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

Don't Believe What You Read About Transition Regret

A loving, first person account of their transition and the dangers of overrelying on the few stories regret that become publicly so visible.

Find more about affirmative care for trans and gender nonconforming youth at our site: www.gdaworkinggroup.com

And follow us on Facebook for updates: @gdaffirmative

Published in Metro. Oct 23, 2019.  Author: Owl.

“I was 18 years old when I first came out as transgender. 

“I’d been harbouring it for as long as I can remember, but wasn’t properly able to articulate it until then. I simply didn’t know that it was a thing, or that there were other people like me. 

“Even when I did tell everyone and started living as myself, there was still a lot of shame, secrecy and fear about being transgender. One of the biggest fears surrounding it was the possibility of regret, or regretting undergoing hormone therapy and genital surgery. 

“Some people thought that I was simply a gay man who was a bit confused, and that I’d end up regretting this all later on if I went through with it. I knew I wasn’t a gay man, and I was fortunate enough to be raised in an environment where I could have easily come out as one. That just wasn’t me. For me (and for transgender people in general) it was never about who I was attracted to, or my sexual orientation…”

“So let’s not forget the bigger picture here, and the thousands of people that benefit from being able to medically transition and undergoing genital surgery. This doesn’t mean we’re not going to talk about those that experience regret. 

“We have to be able to have more nuanced and frank discussions about health care for transgender people, without regret being used to jeopardise the well-being of people who need transgender related health care. 

“Only that way can we truly create well-rounded solutions and health care that minimises the chance of regret, and allows everyone the opportunity to live their lives to the fullest.”

https://metro.co.uk/2019/10/23/dont-believe-what-you-read-about-transition-regret-10961836/

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

American Psychoanalytic Association Speaks Out Against Harmful Laws Targeting Transgender Youth and Healthcare Providers

American Psychoanalytic Association Speaks Out Against Harmful Laws Targeting Transgender Youth and Healthcare Providers

The Gender Dysphoria Affirmative Working Group respects and fully endorses the position of the American Psychoanalytic Association and wants to express thanks for their position affirming the rights and needs of this vulnerable population.

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

And like/follow us on Facebook for more updates: @gdaffirmative

 

“New York, NY – February 4, 2020– The American Psychoanalytic Association urges South Dakota governor Kristi Noem to reject a recently passed bill in the state legislature known as the Vulnerable Child Protection Act (HB 1057). This harmful legislation would make it a misdemeanor for physicians or any other medical professional to perform gender reassignment surgeries on minors or anyone who provides patients younger than 16-years-old with hormone therapy. If passed, South Dakota would be the first state to impose such a law.”"

““APsaA strongly opposes efforts to legislate appropriate medical treatments for transgender youth based on political ideologies that ignore both scientific research and expert clinical opinion,” said Lee Jaffe, president of the Association. “This law is fundamentally dangerous and if it becomes law would jeopardize the health and mental well-being of transgender youth in South Dakota.””

“Since the start of the 2020 legislative session, at least six states have proposed measures to restrict transgender minors' access to gender reassignment treatments, including surgery and hormone therapy. Some of the bills would make it illegal for physicians to administer the treatments, while others would classify the act as child abuse. If HB 1057 becomes law, it would make South Dakota the first state to make it illegal for physicians to assist minors in their gender reassignment process.”

““As psychoanalysts, we know from research and clinical expertise that discriminatory laws such as this law in South Dakota and elsewhere will have long-term mental health consequences for transgender youth, contributing to increased risk of depression, anxiety, substance abuse, and suicidal behavior. We call on leaders to reject these misguided and dangerous laws.”'“

‘Since 1991, APsaA has issued numerous position statements supporting LGBTQ people regarding discrimination in military service, marriage equality, parenting, efforts to change sexual orientation and gender identity, and bullying and harassment. For a link to our position statements, please visit www.apsa.org/position-statements.”

“The American Psychoanalytic Association is the oldest and largest professional organization for psychoanalysts in North America, representing 3,000 members, 32 approved training institutes, and 38 affiliate societies throughout the United States. Visit apsa.org for more information.”

https://apsa.org/content/apsaa-speaks-out-against-harmful-laws-targeting-transgender-youth-and-healthcare-providers

Pubertal Suppression for Transgender Youth and Risk of Suicidal Ideation

Pubertal Suppression for Transgender Youth and Risk of Suicidal Ideation

Published in Pediatrics. February, 2020.: Authors: Jack L. Turban, Dana King, Jeremi M. Carswelland Alex S. Keuroghlian.

The full article is behind a paywall and not everyone will have access, but the overview itself will be helpful for many.

Find more research on affirmative care for trans and non binary youth at our website: www.gdaworkinggroup.com

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

“BACKGROUND AND OBJECTIVES:Gonadotropin-releasing hormone analogues are commonly prescribed to suppress endogenous puberty for transgender adolescents. There are limited data regarding the mental health benefits of this treatment. Our objective for this study was to examine associations between access to pubertal suppression during adolescence and adult mental health outcomes.”

“METHODS:Using a cross-sectional survey of 20 619 transgender adults aged 18 to 36 years, we examined self-reported history of pubertal suppression during adolescence. Using multivariable logistic regression, we examined associations between access to pubertal suppression and adult mental health outcomes, including multiple measures of suicidality.”

“RESULTS:Of the sample, 16.9% reported that they ever wanted pubertal suppression as part of their gender-related care. Their mean age was 23.4 years, and 45.2% were assigned male sex at birth. Of them, 2.5% received pubertal suppression. After adjustment for demographic variables and level of family support for gender identity, those who received treatment with pubertal suppression, when compared with those who wanted pubertal suppression but did not receive it, had lower odds of lifetime suicidal ideation (adjusted odds ratio = 0.3; 95% confidence interval = 0.2–0.6).”

“CONCLUSIONS:This is the first study in which associations between access to pubertal suppression and suicidality are examined. There is a significant inverse association between treatment with pubertal suppression during adolescence and lifetime suicidal ideation among transgender adults who ever wanted this treatment. These results align with past literature, suggesting that pubertal suppression for transgender adolescents who want this treatment is associated with favorable mental health outcomes.”

https://pediatrics.aappublications.org/content/145/2/e20191725?

Substance Use Among a National Sample of Sexual and Gender Minority Adolescents: Intersections of Sex Assigned at Birth and Gender Identity

Substance Use Among a National Sample of Sexual and Gender Minority Adolescents: Intersections of Sex Assigned at Birth and Gender Identity

A study published just this week documenting the very high rates of alcohol and substance use in sexual and gender minority populations.  While this study does not address possible motivations for that use, it is well documented by other research that such use is most often the result of the stigma, discrimination, and abuse to which these LGBTQIA+ youth are subjected.  We are posting it here because this data may be useful as part of advocacy and service development for these vulnerable youth.

Published in LGBT Health. January 13, 2020.  Authors: Ryan J. Watson, Jessica N. Fish, Timothy McKay, Samuel H. Allen, Lisa Eaton, Rebecca M. Puhl.

 

“Purpose:We examined how substance use differed as a function of sex assigned at birth and gender identity (cisgender, transgender, or nonbinary/genderqueer) by type of substance. We sought to test whether current gender identity and sex assigned at birth were key factors in substance use among a large contemporary sample that included transgender and nonbinary/genderqueer adolescents.

“Methods:We analyzed data from a large national U.S. sample of sexual and gender minority (SGM) adolescents (n = 11,129) collected between April and December 2017. Chi-square tests of independence were used to test whether substance use behaviors varied by sex assigned at birth and gender identity. A series of multivariate logistic regression models tested the odds of substance use by sex assigned at birth and gender identity, as well as the interaction between sex assigned at birth and gender identity.

“Results:More than half of our sample reported lifetime alcohol use, and one-fourth of the sample reported lifetime marijuana use. Adolescents assigned male at birth had higher prevalence of substance use compared with adolescents assigned female at birth (AFAB). Multivariate models elucidated greater risk for most substance use outcomes for transgender adolescents compared with cisgender adolescents. We found significant interaction effects between gender identity and sex assigned at birth for recent alcohol use and lifetime and recent cigarette use among adolescents AFAB.

“Conclusions:These findings have implications for stakeholders who develop nationally representative surveys, researchers who examine substance use disparities among SGM adolescents, and mental health professionals who treat underage substance use among vulnerable populations.”

https://www.liebertpub.com/doi/10.1089/lgbt.2019.0066?utm_source=sfmc&utm_medium=email&utm_campaign=LGBT%20FP%20JAN%2016%202020&d=1/16/2020&mcid=1865740788

 

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

 

 

Understanding lesbian, gay, bisexual and trans (LGBT) adolescents’ suicide, self-harm and help-seeking behaviour 

Understanding lesbian, gay, bisexual and trans (LGBT) adolescents’ suicide, self-harm and help-seeking behaviour 

 

Another report, this one from the UK, again documenting that hostile social forces and lack of social supports – not the LGBTQ+ identity – are the primary driver of LGBTQ+ suicide.  Create a more affirming and nurturing environment, and these youth can thrive. 

 

Department of Health Policy Research Programme Project Understanding Lesbian, Gay, Bisexual and Trans (LGBT) Adolescents' Suicide, Self-Harm and Help-Seeking Behaviour. June 30, 2016.  Authors: Elizabeth McDermott (Lancaster University), Elizabeth Hughes (University of Huddersfield) & Victoria Rawlings (Lancaster University).

 

 

“Executive summary 

“Background 

“International research demonstrates that LGBT youth are at much higher risk of suicide and self-harm compared to their heterosexual or cisgender counterparts. Evidence in the UK is sparse and only beginning to establish sexual and gender identity as a risk factor for adolescent suicide and self-harm, and as a result of this research scarcity we also know very little about help seeking behavior. The Suicide Prevention Strategy (2012) has identified LGBT youth as a high risk group but currently there is limited evidence to develop effective suicide prevention policy and practice.”

 

“Key findings 

“Understanding LGBT youth self-harm and suicide 

“Similar to findings from other studies on youth suicide, those who had self-harmed and/or had a disability had an increased likelihood of planned or attempted suicide. Gender identity was also a risk factor for self-harm and suicide. Those who were gender diverse (Trans/unsure) were nearly twice as likely to have self-harmed and one and a half times more likely to have planned or attempted suicide than cisgender participants. Cisgender males were the least likely to plan or attempt suicide, or self-harm compared to other gender identities. There were five interconnecting areas which explained the elevated risk of suicide and self-harm in LGBT youth: 1) homophobia, biphobia or transphobia; 2) sexual and gender norms; 3) managing sexual orientation and gender identity across multiple areas of life; 4) being unable to talk and; 5) other life crises.” 

 

“1. Homophobia, biphobia and transphobia 

“The majority (70.8%, n=527) of the sample had experienced direct abuse or negative interactions about their sexual or gender identity when they were self-harming or feeling suicidal. A great number of these incidents had occurred in schools but the participants experienced this hostility across all areas of life e.g. in public, leisure spaces, work, religious places and on the internet. Those who experienced abuse were one and a half times more likely to plan or attempt suicide. Bisexual participants were least likely to experience abuse compared to other sexual orientation groupings. Trans and disabled participants were twice as likely to experience abuse related to their sexual orientation/ gender identity than those who were not. They were also more likely to indicate that the abuse influenced their self-harm and suicidal feelings. Those who reported they were affected by homophobic abuse had double the odds of planning or attempting suicide.” 

 

“2. Sexual and gender norms 

“Sexual and gender norms that made many participants feel that something was wrong with them (because they were not heterosexual or cisgender), without being told or abused directly, also caused distress. Almost half the questionnaire participants felt negative about their sexual or gender identity during the time they were self-harming or felt suicidal; a far lower proportion felt positive about their sexual orientation or gender identity. Gender diverse participants were most likely to feel negative, and bisexual young people least likely to feel negative, about their sexual orientation and gender identity. Those who felt negative about their sexual and/or gender identity were more likely to have planned or attempted suicide.”

 

“3. Managing sexual orientation and gender identity across multiple areas of life 

“Making decisions about whether to disguise or hide their sexual orientation or gender identity in different contexts (e.g. school, home, public, internet, leisure places) and to a variety of people, impacted negatively on the participants’ mental health. The majority of young people found hiding their sexuality and gender identity distressing. Gender diverse participants were over three and a half times more likely to feel distressed about hiding their sexual orientation/gender identity compared to cisgender young people. Bisexual  participants were significantly less distressed than other sexual identity groupings. Those who found hiding their sexual orientation and gender identity distressing were nearly two times more likely to self-harm. Young people who reported that keeping their sexual orientation/ gender identity a secret strongly affected their self-harm and suicidal feelings were significantly more likely to attempt or plan suicide.” 

 

“4. Being unable to talk 

“Almost three quarters of participants (74.1%, n=533) indicated that not being able to talk about their feelings and emotions (in relation to their mental health, sexuality and gender identity) strongly influenced their self-harm and suicidal feelings. Those young people who felt more affected by not being able to talk about their emotions had significantly higher rates of self-harm and were nearly two and a half times more likely to report they had attempted or planned suicide” 

 

“5. Other life crises 

“Participants experienced a range of additional reasons for distress that were unrelated to sexual orientation/ gender identity. The most common were academic pressure, problems with friends, bullying, family breakdown, participant illness, financial problems, romantic relationships ending, and previous experiences of abuse…”

 

 

“Conclusions 

“To develop effective public health policy to prevent suicide in LGBT young people, the social factors that heighten risk need to be addressed, and supportive services put in place. As a priority this would entail tackling homophobic, biphobic and transphobic abuse in schools, addressing the continuing sexual and gender norms which marginalise those who are not heterosexual and cisgender, and providing support and space for LGBT youth to disclose and discuss their emotions and experiences in secure environments. Key policy areas to focus upon are schools and education, the role of the internet, increasing LGBT youth provision, developing online and face-to face LGBT youth specific mental health support, and improving mental health and gender identity NHS services…”

https://www.academia.edu/26625951/Understanding_lesbian_gay_bisexual_and_trans_LGBT_adolescents_suicide_self-harm_and_help-seeking_behaviour_Final_Report?email_work_card=title

 

Reduction in Mental Health Treatment Utilization Among Transgender Individuals After Gender-Affirming Surgeries: A Total Population Study

Reduction in Mental Health Treatment Utilization Among Transgender Individuals After Gender-Affirming Surgeries: A Total Population Study

Published in: American Journal of Psychiatry. October 4, 2019. Authors: Richard Bränström, Ph.D., John E Pachankis, Ph.D.

Yet another study documenting what we already know: transgender people who receive affirming care show dramatic improvement, especially when compared to those in disaffirming environments.

Find more research about affirmative care for trans and non-binary individuals at our website:

www.gdaworkinggroup.com

And follow us on Facebook for updates:

@gdaffirmative

“Compared with the general population, individuals with a gender incongruence diagnosis were about six times as likely to have had a mood and anxiety disorder health care visit, more than three times as likely to have received prescriptions for antidepressants and anxiolytics, and more than six times as likely to have been hospitalized after a suicide attempt. Years since initiating hormone treatment was not significantly related to likelihood of mental health treatment (adjusted odds ratio=1.01, 95% CI=0.98, 1.03). However, increased time since last gender-affirming surgery was associated with reduced mental health treatment (adjusted odds ratio=0.92, 95% CI=0.87, 0.98).”

https://ajp.psychiatryonline.org/doi/full/10.1176/appi.ajp.2019.19010080

The AusPATH [Australian Professional Association for Trans Health] Position Statement on "Rapid Onset Gender Dysphoria" (ROGD)

Published September 30, 2019. Shared here in its’ entirety.

“The Australian Professional Association for Trans Health (AusPATH) was established in 2009 and is Australia’s peak body for professionals involved in the health, rights and well-being of trans, including gender diverse and non-binary (TGDNB), people. The AusPATH membership comprises approximately 250 experienced professionals working across Australia.

“The term “Rapid Onset Gender Dysphoria (ROGD)” is not a diagnosis or health condition recognised by any major professional association, nor is it listed as a subtype or classification in the Diagnostic and Statistical Manual of Mental Disorders (DSM) or International Classification of Diseases (ICD). Therefore, “ROGD” is an acronym describing a proposed phenomenon, with insufficient peer-reviewed scientific evidence to support its implementation and/or use within clinical, community, social and legal settings1.

“AusPATH affirms the rigorous processes by which diagnoses are developed and applied. These academic and clinical processes operate within professional medical organisations, and are developed by expert working groups of  scientists, clinicians, and stakeholders over long periods of time, with high levels of scientific scrutiny of the evidence-based literature. “ROGD” does not meet this standard, and therefore is not recognised by AusPATH.

“Whilst many have a clear picture of their gender from a very early age, for others the journey towards understanding their gender is more prolonged. The timing of when an individual discloses their gender to others is a separate consideration and does not necessarily reflect the development of their experienced gender. Many do not disclose their identity, rather hiding it for fear of negative reactions from others, including family rejection, discrimination, stigmatisation and social exclusion. The term “Rapid Onset Gender Dysphoria” is not, and has never been, a diagnosis or health condition but has been used in a single report describing parental perception of their adolescent’s gender identity without exploration of the gender identity and experiences of the adolescents themselves.

“AusPATH encourages continued scientific exploration within a culture of academic freedom, not censorship. All TGDNB people are deserving of gender-affirmative, evidence-based care that is underpinned by contemporary, adequately endorsed and community engaged standards of care and clinical guidelines.

“AusPATH recognises the harms caused by conversion, reparative and aversion treatments and opposes any such efforts to invalidate an individual’s experienced gender. AusPATH supports affirmative responses to young people whereby self-reported gender is respected, and young people are able to safely explore their gender and expression without judgment, pathologisation or predetermined outcome. AusPATH urges caution in the use of any term that has the potential to invalidate a person’s gender.

  1. WPATH (World Professional Association for Transgender Health) position on “Rapid-Onset Gender Dysphoria (ROGD)”4 September 2018

https://auspath.org/advocacy/?fbclid=IwAR3GN9E6NmvTyZNx-LcCIgW1mg5zpkE8UgpUaFYweTFBawgMS023DFTgtfI

Counterpoint: Pediatric gender care is safe and necessary

While not research, this is a well written piece, concisely outlining the issues and why evidence-based, affirmative care for trans and gender nonbinary youth is safe and effective, and the current standard of care.

Published in: Star Tribune. June 25, 2019. Authors: KATHLEEN MILLER , MARLA EISENBERG , AMY GOWER AND G. NIC RIDER.

"Transgender and nonbinary youths experience persistent and significant distress when forced to conform to the gender they were assigned at birth. They face substantial health disparities, with higher rates of depression, suicide attempts, substance use, bullying and unprotected sexual encounters than their cisgender (i.e., not transgender) peers. However, research shows that these health outcomes are related to stigma, rather than the simple fact of being transgender or nonbinary. This is a subtle, but critical, distinction: Negative health outcomes are not intrinsic to being trans and nonbinary. Rather, daily experiences of discrimination and harassment lead to poor health outcomes..."

"The medical and research community supports gender affirming medical care as a powerful tool to improve the lives of children and adolescents who are transgender or nonbinary. There is ample and growing evidence that children and adolescents have better health outcomes when they are supported in their gender, which includes access to medical interventions when appropriate. As clinicians and pediatric researchers, we firmly support expanding access to gender affirming care for youth."

http://m.startribune.com/counterpoint-pediatric-gender-care-is-safe-and-necessary/511804792/?fbclid=IwAR0KqZCmu9H8RiUQyTQVVjBDKzlqb5_UjPutRB1CflsVs3AmNhisXrMKG2g

Don Cheadle Makes Powerful Fashion Statements On ‘SNL’

The Gender Dysphoria Affirmative Working Group would like to thank Saturday Night Live and actor Don Cheadle for their clear and visible statement in support of trans and gender nonbinary youth... some of the most vulnerable in our world today.

Don Cheadle Makes Powerful Fashion Statements On ‘SNL’

The award-winning actor offers support for transgender kids and takes a slap at Donald Trump.

SNL.jpeg

By Carla Baranauckas

“Award-winning actor Don Cheadle had more than laughs on his mind when he hosted “Saturday Night Live” this weekend. And he made that clear with some of his wardrobe choices.”

“When he introduced Gary Clark Jr., the show’s musical guest, Cheadle wore a T-shirt that said, “Protect Trans Kids.” “ 

https://www.huffpost.com/entry/don-cheadle-fashion-statements-snl_n_5c6933e3e4b05c889d20071b?utm_medium=facebook&ncid=fcbklnkushpmg00000063&utm_campaign=hp_fb_pages&utm_source=main_fb&fbclid=IwAR0thfObhPBjBt4cjMummkjmqCDNtncDshtxTDbz7W9q02aCyTwN0goVui8

Australian Standards of Care and Treatment Guidelines for Trans and Gender Diverse Children and Adolescents 

The 2018 Australian SOC for Trans and Gender Diverse Children and Adults... a very strongly affirming document based on the latest research making clear that affirmative treatment approaches - in which the youth's identity is respected and supported, where the youth are provided the freedom and safety to explore their gender without judgment - yield much happier and better adjusted youth and young adults. It also makes clear that disaffirming approaches are unethical and may cause harm.

Australian Standards of Care and Treatment Guidelines for Trans and Gender Diverse Children and Adolescents 

Authors: M.M. Telfer, M.A. Tollit, C.C. Pace, & K.C. Pang.   2018.  

“Being trans or gender diverse is now largely viewed as part of the natural spectrum of human diversity. It is, however, frequently accompanied by significant gender dysphoria (GD), which is characterised by the distress that arises from incongruence between a person’s gender identity and their sex assigned at birth. It is well recognised that trans and gender diverse individuals are at increased risk of harm because of discrimination, social exclusion, bullying, physical assault and even homicide. Serious psychiatric morbidity is seen in children and adolescents. A study of the mental health of trans young people living in Australia found very high rates of ever being diagnosed with depression (74.6%), anxiety (72.2%), post-traumatic stress disorder (25.1%), a personality disorder (20.1%), psychosis (16.2%) or an eating disorder (22.7%). Furthermore 79.7% reported ever self-harming and 48.1% ever attempting suicide.”

 

“Increasing evidence demonstrates that with supportive, gender affirming care during childhood and adolescence, harms can be ameliorated and mental health and wellbeing outcomes can be significantly improved.”

 

“Understanding and using a person’s preferred name and pronouns is vital to the provision of affirming and respectful care of trans children and adolescents.  Providing an environment that demonstrates inclusiveness and respect for diversity is essential... Some children or adolescents may request use of a preferred name or pronoun only in certain circumstances, such as when their parents are, or are not, present in the room. This is important to respect and enact to enable optimal patient-clinician engagement, and ensure confidentiality and patient safety.”

 

“Avoiding harm is an important ethical consideration for health professionals when considering different options for medical and surgical intervention. Withholding of gender affirming treatment is not considered a neutral option, and may exacerbate distress in a number of ways including increasing depression, anxiety and suicidality, social withdrawal, as well as possibly increasing chances of young people illegally accessing medications.” 

 

“In the past, psychological practices attempting to change a person’s gender identity to be more aligned with their sex assigned at birth were used.  Such practices, typically known as conversion or reparative therapies, lack efficacy, are considered unethical and may cause lasting damage to a child or adolescent’s social and emotional health and wellbeing.”

 

https://www.rch.org.au/uploadedFiles/Main/Content/adolescent-medicine/australian-standards-of-care-and-treatment-guidelines-for-trans-and-gender-diverse-children-and-adolescents.pdf

 

Chosen Name Use Is Linked to Reduced Depressive Symptoms, Suicidal Ideation, and Suicidal Behavior Among Transgender Youth

Even something as “simple” as using a trans youth’s chosen/preferred/self-identified name can be a very powerful intervention with clear positive outcomes. And don’t we want our youth to have less depression, anxiety, and suicidal ideation?

Published in: Journal of Adolescent Health. October, 2018. Authors: Stephen T. Russell, Amanda M. Pollitt, Gu Li, Arnold H. Grossman.

“Transgender youth whose gender expression and names do not appear to match may be vulnerable to unintended disclosure or “outing,” and to discrimination or victimization, factors that could lead to mental health problems [1]. The purpose of the current study was to examine the relation between chosen name use, as a proxy for youths' gender affirmation in various contexts, and mental health among transgender youth.”

“We asked transgender youth whether they had a preferred name different from the name they were given at birth, and, if yes, asked, ‘are you able to go by your preferred name’ at home (n = 54), at school (n = 57), at work (n = 50), or with friends (n=69).”

“…chosen name use in more contexts predicted fewer depressive symptoms and less suicidal ideation and suicidal behavior. An increase by one context in which a chosen name could be used predicted a 5.37-unit decrease in depressive symptoms, a 29% decrease in suicidal ideation, and a 56% decrease in suicidal behavior. We observed similar results when we individually tested specific contexts for chosen name use (except that chosen name use with friends did not significantly predict mental health after adjusting for demographics and close friend support). Depressive symptoms, suicidal ideation, and suicidal behavior were at the lowest levels when chosen names could be used in all four contexts.”

https://www.jahonline.org/article/S1054-139X(18)30085-5/fulltext



Suicide risk in the UK Trans population and the role of gender transition in decreasing suicidal ideation and suicide attempt

Published in: Mental Health Review Journal. · December 2014.  Authors: Louis Bailey, Jay McNeil, Sonja J. Ellis.

“The findings reported here indicate that there are extremely high rates of suicidal ideation and suicide attempt within this non-random sample of the UK trans population. However, gender transition – for those that wanted it – was shown to drastically reduce instances of suicidal ideation and suicide attempt, highlighting the important role played by social transition and gender reassignment in improving quality of life and overall well-being amongst respondents…”

“A key finding to emerge from the study was the importance of timely access to gender reassignment treatment for those who required it. Transition was shown to have a positive impact on trans people’s mental health and well-being; the processes of gender reassignment and social transition serving to significantly reduce rates of suicidal ideation and suicide attempt. The majority of participants cited the significant benefits of gender reassignment in terms of aligning their physical body with their internal sense of self, and the knock-on effects of being recognised as the gender that they felt themselves to be…”

“Despite the clear advantages of gender reassignment, some respondents reported significant issues whilst trying to obtain treatment. As has been reported elsewhere, funding delays or refusals were common within this sample and respondents alluded to having gender reassignment treatment stopped or postponed altogether. These issues may, in some cases, contribute to suicide risk within this population…”

“It is crucial that those experiencing gender dysphoria have access to gender reassignment treatment with minimal delays or disruption and that they receive relevant information and support both from medical professionals as well as more informal sources – such as family, friends and support organisations – in order to build resilience and bolster health and well-being during this particularly difficult time.”

https://www.researchgate.net/publication/281441727

The role of gender affirmation in psychological well-being among transgender women

No surprise that validating someone’s sense of self decreases depression and improves self esteem.

Published in: Psychology of Sexual Orientation and Gender Diversity. September 2016. Authors Tiffany R. Glynn, Kristi E. Gamarel, Christopher W. Kahler, Mariko Iwamoto, Don Operario, Tooru Nemoto.

“… we found that social, psychological, and medical gender affirmation were significant predictors of lower depression and higher self-esteem... Findings support the need for accessible and affordable transitioning resources for transgender women in order to promote better quality of life among an already vulnerable population.”

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5061456/

The Needs of Gender-Variant Children and Their Parents According to Health Professionals

Another article outlining that more supportive, nurturing, and affirming perspectives on a youth’s self-reported gender identity are needed to support both the youth and their parents.

 

Published in: International Journal of Transgenderism.  March 4, 2013.  Authors: Elizabeth Anne Riley, Gomathi Sitharthan, Lindy Clemson & Milton Diamond

“The issues that gender-variant children face highlight consistent deficits and negativity in the children’s lives and focus our attention to the extraordinary burden placed on gender-variant children in their formative years. A report by Grant et al. (2010) describes in detail the extraordinary levels of harassment, physical assault, and sexual violence experienced by transgender children in years during primary and high school. These issues, if unable to be alleviated, are likely to present ongoing and accumulative difficulties that then impact their lives as adults.”

“… The needs of parents overwhelmingly feature the various types of support that would help parents become informed, be able to cope, and make the best decisions for their child. Societal and community support appear to be crucial factors for parents to comfortably engage with the tasks required of them to support their child.”

“… The needs of gender-variant children identified from the professionals’ responses revealed a lack of respect for the rights of children who experience gender variance. The most frequently mentioned needs were to be accepted and supported; to be heard, respected, and loved; to have professional support and recognition; to be allowed to express their gender; to feel safe and protected; to live a normal life; to have peer contact; to have school support and; to have access to puberty-delaying hormones. The needs of the parents focused primarily on areas of support and professional assistance, namely, the need for emotional support and guidance; education and information; support from society, local community, friends, and family; competent knowledgeable professionals; diagnosis, treatment, and beneficial outcomes for their children; peer support; support, understanding, and acceptance from schools; and research.”

“Together, these findings call for education programs to provide knowledge and exposure to the issues that transgender people face, across such sectors as medicine, mental health, and teaching in schools. The targeted education of medical and counseling professionals, the inclusion of printed materials in doctors’ surgeries, and the distribution of best practice guidelines and training in schools would signal a major change across the professional and community sectors that the needs of transgender children are being taken seriously.”

http://www.hawaii.edu/PCSS/biblio/articles/2010to2014/2011-needs-of-gender-variant-children.html

Social Support Networks for LGBT Young Adults: Low Cost Strategies for Positive Adjustment

A study demonstrating that family support is essential in the wellbeing of LGBTQ+ youth.

Published in: Family Relations.  July, 2015.  Authors: Shannon D. Snapp, Ryan J. Watson, Stephen T. Russell, Rafael M. Diaz, Caitlin Ryan.

“Our study adds to the growing body of evidence that family support, both general and sexuality specific, is a crucial factor in LGBT youth’s health and well-being…”

“Two variables were most relevant in predicting adjustment: (a) the percentage of friends who knew about participants’ sexual or gender identity and (b) support related to being LGBT from friends. The presence of a network of friends to whom youth can be out has been linked to measures of health and well-being…”

“Although friendship support is clearly associated with positive well-being in young adulthood, it appears that family acceptance has a stronger overall influence when other forms of support are considered jointly.”

 

https://www.tandfonline.com/doi/full/10.1080/01612840.2017.1398283