadership in their school and community (e.g. "getting that experience has taught me more people could accept me"). Additionally, youth provided definitions for acceptance and support. Acceptance was described as a deeper experience between parent and youth. Youth feel validated when their gender identity is not discussed because it is a part of who they are (e.g., "she talks with me about being a woman, just casual conversations about me being a woman and my, now, second puberty"). Support was defined as practical and concrete, such as when parents used the correct pronouns, sought out medical services, and researched to learn more about what being transgender entails. Conclusions: These interviews yielded important insights into the experiences gender identity support and acceptance among transgender youth and their caregivers. Youth reported that it was empowering to feel part of a team (with their parent) working towards the common goal of affirming their gender identity. Better understanding of these relationships and how support and acceptance are defined by youth will be critical in identifying ways parents can demonstrate and communicate support and acceptance in order to promote the health and well-being of transgender and gender expansive youth.