A Literature Review of the Secondary School Experiences of Trans Youth

A Literature Review of the Secondary School Experiences of Trans Youth

 Published by: Journal of LGBT Youth.  2020. Author: Ruari-Santiago McBride.

Find more articles on affirmative care for trans youth at our site: www.gdaworkinggroup.com

Like/Follow us on Facebook for updates: @gdaffirmative

“In this article I review 83 empirical studies that provide insight into the secondary school experiences of trans youth.  The studies show that while some trans youth have affirming experiences, the majority are exposed to institutionalized cisnormativity that makes them vulnerable to macroaggressions, microaggressions and violence within school settings. Trans youth’s exposure to institutionalized cisnormativity was found to intersect with multiple vectors of social power, which subject some trans youth to multiple forms of disadvantage while affording others degrees of privilege.  In conclusion, the findings show that trans youth’s educational experiences reflect broader structural inequalities yet defy essentializing explanations.”

https://www.academia.edu/42009727/A_literature_review_of_the_secondary_school_experiences_of_trans_youth?email_work_card=view-paper

Supporting Gender and Sexual Diversity in High Schools

Supporting Gender and Sexual Diversity in High Schools

Published by: Murdoch University, Young and Well Collective.  June 2016. Author: Jance Pearce, Wendy Cumming-Potvin, Veronica Gardiner.

A comprehensive document outlining  strategies and interventions to build increased awareness and to meet the needs of LGBTQIA+ children and adolescents, which leads directly to improved outcomes.  

“Accounts of teachers’ struggles to create safe classrooms and inclusive practices provide valuable insights for other educators, for whom this resource has been written.  The resource builds on the productive work of many community and government organisations, such as the Safe Schools Coalition, Freedom Centre, Curtin University’s Centre for Human Rights Education and the Equal Opportunity Commission, to raise awareness of and support sexual and gender diversity in schools.  It is hoped this resource will be of interest to every educator who wants to engage in conversations to counter discrimination  and bullying specific to gender and sexuality and protect the human rights of all young people, including those who self-identify as LGBTQI.”

https://www.academia.edu/33920096/supporting_gender_and_sexual_diversity_in_high_schools.pdf?email_work_card=thumbnail

Interrupting institutional heteronormativity: School counsellors' role in advocating for gender and sexually diverse students

An important piece on how school counselors and other school allies can be instrumental in creating a safe space for these vulnerable youth, and can make a dramatic impact towards their wellbeing and safety.

Find more information on affirmative care for trans and gender nonbinary youth at our website: www.gdaworkinggroup.com

And Like/Follow us on Facebook for updates: @gdaffirmative

Published in: Canadian Journal of Counseling and Psychotherapy. 2019. Author: Tanya Surette.

“Abstract:

“Many gender and sexually diverse students continue to view their schools as a hostile and oppressive environment. The focus in research has shifted more recently from individualizing this problem to understanding the complex systemic and institutional contributors to the ongoing marginalization of this population. As an integral part of the school system, school counsellors are uniquely positioned to offer important individual- and group-level supports to these students. Using narrative interviewing, this qualitative study provides an opportunity to visit the lived experiences of 6 current gender and sexually diverse high school students and their encounters with heteronormativity at school. Their stories offer insights into factors contributing to their distress and demonstrate stress-ameliorating factors that could be used to guide school counsellors who advocate for the safety and inclusion of students with diverse sexual orientations and gender identities…”

“Conclusion:

“The findings from this study offer important insights from students who are currently trying to navigate the often hostile and heterosexist school spaces. By listening to their experiences, opportunities are illuminated for school counsellors to work with students, educators, administrators, and policymakers, to create meaningful changes in their schools and promote a welcoming, safe, and inclusive learning environment. 

“Based on the most recent Canadian study exploring school climates about gender and sexual diversity, there remains a high number of gender- and sexually-diverse students who are uncomfortable accessing support, regarding topics of gender and sexuality, from their school counsellor (Taylor et al., 2011). School counsellors are uniquely positioned to provide opportunities for empowerment, advocacy, self-determination, and reflection with individual students and groups. Counsellors can support students in advocating for a more inclusive and democratic educational experience. 

“Often, when teachers encounter a student who is having trouble at school, they will reach out to the school counsellor for guidance and support. By listening to the stories contained in this paper, counsellors can better understand the barriers that students who are gender- and sexually-diverse experience when pursuing their right to develop a healthy identity. School counsellors can collaborate with their educational team. They can also collaborate with gender- and sexually-diverse youth to create school spaces that help them thrive, and allow space for diverse gender expressions and non-heteronormative sexual orientations.”

https://www.academia.edu/41076146/Interrupting_institutional_heteronormativity_School_counsellors_role_in_advocating_for_gender_and_sexually_diverse_students?email_work_card=view-paper

The Delaware Journal of Public Health: LGBT Health Equity

This issue of the Delaware Journal of Public Health is devoted to LGBT Health Equity and features several articles relevant to trans and gender nonbinary youth and adults. Several are listed below, and others in the journal are interesting as well.

Most notable are:

Keeping Youth Alive: Considerations for Suicide Prevention of Gender Diverse Youth. Author: Elise Mora, LCSW.

“Objective. This article examines suicidality of gender expansive youth and identifies evidence=based practical interventions for healthcare professionals and other adults who interact with gender expansive youth…

“Results. Gender expansive youth are at significantly heightened risk of suicide compared to their cisgender peers. Nonbinary youth are the most vulnerable of all subgroups.

“Conclusion: Explicit recommendations for enhancing resilience for this population complete the article. More research is critical for this demographic, as current literature is severely limited.”

A Mother’s Story. Author: Sally McBride.

“Sally and David McBride’s youngest child came out as transgender on Christmas Day 2011 as a junior at American University. The news rocked their world. Here is their story as told by Sally.”

Building Resilience, Reducing Risk: Four Pillars to Creating Safer, More Supportive Schools for LGBT Youth. Author: Rev Karla Fleshman, LCSW, M.Div.

“Abstract. In 2017 Delaware, LGBTQ+ Youth reported that almost 1 out of 3 were bullied on school grounds. Additionally, over 50% reported feeling sad/hopeless, and almost as many seriously considered suicide as an option, while 32% planned for suicide with almost 1 in 4 reported having acted on their suicide plan at least once. Of all the students who reported a suicide attempt, 10% required medical treatment as a result of their attempt. The Delaware Department of Education does not have comprehensive statewide protections in place to support some of our most vulnerable youth, yet school districts can make a positive difference in implementing policy/practices to build resilience and reduce risk.

“This article will focus on four key areas where schools and school districts may implement changes toward creating safer, more supportive schools: (1) policy/procedures that protect LGBTQ+ students at the administrative level; (2) comprehensive cultural sensitivity training for serving LGBTQ+ students and their families; (3) incorporating inclusive curriculum on LGBTQ+ history into the classroom; (4) and creating, supporting, and sustaining gender and sexuality alliances in both the middle and high schools.”

https://www.academia.edu/39955943/LGBTQ_Health_Equity

Trans and Non-Binary Children and Youth: A Roadmap for improving Services in Ontario

TRANS AND NON-BINARY CHILDREN AND YOUTH: A ROADMAP FOR IMPROVING SERVICES IN ONTARIO

Posting this as a very comprehensive report on the needs of trans and gender nonbinary youth, and information on how services might be developed to address those issues. It would be a useful read for educators, social service directors, family members, legislators, or others involved in work to affirm these vulnerable youth.  This is relevant not just in Ontario but in so many other contexts as well.

Published by: Rainbow Health Ontario.  2019.  Authors: Loralee Gillis, Dominic Popowich, Dr. Ilene Hyman, J. Skelton, Susan Barrass.  

“Executive Summary:

“Awareness of trans and non-binary children and youth is increasing, both socially and among service agencies. However, despite legislative and regulatory progress in trans rights, the specific needs of trans and non-binary children and youth remain largely unaddressed. Many agencies looking to strengthen their supports for this vulnerable group and their caregivers don’t yet know how, leaving trans and non-binary children and youth to encounter avoidable problems.

“Rainbow Health Ontario (RHO), a program of Sherbourne Health, led a needs assessment to learn about ongoing concerns and challenges faced by trans and non-binary children and youth; their parents and caregivers; and their service providers. Evidently, significant barriers remain for these children and youth to have access to needed health care in a timely way, and to fully participate in their families, communities and broader society. 

“In this report, we review the current literature on trans and non-binary children and youth and share their perspectives, along with those of their caregivers, on their health and social needs. We also offer evidence for policy and service development in support of these populations, and provide cross-sectoral recommendations for public and community sector agencies to better address the needs of these youth and their families.”

https://www.academia.edu/41337441/TRANS_AND_NON-BINARY_CHILDREN_AND_YOUTH_A_ROADMAP_FOR_IMPROVING_SERVICES_IN_ONTARIO?email_work_card=title

Statement from Brown University School of Public Health Faculty Members Committed to LGBTQI Affirmative Health Research

We at the Gender Dysphoria Affirmative Working Group wish to thank these distinguished faculty from Brown University School of Public Health for openly and directly speaking out to the Rapid Onset Gender Dysphoria ‘controversy’. We respect and appreciate their commitments to scientific honesty and rigor, to creating an environment of compassion and openness, to the necessity to include members of the trans and gender nonbinary community in all work done about the trans and nonbinary community, and to the health and wellbeing of trans and gender nonbinary people worldwide.

https://www.optionsri.org/post/a-letter-on-rapid-onset-gender-dysphoria?fbclid=IwAR3CDdGEy2s067VEjS9_Sa75gWyKWf4lnEs6Su-EHNsjXYJfXRJ3PmKOJHo

A few notable quotes:

“… [W]e write this letter as individual scientists and educators—who benefit from academic freedom—to publicly acknowledge the health-related harms and consequences of a lobby that seeks to undermine the legitimacy of transgender experiences. We also write this letter to state and underscore our commitment to uplift transgender and gender diverse communities through our research, scholarship, teaching, and service.”

“…The ROGD lobby has worked to undermine the experiences and identities of transgender and gender diverse individuals, with the potential for dire health consequences.”

“The ROGD lobby is also threatening transgender individuals’ rights via healthcare practice and public policy.”

“It is well-documented that being affirmed in one’s gender identity yields mental health benefits. Thus, we are committed to creating a safe and gender-affirming educational space for our students, staff, and fellow faculty of all genders, gender expressions, and sexual orientations.” 

“We also recognize that research is best conducted withnot onmembers of the population of interest. Thus, we are committed to carrying out our research in accordance with best practices for community-engaged research.”

“We also recognize the importance of having research agendas developed and implemented bytransgender and gender diverse communities. Thus, we are committed to building a pipeline of transgender students, fostering an environment where transgender and gender diverse students can thrive, and mentoring and training future generations of transgender and gender diverse researchers.”

“Finally, an essential responsibility of learned communities is to contribute to social good by amplifying the voices of vulnerable populations. Thus, we affirm our unwavering commitment to transgender and gender diverse communities and the highest standards of ethical, rigorous, and affirming research and practice.”

We encourage the Brown University School of Public Health and Brown University as a whole to issue similar statements in the near future. 

Stigma, Mental Health, and Resilience in an Online Sample of the US Transgender Population

Family and peer support, key components of affirmative approaches for gender variant youth, are all protective factors. This study also clearly refutes the notion among some proponents of "Rapid Onset Gender Dysphoria" that disaffirming approaches and limiting access to peers is beneficial. 

Published in: American Journal of Public Health.  May, 2013. Authors: Walter O. Bockting, PhD, Michael H. Miner, PhD, Rebecca E. Swinburne Romine, PhD, Autumn Hamilton, HSD, and Eli Coleman, PhD.

 “… family support, peer support, and identity pride all were negatively associated with psychological distress, confirming that these assets are protective factors. Moreover, peer support significantly moderated the relationship between enacted stigma and psychological distress, thus emerging as a demonstrated factor of resilience in the face of actual experiences of discrimination. Only at high (but not low or medium) levels of peer support was enacted stigma not associated with psychological distress, which suggests that the negative impact of enacted stigma on mental health is pervasive and that regular contact with peers is necessary to ameliorate it.”

“Together, these results offer support for the value of transgender individuals connecting with similar others, possibly providing the opportunity to question stigma from the majority culture and reappraise their experiences in a self-affirmative way, which is consistent with what has been postulated and observed among gay and lesbian individuals. This finding is particularly pertinent because previous research found that transgender people have higher levels of depression and lower levels of peer and family support than their gay, lesbian, and bisexual counterparts. These results support a need to promote resilience by facilitating ample peer support.”

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3698807/

Surviving a Gender Variant Childhood: The Views of Transgender Adults on the Needs of Gender Variant Children and Their Parents

Published in: Journal of Sex & Marital Therapy. 2012. Authors: Elizabeth Anne Riley, Lindy Clemson, Gomathi Sitharthan, Milton Diamond.

“… the needs of children that emerged were most notably, for parents, school staff and other authority figures to be educated so that children do not need to ‘hide’ themselves and their gender expression for fear of adversity. The participants also expressed their need as children to be able to speak about their feelings, to have their gender expression accepted, to be recognised, to be protected, to be given the opportunity to know others with similar feelings and for their parents to be open-minded, able and willing to accept their gender variant children. This study identified that the participants’ parents primarily needed access to information and educated professionals, particularly in schools, counselling and medical contexts. Exposure to successful transgender people and access to parent support groups was also seen as a need to help parents become more accepting of their children's diversity. The need for family and wider support was mentioned as a need for both the gender variant children and the parents as some participants felt that even though support of their parents was necessary, it was not enough for them to live happily and safely within the broader society.”

“The need for ‘health literacy’ was highlighted as tool to empower individuals, in this case, parents, to respond effectively in addressing the issues with regard to their gender variant children. In particular, allowing confidence to approach professionals for support with their own and their child's emotional, physical and social well-being….”

“… it appears that living in a society where punishment is customary for lack of conformity to gender stereotypes creates a lifelong struggle and sometimes ‘withdrawal’ that caused some participants great distress and impacts on their self-esteem and ability to thrive.”

https://www.semanticscholar.org/paper/Surviving-a-gender-variant-childhood%3A-the-views-of-Riley-Clemson/20d1168cecafe4aa6c633e4691b60e88ed31c901

High School Gay-Straight Alliances (GSAs) and Young Adult Well-Being: An Examination of GSA Presence, Participation, and Perceived Effectiveness

Yet one more study outlining the importance of LGBTQ+ youth having the opportunity to associate with each other. Rather than making youth LGBTQ+ through ‘social contagion’, contact with other LGBTQ+ youth is protective and aids with development and health.

Published in: Applied Developmental Science. 2011. Authors: Russell B. Toomey, Caitlin Ryan, Rafael M. Diaz & Stephen T. Russell.

“… there appear to be positive associations between GSAs and well-being and educational attainment. Our finding that students who were in schools with GSAs were more likely to obtain a college education underscores the potential impact on educational achievement and socioeconomic and occupational status as an adult. In addition, given the heightened attention to suicides of young males who were known or perceived to be gay and bisexual that have been linked to anti-gay harassment at school (e.g., Katz, 2010), our findings point to GSAs as a potential context for reducing this risk – at least at low levels of LGBT school victimization - given the significant interaction between GSA participation and LGBT school victimization on lifetime suicide attempts.”

“In sum, our findings suggest that school administrators and personnel should be supportive in helping students to form and facilitate GSAs in schools as a potential source of promoting positive development for this underserved population. “

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3217265/

Describing Roles that Gay-Straight Alliances Play in Schools

Yet another study making clear the link between supporting LGBT youth and better mental health outcomes...

Published in: Addictive Behaviors. April 2014. Authors: Nicholas Heck, Nicholas Liivngston, Annesa Fletne, Katherine Oost, Brandon Steward, Bryan Cochran

"After controlling for demographic variables and risk factors associated with illicit drug use, the results of 12 logistic regression analyses revealed that LGBT youth attending a high school without a GSA evidenced increased risk for using cocaine... hallucinogens... and marijuana... relative to peers attending a high school with a GSA. Youth without a GSA also evidenced increased risk for the misuse of ADHD medication... and prescription pain medication. The present findings underscore the importance of providing LGBT youth with school-based support groups and highlight the potential damaging effects of not having these resources in our nation's schools."

“Highlights:

• "Assessed association between high school gay-straight alliances (GSA) and illicit drug use."

• "LGBT youth evidence lower risk for illicit substance use when their school has a GSA."

• " Inclusive school-based programs may be protective factors for LGBT youth."

"These findings extend the research base related to GSAs and further demonstrate the importance of providing LGBT youth with opportunities for socialization and support within the school setting."

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4066611/

Demographic and Psychosocial Factors Associated With Psychological Distress and Resilience Among Transgender Individuals

Published in: The American Journal of Public Health. October, 2015. Authors: Emily Bariola, BA, Anthony Lyons, PhD, William Leonard, BSc, BA, Marian Pitts, PhD, Paul Badcock, PhD, and Murray Couch, BA.

“The findings indicated that, relative to other sources, family of origin may have the most influence in protecting against psychological distress… our findings support a need to encourage family members to be open and receptive sources of support.”

“…frequent contact with LGBT peers was revealed as a significant [protective] factor… for transgender individuals, frequent peer contact may be particularly important for developing individual resilience, as gender transitioning can be a complex and challenging process and having peers who share similar experiences may provide not only a sense of support and understanding, but also a sense of belonging.”

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4566567/

Access to GSAs Yields Happier, Better Adjusted Youth...

Contrary to current research, proponents of “Rapid Onset Gender Dysphoria” have argued that the trans identity in some youth could possibly be due to “social contagion” (ie being around youth who identify as trans and taking on the identity themselves though it is not authentic) and thereby urge parents be cautious when around allowing trans youth access to their peers via friends, GSAs, and online resources, so as to limit their exposure to the “contagion”.

There is extensive literature to document that social supports - these same friends, GSAs, and online resources - actually improve the lives and outcomes for these youth. Below is a piece from the publication of the American Federation of Teachers.

Gay-Straight Alliances

Promoting Student Resilience and Safer School Climates

Published in: American Educator. Winter 2016-2017. Author: V. Paul Poteat.

“Students in schools with GSAs report lower mental and physical health concerns, greater overall well-being, less drug use, less truancy, and greater perceived school safety than students in schools without GSAs. These findings now have been documented across a range of studies at local and national levels. Other studies have recorded feedback from GSA members who attribute instances of personal growth and empowerment, as well as a range of other positive experiences, to their GSA involvement.”

https://www.aft.org/sites/default/files/ae-winter2016poteat.pdf

Trans Youth: Digging Beneath the Surface: Factors That Facilitate Or Impede Trans Youth Well-being in Quebec

“Quebec has one of the leading identity-affirming clinics for trans kids, the Gender Variance Clinic of the Mon- treal Children’s Hospital. This fact sheet aims at presenting oppressive factors and structures that negatively influence the well-being of trans youth as well as aspects that contribute to it…”

• “Experiences and Dynamics in the Healthcare System: Healthcare system is a primary contributor to participants’ well-being (gender specific or general care), yet, resources in this system are not trans affirmative. Indeed, because of their gender identity, even when the services they are seeking are not transition-related, barriers to access and fear of negative treatment from healthcare professionals are an issue…”

• “Other Institutional Spaces: Schools, Child Protection Services, Justice System - Participants feel that those institutions are positive in their lives as long as they are affirming of their identity…”

• “Family relations and Other Social circles: Family support, in the form of feeling loved, accepted, and supported by immediate and extended family, is a significant resource to help participants cope with difficulties in other spheres of their lives. However, family can also be a source of fear and anxiety (when being rejected, or kicked out). Explicit lack of parental support is detrimental to participants’ well-being…” 

• “Community spaces: Trans youth identified trans and LGBTQ+ non-governmental organizations (NGOs), support agencies, and other community spaces as an important source of support and information (student unions for example). Online spaces (social medias and web) were also identified as important to affirm their identity…”

https://img1.wsimg.com/blobby/go/8547e446-90ba-4bfb-9351-591f088e59a1/downloads/1cnmpjs2e_3073.pdf

Ensuring Comprehensive Care and Support for Transgender and Gender-Diverse Children and Adolescents.

Published By: The American Academy of Pediatrics. September 17, 2018.

“Supportive involvement of parents and family is associated with better mental and physical health outcomes. Gender affirmation among adolescents with gender dysphoria often reduces the emphasis on gender in their lives, allowing them to attend to other developmental tasks, such as academic success, relationship building, and future-oriented planning. Most protocols for gender-affirming interventions incorporate World Professional Association of Transgender Health and Endocrine Society recommendations and include ≥1 of the following elements:

“Social Affirmation: This is a reversible intervention in which children and adolescents express partially or completely in their asserted gender identity by adapting hairstyle, clothing, pronouns, name, etc. Children who identify as transgender and socially affirm and are supported in their asserted gender show no increase in depression and only minimal (clinically insignificant) increases in anxiety compared with age-matched averages…

“Legal Affirmation: Elements of a social affirmation, such as a name and gender marker, become official on legal documents, such as birth certificates, passports, identification cards, school documents, etc…

“Medical Affirmation: This is the process of using cross-sex hormones to allow adolescents who have initiated puberty to develop secondary sex characteristics of the opposite biological sex…

“Surgical Affirmation: Surgical approaches may be used to feminize or masculinize features… These changes are irreversible. Although current protocols typically reserve surgical interventions for adults, they are occasionally pursued during adolescence on a case-by-case basis, considering the necessity and benefit to the adolescent’s overall health…”

http://pediatrics.aappublications.org/…/09/13/peds.2018-2162