Psychologists recognize that TGNC people are more likely to experience positive life outcomes when they receive social support or trans-affirmative care. (APA)

Source: American Psychological Association. (2015). Guidelines for Psychological Practice with Transgender and Gender Nonconforming People. American Psychologist, 70 (9), 832-864. doi: 10.1037/a0039906

Guideline 11. Psychologists recognize that TGNC people are more likely to experience positive life outcomes when they receive social support or trans-affirmative care.

Research has primarily shown positive treatment outcomes when TGNC adults and adolescents receive TGNC-affirmative medical and psychological services (i.e., psychotherapy, hormones, surgery; Byne et al., 2012; R. Carroll, 1999; Cohen-Kettenis, Delemarre-van de Waal, & Gooren, 2008; Davis & Meier, 2014; De Cuypere et al., 2006; Gooren, Giltay, & Bunck, 2008; Kuhn et al., 2009), although sample sizes are frequently small with no population-based studies. In a meta-analysis of the hormone therapy treatment literature with TGNC adults and adolescents, researchers reported that 80% of participants receiving trans-affirmative care experienced an improved quality of life, decreased gender dysphoria, and a reduction in negative psychological symptoms (Murad et al., 2010).

In addition, TGNC people who receive social support about their gender identity and gender expression have improved outcomes and quality of life (Brill & Pepper, 2008; Pinto, Melendez, & Spector, 2008).

Several studies indicate that family acceptance of TGNC adolescents and adults is associated with decreased rates of negative outcomes, such as depression, suicide, and HIV risk behaviors and infection (Bockting et al., 2013; Dhejne et al., 2011; Grant et al., 2011; Liu & Mustanski, 2012; Ryan, 2009).

Family support is also a strong protective factor for TGNC adults and adolescents (Bockting et al., 2013; Moody & Smith, 2013; Ryan et al., 2010).

TGNC people, however, frequently experience blatant or subtle antitrans prejudice, discrimination, and even violence within their families (Bradford et al., 2007). Such family rejection is associated with higher rates of HIV infection, suicide, incarceration, and homelessness for TGNC adults and adolescents (Grant et al., 2011; Liu & Mustanski, 2012). Family rejection and lower levels of social support are significantly correlated with depression (Clements-Nolle et al., 2006; Ryan, 2009).

Many TGNC people seek support through peer relationships, chosen families, and communities in which they may be more likely to experience acceptance (Gonzalez & McNulty, 2010; Nuttbrock et al., 2009).

Peer support from other TGNC people has been found to be a moderator between antitrans discrimination and mental health, with higher levels of peer support associated with better mental health (Bockting et al., 2013).

Works cited:

  1. Bockting, W. O., Miner, M. H., Swinburne Romine, R. E., Hamilton, A., & Coleman, E. (2013). Stigma, mental health, and resilience in an online sample of the US transgender population. American Journal of Public Health, 103, 943–951. http://dx.doi.org/10.2105/AJPH.2013 .301241

  2. Brill, S., & Pepper, R. (2008). The transgender child: A handbook for families and professionals. San Francisco, CA: Cleis Press.

  3. Byne, W., Bradley, S. J., Coleman, E., Eyler, A. E., Green, R., Menvielle, E. J., . . . American Psychiatric Association Task Force on Treatment of Gender Identity Disorder. (2012). Report of the American Psychiatric Association Task Force on Treatment of Gender Identity Disorder. Archives of Sexual Behavior, 41, 759 –796. http://dx.doi.org/10.1007/ s10508-012-9975-x

  4. Carroll, R. (1999). Outcomes of treatment for gender dysphoria. Journal of Sex Education & Therapy, 24, 128 –136.

  5. Clements-Nolle, K., Marx, R., & Katz, M. (2006). Attempted suicide among transgender persons: The influence of gender-based discrimination and victimization. Journal of Homosexuality, 51, 53– 69. http://dx .doi.org/10.1300/J082v51n03_04

  6. Cohen-Kettenis, P. T., Delemarre-van de Waal, H. A., & Gooren, L. J. G. (2008). The treatment of adolescent transsexuals: Changing insights. Journal of Sexual Medicine, 5, 1892–1897. http://dx.doi.org/10.1111/j .1743-6109.2008.00870.x

  7. Davis, S. A., & Meier, S. C. (2014). Effects of testosterone treatment and chest reconstruction surgery on mental health and sexuality in femaleto-male transgender people. International Journal of Sexual Health, 26, 113–128. http://dx.doi.org/10.1080/19317611.2013.833152

  8. De Cuypere, G., Elaut, E., Heylens, G., Van Maele, G., Selvaggi, G., T’Sjoen, G.,... Monstrey, S. (2006). Long-term follow-up: Psychosocial outcomes of Belgian transsexuals after sex reassignment surgery. Sexologies, 15, 126 –133. http://dx.doi.org/10.1016/j.sexol.2006.04.002

  9. Dhejne, C., Lichtenstein, P., Boman, M., Johansson, A. L. V., Långström, N., & Landén, M. (2011). Long-term follow-up of transsexual persons undergoing sex reassignment surgery: Cohort study in Sweden. PLoS ONE, 6(2), e16885. http://dx.doi.org/10.1371/journal.pone.0016885

  10. Gooren, L. J., Giltay, E. J., Bunck, M. C. (2008). Long-term treatment of transsexuals with cross-sex hormones: Extensive personal experience. Journal of Clinical Endocrinology & Metabolism: Clinical and Experimental, 93, 19 –25. http://dx.doi.org/10.1210/jc.2007-1809

  11. Grant, J. M., Mottet, L. A., Tanis, J., Harrison, J., Herman, J. L., & Kiesling, M. (2011). Injustice at every turn: A report of the national transgender discrimination survey. Washington, DC: National Center for Transgender Equality & National Gay and Lesbian Task Force. Retrieved from http://endtransdiscrimination.org/PDFs/NTDS_Report .pdf

  12. Kuhn, A., Brodmer, C., Stadlmayer, W., Kuhn, P., Mueller, M. D., & Birkhauser, M. (2009). Quality of life 15 years after sex reassignment surgery for transsexualism. Fertility and Sterility, 92, 1685–1689. http:// dx.doi.org/10.1016/j.fertnstert.2008.08.126

  13. Liu, R. T., & Mustanski, B. (2012). Suicidal ideation and self-harm in lesbian, gay, bisexual, and transgender youth. American Journal of Preventive Medicine, 42, 221–228. http://dx.doi.org/10.1016/j.amepre .2011.10.023

  14. Moody, C. L., & Smith, N. G. (2013). Suicide protective factors among trans adults. Archives of Sexual Behavior, 42, 739 –752. http://dx.doi .org/10.1007/s10508-013-0099-8

  15. Murad, M. H., Elamin, M. B., Garcia, M. Z., Mullan, R. J., Murad, A., Erwin, P. J., & Montori, V. M. (2010). Hormonal therapy and sex reassignment: A systemic review and meta-analysis of quality of life and psychosocial outcomes.Clinical Endocrinology, 72, 214 –231. http:// dx.doi.org/10.1111/j.1365-2265.2009.03625.x

  16. Pinto, R. M., Melendez, R. M., & Spector, A. Y. (2008). Male-to-female transgender individuals building social support and capital from within a gender-focused network. Journal of Gay and Lesbian Social Services, 20, 203–220. http://dx.doi.org/10.1080/10538720802235179

  17. Ryan, C. (2009). Supportive families, healthy children: Helping families with lesbian, gay, bisexual & transgender children. San Francisco, CA: Family Acceptance Project, Marian Wright Edelman Institute, SanFrancisco State University. Retrieved from http://familyproject.sfsu.edu/files/FAP_English%20Booklet_pst.pdf

  18. Ryan, C., Russell, S. T., Huebner, D., Diaz, R., & Sanchez, J. (2010). Family acceptance in adolescence and the health of LGBT young adults. Journal of Child and Adolescence and the Health of LGBT Young Adults, 23, 205–213.

Doctor's Rec: 64,000+ pediatricians recommend gender-affirming treatment for children based on best available evidence

A September 2015 presentation from the American Academy of Pediatrics notes that treatment recommendations are based on the best available evidence. Their guidance defined three approaches to gender dysphoria in children: “corrective,” “supporting,” and “affirming,” with the AAP advising the “affirming” approach to gender dysphoria in children.



Sources:

  1. Kim Lacapria. (2016) American Pediatricians Issue Statement That Transgenderism Is ‘Child Abuse’? It was an official-sounding but fringe group of politically motivated pediatricians who issued a statement on gender, not the respected American Academy of Pediatrics. Snopes (6 May 2016) (pdf).

  2. Robert Garofalo. (2015) Understanding Gender Nonconformity in Childhood and Adolescence. American Academy of Pediatrics (September 2015). (pdf).

Doctor's Rec: Statement from American Academy of Pediatrics

The official American Academy of Pediatrics published (link to summary article) 9 clear recommendations for caring for youth and adolescents who identify as transgender or gender-diverse.

I highlight the portions that specify providing health care according to what the youth wants, especially to match the youth’s gender expression. Not parent, guardian, teacher, staff member, administrator, guidance counselor, etc.

[Aside: You may have heard a FoxNews Glenn Beck headline about an anti-gay-marriage hate group calling itself “American Pediatricians” creating a hoax claiming supporting a transgender youth is abuse. Read more about how Snopes debunked this, as well as the American Academy of Pediatrics’ internal presentation recommending affirming a child’s gender expression (pdf). —RXS]

1. that youth who identify as TGD have access to comprehensive, gender-affirming, and developmentally appropriate health care that is provided in a safe and inclusive clinical space;

2. that family-based therapy and support be available to recognize and respond to the emotional and mental health needs of parents, caregivers, and siblings of youth who identify as TGD;

3. that electronic health records, billing systems, patient-centered notification systems, and clinical research be designed to respect the asserted gender identity of each patient while maintaining confidentiality and avoiding duplicate charts;

4. that insurance plans offer coverage for health care that is specific to the needs of youth who identify as TGD, including coverage for medical, psychological, and, when indicated, surgical gender-affirming interventions;

5. that provider education, including medical school, residency, and continuing education, integrate core competencies on the emotional and physical health needs and best practices for the care of youth who identify as TGD and their families;

6. that pediatricians have a role in advocating for, educating, and developing liaison relationships with school districts and other community organizations to promote acceptance and inclusion of all children without fear of harassment, exclusion, or bullying because of gender expression;

7. that pediatricians have a role in advocating for policies and laws that protect youth who identify as TGD from discrimination and violence;

8. that the health care workforce protects diversity by offering equal employment opportunities and workplace protections, regardless of gender identity or expression; and

9. that the medical field and federal government prioritize research that is dedicated to improving the quality of evidence-based care for youth who identify as TGD.

Citation:

Jason Rafferty (2018) Ensuring Comprehensive Care and Support for Transgender and Gender-Diverse Children and Adolescents. Pediatrics Sep 2018, e20182162; DOI: 10.1542/peds.2018-2162 (direct pdf)

Disrupt Education #118: Gender-Inclusive Biology

Peter Hostrawser hosts a podcast called Disrupt Education, and recently spoke with us about growing a gender-inclusive biology curriculum. Thanks Peter, for hosting us and for helping spread the word about our developing work. ● Visit Peter’s website at https://www.disrupteducation.co to see more of his work in education.

Sam Long (he/him) and River Suh (they/them or he/him) are science teachers in Colorado and San Francisco respectively.  They have a unique focus on gender-inclusive biology content. This means teaching topics like genetics, reproduction, and evolution in ways that affirm rather than omit or marginalize LGBTQ+ identities. The are a part of a group with one other trans science teacher who have been doing this work in their classrooms for many years. Recently they began training other teachers and publishing essays, and compiling web resources (in progress) on this topic. They are experts in this emerging area of education. River and Sam  talk about the need for diverse and accurate biology curriculum, how it benefits all students, and how it looks in practice.

Gender-inclusive Biology curriculum, research, advocacy resources, and newsletter https://www.genderinclusivebiology.com/

Check out Sam and Lewis' workshops at HRC Time To Thrive (February 14-16, 2020) http://timetothrive.org/agenda/schedule and the NSTA National Conference (April 2-5, 2020) https://s6.goeshow.com/nsta/national/2020/overview.cfm

Using a Transgender Person's Name Can Decrease Their Risk of Depression and Suicide (Teen Vogue)

A new study from The University of Texas at Austin has shed light on the importance of name usage for transgender youth. The study, which was published in the Journal of Adolescent Health in preparation for the annual Transgender Day of Visibility, concluded that when young transgender people are able to use their names in areas of everyday life, their risk of suicide and depression decreases.

They found that young people who could use their names in all four scenarios experienced 71% fewer symptoms of depression, 34% fewer symptoms of suicidal ideation, and a 65% decrease in attempted suicide than those who were not able to use their names.

Read the article here: https://www.teenvogue.com/story/using-transgender-persons-name-decrease-risk-of-depression-suicide

Using Chosen Names Reduces Odds of Depression and Suicide in Transgender Youths (Journal of Adolescent Health)

““It’s practical to support young people in using the name that they choose It’s respectful and developmentally appropriate.””
— Stephen T. Russell (University of Texas at Austin)

After interviewing 129 youths in 3 US cities, the researchers found that having even one context in which a chosen name could be used was associated with a 29 percent decrease in suicidal thoughts.

The research was funded by a grant from the National Institute of Mental Health and supported by the UT Population Research Center and a grant from the Eunice Kennedy Shriver National Institute of Child Health and Human Development.

Citation: Stephen T. Russell, Amanda M. Pollitt, Gu Li, & Arnold H. Grossman. (2018) Chosen Name Use Is Linked to Reduced Depressive Symptoms, Suicidal Ideation, and Suicidal Behavior Among Transgender Youth. Journal of Adolescent Health, Volume 63, Issue 4, 503 - 505. DOI: https://doi.org/10.1016/j.jadohealth.2018.02.003

Victimization of Transgender Youths Linked to Suicidal Thoughts, Substance Abuse (Journal of Adolescent Health)

In two peer-reviewed papers, researchers at The University of Texas at Austin have found that transgender adolescents are twice as likely to have suicidal thoughts as the general population, and they are up to four times as likely to engage in substance use. Depression and school-based victimization factored heavily into the disparities in both cases.

Read more: https://cns.utexas.edu/news/victimization-of-transgender-youths-linked-to-suicidal-thoughts-substance-abuse

Lesson Plan — Chimera Butterflies: Non-Binary Animals (K-2)

Caption: Photograph of a Chimera Butterfly, from Kathy Pillsbury at the Insectarium, Montreal, CA

Caption: Photograph of a Chimera Butterfly, from Kathy Pillsbury at the Insectarium, Montreal, CA

Source: Welcoming Schools (HRC)

Chimera Butterflies: Non-Binary Animals

OBJECTIVES

• Students will learn about Chimera butterflies that are both female and male.

• Students will engage in a discussion and art activity that will help them understand

what the concept non-binary means.

• Students will create a colorful butterfly that is unique to them.