Perceptions of Support Among Transgender and Gender-Expansive Adolescents and Their Parents



      To capture and compare the perspectives of parents and their transgender and gender expansive (TGE) adolescents during pivotal moments of gender identity development and to report the level of adjustment during these parental experiences.


      We utilized a mixed-methods approach and interviewed 36 parents and 23 TGE adolescents at our Gender Clinic. Parents retrospectively identified “pivotal moments” in their child’s gender identity development and rated their levels of support and adjustment. Adolescents independently rated their parent’s level of support during these moments to allow for comparative analyses.


      The supportive behavior most frequently identified by parents was connecting the adolescent to services, while adolescents considered their parents’ use of the affirmed name or pronouns to be most supportive. We found a positive correlation between the parents’ perceptions of support and those of TGE adolescents during pivotal moments (r = 0.4, p < 0.001). Adolescents rated the degree of parental support to be 3.73 points (95% confidence interval: [2.67,4.8], p < 0.001) higher on a Likert scale than corresponding ratings provided by parents in a generalized estimating equation model. Parents experienced moderate need for adjustment during these moments.


      Providers may use these findings to guide parents toward gender affirmative behaviors that may protect against negative mental health outcomes.


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      Linked Article

      • Clinicians' Roles in Supporting Caregivers of Transgender and Gender-Expansive Youth
        Journal of Adolescent HealthVol. 68Issue 6
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          Parental support and acceptance have repeatedly been found to be protective against negative health outcomes in transgender and gender-expansive (TGE) youths [1–4]. In this issue of JAH, Hale et al. [5] make an important contribution to the literature with their report on a mixed methods study of families of TGE youths receiving care in a pediatric gender clinic. This study provides a deeper understanding of parents' and adolescents' experiences in providing and receiving parental support. Results can help to inform clinicians, who are well-positioned to encourage and facilitate parents' support and acceptance of their TGE children as one important strategy to improving adolescent and young adult health outcomes.
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