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

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“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?

WPATH and USPATH Joint Statement in Response to Proposed Legislation Denying Evidence-Based Care for Transgender People Under 18 Years of Age

WPATH and USPATH Joint Statement in Response to Proposed Legislation Denying Evidence-Based Care for Transgender People Under 18 Years of Age

Published: January 28, 2020.

Yesterday, WPATH and USPATH released a joint statement about a recent and troubling trend across various states in the US. The Gender Dysphoria Affirmative Working Group fully endorses what is written here.

A web link to the statement can be found here: https://listloop.com/wpath/mail.cgi/archive/adhoc/20200128125839/

Statement in Response to Proposed Legislation Denying Evidence-Based Care for Transgender People Under 18 Years of Age and to Penalize Professionals who Provide that Medical Care

The World Professional Association for Transgender Health (WPATH) and its US chapter, the United States Professional Association for Transgender Health (USPATH), vehemently oppose the legislation being proposed in Florida (HB 1365), South Carolina (HB 4716), South Dakota (HB 1057), Colorado (HB 20-1114), and similar legislation in other states.  These bills seek to deny evidence-based care for transgender people under 18 years of age and to penalize professionals who provide that medical care.  These bills will punish practitioners of gender affirming care with revocation of their medical license, or up to 15 years in prison in some states.  These bills will treat health care providers as if they committed manslaughter or arson.  

Many of the procedures mentioned by these bills are not even offered to transgender youth, revealing these bills to be alarmist expressions of ill-informed opinion. Guidance for the provision of medical care for transgender youth is outlined within the 7th edition of Standards of Care (SOC) for the Health of Transsexual, Transgender, and Gender-Nonconforming People created by the World Professional Association for Transgender Health (Coleman et al. 2012). The guidelines differentiate between children and adolescents with regard to the provision of care. 

Under the SOC, children do not receive any of the medical care identified within these bills, but mental health and social supports are provided to them along with their families.  Surgeries on genitals and reproductive systems are considered for people who are typically over 18 years of age (depending on the age of consent and other relevant factors in the pertinent jurisdiction) and have been living in their affirmed gender for at least 12 months. Medical treatments that might be recommend for certain adolescents include puberty-blocking medication and – in carefully selected cases – hormone replacement therapies and surgery, most often non-genital. These treatments are not offered without conscientious medical attention and informed clinical evaluation.

Puberty suppression has been found to be very beneficial for transgender adolescents, and it is reversible (Mahfouda et al. 2017; Olson-Kennedy et al. 2018; Hodax et al. 2019; Salas-Humara et al. 2019).  Further, a recently published study has concluded that transgender adults who had access to pubertal blockers had a lower risk of suicidal ideation compared to those transgender adults who did not have access to pubertal blockers (Turban et al. 2020).

We are disturbed by these attempts to legislate medical treatment without expert guidance from the relevant national medical organizations or even testimony from experienced, qualified local or regional providers and patients for whom these treatments have been beneficial, if not lifesaving. Given the climate in which these bills are presented, however, we can imagine that few young patients or their parents would be willing to present themselves for the scrutiny of potentially hostile legislators and the activists who are promoting these damaging bills. 

All medical treatment is a crucial and very personal service that virtually everyone depends upon at some point in their lives, and it should not be delivered or restricted according to the whims of distant lawmakers who know little or nothing about the circumstances of an individual’s life. Proper medical care for any condition is a matter best negotiated between patients and their trained and qualified medical providers who are relying on clinical evidence and experience. 

These bills attempt to criminalize treatments or at best restrict medical professionals from helping their patients and their families. Since transgender children, adolescents, or adults cannot be legislated out of existence, these bills seem to be a misguided attempt to prevent transgender people from coming forward for services they need in order to live healthy lives. 

We urge you to reject these harmful bills and assure your transgender constituents and their families that their health and well-being is just as important as your own.

Click here for an additional WPATH Statement in Response to Calls for Banning Evidence-Based Supportive Health Interventions for Transgender and Gender-Diverse Youth.

References

Coleman E, Bockting W, Botzer M, et al (2012) Standards of care for the health of transsexual,

transgender, and gender-nonconforming people, version 7. Int J Transgenderism 13:165–232

Hodax JK, Wagner J, Sackett-Taylor AC, et al (2019) Medical options for care of gender diverse and

Transgender youth. J Pediatr Adolesc Gynecol S1083-3188(19)30206–2.

https://doi.org/10.1016/j.jpag.2019.05.010

Mahfouda S, Moore JK, Siafarikas A, et al (2017) Puberty suppression in transgender children and

adolescents. Lancet Diabetes Endocrinol 5:816–826. https://doi.org/10.1016/S2213-8587(17)30099-2

Olson-Kennedy J, Okonta V, Clark LF, Belzer M (2018) Physiologic Response to Gender-Affirming

Hormones Among Transgender Youth. J Adolesc Health 62:397–401.

https://doi.org/10.1016/j.jadohealth.2017.08.005

Salas-Humara C, Sequeira GM, Rossi W, Dhar CP (2019) Gender affirming medical care of transgender

youth. Curr Probl Pediatr Adolesc Health Care 49:100683.

https://doi.org/10.1016/j.cppeds.2019.100683

Turban JL, King D, Carswell JM, Keuroghlian AS. Pubertal Suppression for Transgender Youth and Risk of

Suicidal Ideation. Pediatrics. 2020 Jan 23. pii: e20191725

Yadegarfard M, Meinhold-Bergmann ME, Ho R (2014) Family rejection, social isolation, and loneliness as

predictors of negative health outcomes (depression, suicidal ideation, and sexual risk behavior) among

Thai male-to-female transgender adolescents. J LGBT Youth 11:347–363

CLICK HERE TO DOWNLOAD FULL POLICY STATEMENT

WPATH Board of Directors

USPATH Board of Directors

STAFF

President

Vin Tangpricha, MD, PhD

President

Erica Anderson, PhD

Executive Director

Sue O’Sullivan; sue@wpath.org

President-Elect

Walter Pierre Bouman, MD, PhD

President-Elect

Madeline Deutsch, MD, MPH

Executive Director of Global Education & Development

Donna Kelly; donna@wpath.org

Secretary

Randi Ettner, PhD

Secretary/Treasurer

Emilia Lombardi, PhD

Deputy Executive Director

Blaine Vella; blaine@wpath.org

Treasurer

Baudewijntje Kreukels, PhD

Immediate Past-President

Gail Knudson, MD, MEd, FRCPC

BOARD OF DIRECTORS

Tamara Adrian, JD Marci Bowers, MD

Tone Maria Hansen, MSN Ren Massey, PhD

Asa Radix, MD, PhD, MPH

Loren Schechter, MD Jaimie Veale, PhD

Immediate Past-President Joshua Safer, MD, FACP BOARD OF DIRECTORS

Dana (Thomas) Bevan, PhD John Capozuca, PhD

Lisa Griffin, PhD

Johanna Olson-Kennedy, MD, MS

Asa Radix, MD, PhD, MPH

Student Representative

Nova Bradford, BA

Communications Director

Jamison Green; jamison@veritasmeetingsolutions.com

EPATH Representative

Walter Pierre Bouman, MD, PhD

USPATH Representative

Erica Anderson, PhD

GEI Representative (Ex-Officio)

Lin Fraser, EdD

Student Representative (Ex-Officio)

Penelope Strauss, BA, MPH

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