Comparing Trans-Spectrum and Same-sex-Attracted Youth in Australia: Increased Risks, Increased Activisms

Abstract

Tran-spectrum youth include those who are gender questioning, transgender, intersex, genderqueer, and androgynous. Drawing on data from an Australian study of more than 3,000 same-sex-attracted and trans-spectrum youth aged 14 to 21, this article compares a group of 91 trans-spectrum youth from the study to “cisgender” same-sex-attracted peers (who feel their gender identity aligns more fully with their ascribed sex). Comparisons are made on topics including identity disclosure and support; experience of abuse; suicide and self-harm; and school experiences. The trans-spectrum respondents particularly reported experiencing homophobic abuse and suicide attempts in response to homophobia and cissexism significantly more often than their cisgender counterparts. However, an exciting finding of the study was that some of these youth were able to reframe social rejection of their identities using a variety of self-affirming strategies. They were also more likely to respond to discrimination through activism, and many held high hopes for the ways in which they might impact their worlds in the future. The article finally reflects on the special provisions needed for this group in areas such as youth services and education, and the need for individuals to be supportive of trans-spectrum youth who disclose their identities to them.

KEYWORDS:

• Abuse
• activism
• Australia
• gender
• gender identity
• intersex
• queer
• resilience
• suicide
• transgender
• youth

While same-sex-attracted youth (SSAY) have been included in Australian national and state education policies in recent years (Boston, 1997; Ministerial Council for Education, Early Childhood Development, and Youth Affairs, 2008; State Government of Victoria, 2008), trans-spectrum youth have been less visible in educational provisions. Both international and Australian data have been widely quoted in this country that, among secondary students, an estimated 10% identify as gay or lesbian, and the prevalence of bisexuality—which could count for upward of one-third of adolescents’ sexual experiences—is equally becoming known (Sears, 2005; Smith, Agius, Mitchell, Barrett, & Pitts, 2008; Smith, Lindsay, & Rosenthal, 1999). However, a lesser-known statistic is that around 2% of students are “born” intersex with respect to variation from male and female “norm” constructions for sex chromosome composition, gonadal structure, hormone levels, and internal and external genitalia structure (Blackless et al., 2000). Further, recent changes to the availability of body modifications, medical and hormonal interventions affecting (and expanding) the trans-spectrum youth demographic in Australia (such as a recent legal precedent allowing gender-reassignment technologies to a youth aged 12 years, McCredie, 2008) are not widely understood. In addition, queer theory movements are impacting a growing number of students who reject both male/female and trans male/trans female dichotomies in favor of less clearly defined gender identities such as “queer” and “genderqueer.” Youth in Western countries generally are thus increasingly identifying as being on the trans spectrum (i.e., the range of identities beyond male and female), and increasingly publicly “disclosing” such nonconforming gender identities at earlier ages (Cloud, 2005; Grossman, D’Augelli, Howell, & Hubbard, 2005; Hillier et al., 2010).

While it can be useful to use terms that group gay, lesbian, bisexual, transgender, intersex, and queer student issues together (such as GLBTIQ), in education policy advocacy to get educational leadership simply to start considering the broad diversity in students that must be considered, distinguishing the needs of students on the trans spectrum from those who are same-sex attracted and not transgender (for example, gay, bisexual, and lesbian) is becoming increasingly important. This is particularly the case in countries such as Australia, where some progress around same-sex attraction has been made and a sense of achievement around issues like policies against homophobic bullying can cause advocates to relax their efforts, when the separate needs of trans-spectrum youth may still be getting overlooked. The sustained nature of these unmet and to some extent unidentified needs has been illustrated by objections from the Australian chapter of Intersex International to otherwise widely lauded Victorian education policy provisions around sexual diversity (Organisation Intersex International Australia, 2009). These objections mainly center on the lack of consultation with intersex and diagnosis-specific organizations, and issues with gender and sex terminologies.

Australian media controversies have further underlined the need to consider youth gender identity issues separately. These have included debates around the desire of a second-grader/self-proclaimed “tomgirl” to bring glittery rings to show-and-tell and to wear dresses to class (Gradwell, 2009); a 17-year-old transsexual f-m student's decision to undergo breast removal surgery (Kissane, 2009); and the physical abuse experienced by transsexual student Mikey James, which caused him to leave school (Hiatt, 2012).

This article aims to frame such issues more clearly and explore the research on how the experiences of trans-spectrum students compare to the experiences of cisgender same-sex-attracted students. To achieve this aim, it is necessary first to consider the theoretical frames used for understanding trans-spectrum identity and the research literature on trans-spectrum youth that provides a background to the ways they can be conceived.

THEORETICAL FRAMES FOR TRANS-SPECTRUM YOUTH IDENTITIES

Traditional or “essentialist” understandings of sex and gender have long framed these concepts as inextricably linked, biologically determined, and dichotomized into two “normative” human expressions: masculine males and feminine females. Historically, doctors and medical experts have been complicit in enforcing this dichotomy in various ways, particularly through surgical and other interventions for “correcting” the sexed bodies of intersex babies and teens (Haas, 2004). Freud's psychoanalysis subsequently developed notions of the “psychical hermaphrodite adult,” whose gender identity development had supposedly been “inverted” during youth to mimic the development of the “opposite sex” and could incorporate homosexual attraction (Freud, 1910/2006, pp. 118–127).

Advances to psychosocial frames increasingly viewed sex and gender identity development as a process of “adjustment” with both biological and sociological influences, and feminism particularly influenced the view that much of what we consider a natural “sex role” is based on largely social ideals for gendered behaviors (Fausto-Sterling, 2012). For example, beyond recognizing “natural” hormonal influences that can make some boys and girls differ in some behaviors, Mallon and DeCrescenzo (2006) argued that society rewards parents for raising gender-conforming youth, and that this social process of rewarding and negating different parenting acts can impact what is seen as “normal” gender identity development and gendered behavior for girls and bodies. Theorists now hold that children learn about gender-role expectations during early development (Grossman & D’Augelli, 2007), generally forming a “male” or “female” identity by around age three (Stieglitz, 2010). Indeed, it is argued that environmental influences can be so strong that children can experience gender stereotypes as moral imperatives which impact their well-being negatively when they do not conform to them (Carver, Yunger, & Perry, 2003; Yunger, Carver, & Perry, 2004).

While modern psychology and medicine allow for some amount of childhood gender nonconformity—“cross-dressing” experimentation or using variously gendered toys are argued as natural for all children (Mallon & DeCrescenzo, 2006), although it is less socially accepted for male-assigned children—intersex infants are nevertheless still often seen as “requiring” medical reconstruction simply to fit the sex-based expectations of society (Haas, 2004). There has been an emphasis making older gender-nonconforming youth fit “male”/”female” binaries through therapy measures to realign their gender identity with their allocated natal sex or surgical and hormonal interventions to align their external physiological sex with their internally experienced gender identity (Roen, 2011). On one hand, some conservative organizations advocate reprogramming trans-spectrum youth into a life of heterosexuality and their “real sex,” considering gender identity issues a “treatable disease” in a similar way to conservative and ex-gay movement conceptions of homosexuality as a pathology that can be “fixed” with counseling interventions (Gibson & Catlin, 2010). These organizations argue against bodily modifications allowing youth to have a sex change, claiming that such changes are irreversible and can lead to suicide risk (discussed in Geddes, 2008; Gibson & Catlin, 2010). On the other hand, some lawyers argue (in and out of courts) for allowing for bodily modifications for those children for whom transition offers relief from suffering (Minter, 2012).

Many researchers propound suspending the puberty of children with “gender identity disorders” (GIDs) through hormone suppressants, with a view to ensuring bodily modifications allowing children to align their bodies with their “true gender identities” will be easier to make later on (Asscheman, 2009; Cohen-Kettenis & van Goozen, 1998; Giordano, 2008). Such researchers argue that youth who experience GIDs into adolescence are very likely to pursue sex reassignment (Shield, 2007), and a lack of “treatment” can put them at risk of suicide or a range of social problems (Giordano, 2008). Some researchers argue that while the short-term risks of suppressants seem minimal, the long-term effects are unknown (Drescher & Byne, 2012); thus, they may look to nonmedical solutions such as counseling—albeit with reservations about the stereotypical views on gender norms many counselors can have (Stein, 2012). All sides of the debate suggest that gender-nonconforming youth are at risk of suicide if they are not supported to safely transition to a male or female identity, although the processes and the end results they argue for are strongly divergent.

Queer theory offers a different frame for understanding sex and gender, and with it a very different range of possibilities for the lives of trans-spectrum youth. This theory frames gender and even sex development as socially constructed processes based on hegemonic norms that police and limit the broader range of human expressions possible. Rather than advocating “for” intersex or transgender identity to be seen as equally natural to male or female sex positions, queer theory is critical of the notion of identity generally. Queer theorists such as Judith Butler (1990, 2005) do not so much theorize how girls and boys develop but how the very categories of “boy” and “girl” are socially constructed, advanced, and policed (particularly where they are disrupted or shown to be problematic by nonconforming individuals). Butler emphasizes the perspective that sex and gender rely on a performative “doing” of gender, in the use of sex labels, and repeated performing of the associated gendered behaviors, mannerisms, and traits thought to be explained by those labels (but indeed scripted by them). Queer theory can be best understood as promoting non- or anti-identity positions (Jones, 2009), sometimes termed as genderqueer positions, marking a sense that sex and gender performance are inconsistent, are fluid, or somehow subvert social expectations of feminine female or masculine male identities. Because it supports no true or right identity performance, queer theory does not frame trans-spectrum youth (whether interpreted in other frames as biologically intersex, transgender, confused, or “suffering from a GID”) as requiring any particular treatment, correction, bodily adjustment, or sex reassignment. However, neither does it place limitations on the potential gender expressions or bodily modifications youth may legitimately pursue. The main offering of the theory is an interrogative lens on any strongly defined identity scripts, a challenge to the claim of any identity label as “true” and stable (including both transgender and gay identities), and a spotlight on the problematic scripts associated even with alternative identity labels.

Trans-spectrum and queer activists have developed many terms related to the policing of trans-spectrum identities and the labeling of transgender people with GIDs or other pathologies. These have included the concepts of cisgender or cissexual as labels for people who believe themselves to experience an “alignment” between their natal sex (the sex they were assigned at birth, as male or female) and their personal gender identity (Green, 2006; Serano, 2007). This allows the differentiation of cisgender SSAY and trans-spectrum youth as two groups within the GLBTIQ acronym, for example. Cisgender privilege is a related term used in some activist and queer literature to describe and the unearned advantages accrued by those individuals with a cisgender status, and cissexism describes bias against trans-spectrum identities generally (Serano, 2007; Walls & Costello, 2010). Activists have labeled much policy around trans-spectrum identity as transphobic or cissexist. Recent shifts in conceptualization of trans-spectrum people that show the influence of such critical thinking about identities has been evidenced in changes to Scottish policies around body modifications, which no longer require GID diagnoses or traditional female/male dichotomies in sex/gender pathways (Scottish Government, 2012). There have also been changes to the 2013 fifth edition of the American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-V), for which it was agreed that the pathologizing term GID would be replaced with gender dysphoria, which was argued to denote “a marked incongruence between one's experienced/expressed gender and assigned gender” within a broader understanding of gender expression possibilities (Craig, 2012). While the changes appear promising, it must be emphasized that trans-spectrum identity has been pathologized more recently and for longer than homosexual identities by such influential bodies as the American Psychological Association, and the shift in organizational thinking has yet to fully make its impact.

RESEARCH LITERATURE ON TRANS-SPECTRUM YOUTH

There has not been a large amount of research on trans-spectrum youth. The research that does exist mainly uses psychosocial frames that consider trans-spectrum youth as having a GID or transgender identity and analyzes qualitative data collected from a few individuals, interviews, or focus groups. Some research highlights that transgender people are at significant risk for contracting human immunodeficiency virus (HIV) but are often overlooked in sex education efforts (Bocking, Robinson, & Rosser, 1998; Garofalo, Deleon, Osmer, Doll, & Harper, 2006; Stieglitz, 2010). Several studies identify sexual risk factors specific to transgender identity, such as prostitution, shame and isolation, compulsive sexual behavior, secrecy, and sharing needles while injecting hormones (Bocking et al., 1998; Clements-Nolle, Marx, Guzman, & Katz, 2001; Stieglitz, 2010).

Other research is themed around negative reactions to transgender identities from parents, siblings, extended family members, and social networks (Cahill, Mitra, & Tobias, 2002; Grossman et al., 2005; Mallon & DeCrescenzo, 2006). For example, one study based on interviews with 55 transgender youth shows 54% of their mothers and 63% of their fathers reacted negatively to their identity disclosures (Grossman et al., 2005). The study highlights that more gender-nonconforming young people are particularly likely to be verbally and physically abused by their parents (Grossman et al., 2005). Some studies argue trans-spectrum youth are at high risk of being discriminated against and verbally and physically abused by the public (Beemyn & Rankin, 2011; Giordano, 2008; Ryan & Rivers, 2003), and this is a common theme of larger quantitative studies that include transgender students as a subgroup within largely SSAY populations (Kosciw, Diaz, & Greytak, 2008; Kosciw, Greytak, Diaz, & Bartkiewicz, 2010; Rankin, Weber, Blumenfeld, & Frazer, 2010). There is also research underlining their high risk of suicide (Clements-Nolle, Marx, & Katz, 2006; Giordano, 2008; Grossman & D’Augelli, 2007).

Studies using queer theory or concepts of cissexism are rarer and tend to interrogate representations of trans-spectrum youth and SSAY identities in media or clinical constructions (Rasmussen, 2006; Roen, 2011). Beemyn and Rankin (2011) surveyed nearly 3,500 U.S. transgender people aged 18 and older, and included 400 follow-up interviews in the study (including 21 youth aged 18 to 22). They note that there is a shift away from notions of the “transsexual or cross-dresser” for younger participants and a shift toward identification outside of binary gender categories. Only one study (which revisits earlier data on the small sample of 55 transgender youth) focuses on the topic of resilience, finding that youth who focus on the emotions generated by adversity (rather than social supports, for example) are at greater risk of “negative mental health issues” (Grossman, D’Augelli, & Frank, 2011).

RESEARCH QUESTIONS

Much of the research literature focuses strongly on deficit or at-risk framings of trans-spectrum youth, offering little discussion of their resilience, their engagement with activism, and their life goals beyond gender-related aims. Another issue is that this group is either researched separately to cisgender SSAY or “lumped in” with them in research findings, without comparative analysis.

The research presented here aims to provide a comparison of trans-spectrum youth and cisgender SSAY, and to also highlight some positive aspects to trans-spectrum youth that appear underreported. Key research questions include the following:

•	How do trans-spectrum youth compare to cisgender SSAY in terms of issues of identity disclosure and social support?
•	How do trans-spectrum youth compare to cisgender SSAY in terms of issues of experiences of abuse and related well-being issues?
•	How do trans-spectrum youth compare to cisgender SSAY in educational issues?

These questions are answered using analysis of data from the 2010 Australian “Writing Themselves In” survey of same-sex-attracted and gender questioning (SSAGQ) youth aged 14 to 21 years (Hillier et al., 2010). The third in a series of national studies taking place every six years, the online survey gathered responses from 3,134 participants, including 91 trans-spectrum youth (with this group also ranging in ages from 14 to 21).

METHOD

The 2010 “Writing Themselves In” survey used an online questionnaire for data collection. This questionnaire was divided into ten categories that contained closed- and open-ended items and a request for young people to relate their personal stories. Ethical approval was obtained from the La Trobe University Human Ethics Committee, and we argued that it was unethical to request parental approval for participation (as many participants were not out to their parents or could suffer abuse during the outing processes seeking permission would necessitate). The questionnaire was officially launched in December 2009. The target group was Australian SSAY and trans-spectrum youth aged 14 to 21. Youth needed to self-select to participate. The sample represented youth from all states and territories, rural and urban areas, and culturally diverse backgrounds.

The recruitment campaign is detailed in a report (Hillier et al., 2010). It included promotions through Facebook advertising, website banner advertisements, service providers, coverage in the mainstream and alternative media, and social networks. We also sent business card sized advertisements (with the website address of the online survey) to a range of youth service providers. While the survey initially attracted more than 8,000 participants, we subjected the data to a rigorous and lengthy cleansing process. (Each survey was read in full, and we eliminated surveys outside of our specified Australian youth target group, surveys with suspicious inconsistencies, surveys completed in jest or as abuse, and repeat surveys.)

To make comparisons between trans-spectrum participants and cisgender SSAY, we divided participants into those who self-identified as same-sex-attracted males and females, and those who self-identified as a having a range of alternate sex and gender identities (intersex, transgender, gender queer, or “other” identities that the participants self-identified). We then ran chi-square and other simple tests on the quantitative data to compare results for the two groups in a variety of areas, including identity disclosures, support and rejection, experiences of abuse, and impacts on schooling. We also explored related responses in the qualitative data particularly from the trans-spectrum participants and grouped responses thematically to understand the main ways they understood issues of support and rejection, abuse, and education.

RESULTS

Comparing Identity Disclosure and Social and Support Networks

Of the 91 trans-spectrum youth who participated in the survey, 43 elected their sex as “Gender Queer,” 21 as “Transgender f-m,” 18 as “Transgender m-f,” and the remainder as “Other.” Of the latter group, those who expanded on their gender identity gave such descriptions as “androgynous,” “gender fluid,” “no gender,” “hermaphrodite,” or expressed affiliation with several labels. As with cisgender SSAY, the trans-spectrum youth were aged 14 to 21, and their average age was 17. One-tenth of the trans-spectrum youth were of Aboriginal or Torres Strait Islander descent, compared to only 3% of cisgender SSAY. Of the 3,043 cisgender SSAY youth who participated in the survey, 1,265 were males (the vast majority of whom described themselves as gay/homosexual) and 1,766 were females (whose identifications were more evenly divided between being bisexual and gay/homosexual).¹ Trans-spectrum youth were more likely than cisgender SSAY to have disclosed their identity to most people in their lives, including their parents (Table 1). The data show they had often discussed their identities with friends and Internet contacts, although it is noteworthy that both trans-spectrum youth and cisgender SSAY were similarly very likely to have disclosed to a female friend. Trans-spectrum youth were particularly more likely to disclose their identities to (or perhaps were unable to “hide” their identity from) professionals than cisgender SSAY—underscoring their desire for professional advice, which could be associated with the ways in which trans-spectrum identities are frequently still medicalized and pathologized.

TABLE 1 Comparison of Identity Disclosures Made by Trans-Spectrum and Cisgender Same-Sex-Attracted Youth

Person	Pearson Chi-Square	df	Percentage of Cisgender SSAY Who Disclosed to This Person	Percentage of Trans-Spectrum Youth Who Disclosed to This Person
Mother (n = 3,075)	6.280*	1	65.91	78.65
Father (n = 3,032)	4.151*	1	49.32	60.47
Female friend (n = 3,087)	0.069	1	93.86	93.18
Male friend (n = 3,061)	1.591	1	89.86	94.05
Partner (n = 2,758)	1.946	1	78.39	85.14
Someone on the Internet (n = 2,869)	1.962	1	84.78	90.36
Doctor (n = 2,851)	22.815***	1	26.25	50.00
Youth service worker (n = 2,642)	15.918***	1	31.27	57.53
Counselor (n = 2,591)	44.835***	1	33.88	71.05
Teacher (n = 2,871)	2.788	1	39.48	48.75
Student welfare coordinator/ Student counselor (n = 2,681)	38.140***	2	34.33	56.76
School nurse (n = 2,470)	5.394*	1	11.98	21.54
School chaplain (n = 2,463)	10.079***	1	15.13	29.69
Note. SSAY = Same-sex-attracted youth.
*p < 0.05; **p < 0.01; ***p < 0.001.

A key finding was that trans-spectrum youth were more likely to experience rejection from their disclosures (see Table 2), exposing them to more precarious living conditions and the social isolation they often reported. They were particularly more likely to be rejected by school-based staff (teachers, school nurses, student welfare coordinators/counselors)—the very people trans-spectrum youth would turn to for assistance in the place where transphobic abuse is most likely to occur. Casey (gender queer, age 20), like many trans-spectrum youth, wished for greater access to “trans-aware, queer-friendly health care and counseling,” while Toni (gender queer, age 16) wished for “more support from official figures (like chaplains, teachers, etc.).” School chaplains were the most rejecting group overall, a finding which problematizes Australia's National School Chaplaincy Program as an intended “student support” service.² Fathers were the least supportive family members. Rejection caused anxiety for many youth, as Rihanna (transgender m-f, age 15) explains: “I’m terrified of rejection, so even at home, where I’m out, I’m too scared to be myself.”

TABLE 2 Comparison of Support and Rejection for Identity Disclosures Made by Trans-Spectrum and Cisgender Same-Sex-Attracted Youth

Person	Pearson Chi-Square	df	Percentage of Disclosing Cisgender SSAY Who Were Supported by This Person	Percentage of Disclosing Cisgender SSAY Who Were Rejected by This Person	Percentage of Disclosing Trans-Spectrum Youth Who Were Supported by This Person	Percentage of Disclosing Trans-Spectrum Youth Who Were Rejected by This Person
Mother (n = 2,038)	4.256*	1	76.42	23.58%	65.71%	34.29%
Father (n = 1,505)	1.915	1	73.98	26.02	65.38	34.62
Female friend (n = 2,897)	8.266**	1	97.05	2.95	91.46	8.54
Male friend (n = 2,754)	8.486**	1	94.84	5.16	87.34	12.66
Partner (n = 2,167)	11.856**	1	95.29	4.71	85.71	14.29
Someone on the Internet (n = 2,437)	4.620*	1	95.81	4.19	90.67	9.33
Doctor (n = 768)	12.171***	1	90.37	9.63	73.17	26.83
Youth service worker (n = 948)	6.762**	1	96.25	3.75	88.10	11.90
Counselor (n = 906)	0.646	1	93.54	6.46	90.74	9.26
Teacher (n = 1,141)	30.903***	1	89.93	10.07	61.54	38.46
Student welfare coordinator/ student counselor (n = 937)	13.931***	1	91.17	8.83	73.81	26.19
School nurse (n = 302)	16.600***	1	88.19	11.81	50.00	50.00
School chaplain (n = 382)	3.600	1	68.32	31.68	47.37	52.63
Note. SSAY = Same-sex-attracted youth.
*p < 0.05; **p < 0.01; ***p < 0.001.

A positive theme uncovered in the qualitative data related to this issue was that some trans-spectrum youth faced rejection with resilience. Ashley (unsure about gender, age 17) overcame their³ father's rejection through logic: “I argued with him till he ran out of points‥ ‥ He also says he doesn't like Indians or Americans yet he has close friends from both countries, so his opinions don't bother me.” Most trans-spectrum youth overcame rejection through concentrating on the support they did have. For example, Addison (androgynous, age 17) comments, “While my priest hasn't been very supportive, my girlfriend's priest is very supportive.” Jo (gender queer, age 20) overcame their mother's rejection through living with like-minded people:

I’m out of home and living in (an urban area) now and I live in a strong and supportive community of queer, trans and feminist people who provide safe spaces for me to live my life and learn how to take care of myself. But this community isn't supported by society at large, it has to support itself.

Further, Jo negates rejection generally by reframing it as a social problem, not an internal one: “I’m happy with myself but I’m angry at the way I’m made to live my life within the world. I’m marginalised, discriminated against and made second class by the law.” With access to alternative logic, support, people, and perspectives, trans-spectrum youth can find alternative positions to those ascribed to them in discourses of social rejection.

Comparing Experiences of Homophobic/Cissexist Abuse

Trans-spectrum youth were significantly more likely to have been physically assaulted due to homophobia (or related transphobia/cissexism) than cisgender SSAY (already at high risk), and to have been exposed to other types of transphobic/homophobic abuse, such as written notes, rumors, graffiti, and social exclusion (see Table 3). This abuse occurred in several places (see Table 4), but the most highly significant difference for trans-spectrum youth was the increased likelihood of abuse in the home—echoing the literature on family rejection. Such risks challenge schools, housing services, and refuges to ensure that the location of service provision is as safe as possible for the trans-spectrum youth by actively working to reduce violence and other abuse. But it is also to provide a space where those who have been abused at home receive the support and referrals they need.

TABLE 3 Comparison of Experience of Homophobic/Cissexist Abuse for Trans-Spectrum and Cisgender Same-Sex-Attracted Youth

Harm Type	Pearson Chi-Square	df	Percentage of Trans-Spectrum Youth Experiencing Harm Type	Percentage of Cisgender SSAY Experiencing Harm Type
Experience of physical homophobic/cissexist abuse (n = 3,104)	10.271**	1	49.17	29.13
Experience of other types of homophobic/cissexist abuse (n = 3,104)	6.459*	1	24.52	15.32
Note. SSAY = Same-sex-attracted youth.
*p < 0.05; **p < 0.01; ***p < 0.001.

TABLE 4 Comparison of Experience of Homophobic/Cissexist Abuse for Trans-Spectrum and Cisgender Same-Sex-Attracted Youth

Location	Pearson Chi-Square	df	Percentage of Trans-Spectrum Youth Experiencing the Abuse at This Location	Percentage of Cisgender SSAY Experiencing the Abuse at This Location
Experienced the abuse at school (n = 2,327)	0.114	1	81.25	79.71
Experienced the abuse at home (n = 2,327)	11.062**	1	40.00	23.77
Experienced the abuse at a sporting event (n = 2,327)	3.175	1	17.5	11.08
Experienced the abuse on the street (n = 2,327)	8.608**	1	51.25	35.25
Note. SSAY = Same-sex-attracted youth.
*p < 0.05; **p < 0.01; ***p < 0.001.

There were other harms linked to the abuse that further underlined this need for safe and supportive services (see Table 5). A similar percentage of trans-spectrum youth had thought about engaging in self-harm and suicide to cisgender SSAY; yet trans-spectrum youth were significantly more likely to act on these thoughts. Shockingly, 27.2% of trans-spectrum youth reported having attempted suicide due to experiences of transphobia/homophobia, almost double the percentage of cisgender SSAY. (The trans-spectrum youth engaged in activities specifically designed and intended to end their lives, which they classified as a suicide attempt, for example, attempting to take an overdose of drugs or to hang themselves.)

TABLE 5 Comparison of Self-Harm and Suicide Attempts Due to Homophobic/Cissexist Abuse for Trans-Spectrum and Cisgender Same-Sex-Attracted Youth

Behavior	Pearson Chi-Square	df	Percentage of Trans-Spectrum Youth	Percentage of Cisgender SSAY
Self-harmed due to homophobic/cissexist abuse (n = 3,122)	10.695**	1	46.15	30.12
Attempted suicide due to homophobic/cissexist abuse (n = 3,122)	8.321**	1	27.47	16.10
Note. SSAY = Same-sex-attracted youth.
*p < 0.05; **p < 0.01; ***p < 0.001.

Bradley (transgender f-m, age 17) explained that his suicide attempts were related to “trauma related depression” from the physical transphobic abuse he had experienced from people on the street and verbal abuse from teachers. Suicide is a strong theme in the broader literature; one study (Whittle, Turner, & Al-Alami, 2007) revealed that more than one-third of trans-spectrum people had attempted suicide as an adult, although data on youth has been limited until now.

This study provides a quantitative link with a large sample that specifically highlights suicide risks for youth. It also emphasizes the issue of self-harm: almost half of trans-spectrum youth (46.1%) had self-harmed due to experiences of transphobia/homophobia. (They engaged in activities aimed at inducing bodily pain/harm rather than ending their lives, which they classified as self-harm, for example, cutting, burning, or scratching themselves.) Shannon (gender queer, age 19), seeking relief from feeling misunderstood and feeling too unsafe to use the school toilets and changing rooms, engaged in five years of self-harm, which involved “cutting and burning my skin from ages 13–18, at varying levels of severity.”

The well-being of this group must be increased through measures aimed both at strengthening their resilience and making their social environments more livable. It is possible that the residual pathologizing of trans-spectrum identities in psychological frames and the relative lack of education policy in Australia specifically targeting cissexism and transphobia has impacted these results.

Comparing Educational Provisions

With trans-spectrum youth reporting 81.2% of the homophobic/cissexist abuse they experienced occurred at school (see Table 4), education sectors must be urgently targeted for change. The only state with education policy specific to issues of gender identity in Australia is Victoria, and this policy is relatively new (State Government of Victoria, 2013). Specific issues for trans-spectrum students highlighted in the policy include the need for privacy around gender identity disclosures, referral to appropriate gender clinics if needed, and the need to provide gender-neutral bathrooms. This was a different approach to policies on cisgender SSAY, which focused on the need to discourage bullying and discrimination.

However, it appears that taking a privacy approach that does not include looking at educational interventions to preventing bullying may not be the best approach. In response to a question about the impacts of homophobia/cissexism on schooling, Table 6 shows there were highly significant relationships between abuse and lack of concentration in class, lower marks, and attendance issues (missing classes, missing days, changing schools, dropping out of extracurricular activities, or dropping out of school) for all participants. Yet school disruption was significantly higher for trans-spectrum youth. For example, Paige (gender fluid, age 18) missed days after becoming overwhelmed by rumors and “demeaning jokes about me engaging in sexual intercourse.” Sammy (gender queer, age 19) left school altogether after being continually verbally attacked, humiliated, and excluded by peers, explaining, “In my situation, there was nothing I could do, I was attending a school with a slack bullying policy.” Further, 30.7% of trans-spectrum youth reported hiding during recess or lunch, with “going to the toilets” and “using the changing rooms” being particularly dangerous for this group compared to cisgender SSAY.

TABLE 6 Comparison of Impact of Abuse on Schooling for Trans-Spectrum and Cisgender Same-Sex-Attracted Youth

Impact	Pearson Chi-Square	df	Percentage of Trans-Spectrum Youth Reporting Impact	Percentage of Cisgender SSAY Reporting Impact
Couldn't concentrate in class (n = 3,122)	8.774**	1	40.66%	26.66%
Marks dropped (n = 3,122)	11.548**	1	32.97%	18.74%
Moved schools (n = 3,122)	15.872***	1	20.88%	8.71%
Left school altogether (n = 3,122)	27.427***	1	21.98%	7.19%
Missed classes (n = 3,122)	15.353***	1	35.16%	18.74%
Missed days (n = 3,122)	11.352**	1	34.07%	19.70%
Hid at recess/lunch (n = 3,122)	13.287***	1	30.77%	16.30%
Couldn't go to the toilet (n = 3,122)	20.404***	1	21.98%	8.38%
Couldn't use the change-rooms (n = 3,122)	26.628***	1	34.07%	14.45%
Dropped out of sport/extracurricular activity (n = 3,122)	7.925**	1	21.98%	12.11%
Became involved in activism (n = 3,122)	18.995***	1	27.47%	12.11%
No affect at all (n = 3,122)	13.938***	1	20.88%	40.32%
Note. SSAY = Same-sex-attracted youth.
*p < 0.05; **p < 0.01; ***p < 0.001.

Such data speak volumes of the daily trials of trans-spectrum youth around school-based bullying, particularly outside of formal classroom hours where teacher supervision is minimal and in locations where gender-based differences become visible. Trans-spectrum youth were less likely than cisgender SSAY to report that their experiences of transphobic/homophobic bullying had no impact. These data suggest schools must take preventive measures against bullying. Reagan (transgender f-m, age 17) felt teachers took a biased stance with his problems. He comments that, while transsexuality is uncommon, “it's their responsibility to be educated about an issue that arises among students, especially if it has effects as severe as the ones I suffered.”

However, the news was not all bad. A positive finding of the study was the highly significant relationship between being a trans-spectrum youth and responding to abuse by engaging in activism in the school: 27.4% of trans-spectrum youth engaged in activism compared to 12.1% of cisgender SSAY (Table 6). This increased involvement in activism suggests that trans-spectrum youth possess resilience, feel empowered, and know their rights. This potential for creating social change through these youth is rarely considered in the broader literature, and it may be that they have an increased need to organize due to their marginalization. Some of the key areas this activism focused on included starting a group, making speeches, or helping with education against discrimination. Shay (gender queer, age 18) enthused: “We've been recruited as peer educators and are loving the role.” Some of this activism continued from school into university. Monty (transgender f-m, age 21) worked with other activists at his university to ensure the position of gender and sexuality counselor would not be made redundant: “We are working with our councillor's union to take action, raise awareness and make change.” Like many of the young people, Monty aimed to “give back to the queer community, but also be a positive ambassador to the rest of society.” Reagan (transgender f-m, age 17) wishes to become a community representative on an even larger scale, as an internationally famous activist:

I think the world needs someone in this position to tell them that they’re okay. They’re normal. They’re going to survive it. That they don't have to suffer like I did. That they can't let other people destroy them. That they’re worth something. I want to be, for someone else, exactly the idol I needed my whole life.

The need to allow trans-spectrum youth to have activist opportunities in schools, and to also recognize that some trans-spectrum youth may wish to negotiate a private way of managing gender differences, must be balanced in school-based approaches to supporting this group.

CONCLUSION AND RECOMMENDATIONS FOR RESEARCH AND PRACTICE

The findings reveal issues faced by trans-spectrum youth in their daily lives. Butler's understandings of the policing of gender identities discussed earlier in this article should not be dismissed lightly. The “real-world” social practice of the kind of policing of gender, about which Butler theorized, manifests in how many trans-spectrum youth experience rejection of their identity disclosures from family and professionals. It also manifests in their experiences of increased abuse when at school, at home, or simply walking down the street. It is clear that transgressions of gender normativity are looked on even more harshly than same-sex attraction both in the literature and in Australian social contexts, and psychosocial frames policing the boundaries of sex and gender still have a strong hold on the communal psyche. Due to this persistent policing of gender norms, one-tenth of young trans-spectrum people are homeless, almost half have self-harmed, and more than one-quarter reported attempting suicide in our study.

These are disturbing findings that highlight an urgent need for distinct trans-spectrum-youth-friendly support services, particularly in light of the rejection trans-spectrum youth can experience from the family and professionals they are turning to for support and assistance. The lack of support from counselors and service workers particularly raises a red flag; these are often the last resort for trans-spectrum youth who have little support anywhere else in their social and familial networks.

We should all join in calling for more equity for this group and push for policy protecting their interests in the training of psychology, education and social services professionals and employees. School-level antibullying policies that specifically negate cissexism and transphobia, and guidelines for all staff around providing structural and social supports for diverse gender identities, are of particular importance.

However, the lived experiences of trans-spectrum youth often demonstrate agency and self-definition outside the realm of psychomedical discourses, particularly assisted by access to more complex ways of (re)framing sex, gender, and sexuality. These framings can come from activist discourses, participation in diversity-affirming groups and services, queer theory, subcultural trends around use of genderqueer and pansexual positions, social supports, or their own unique logic.

A related positive discovery was that trans-spectrum youth were particularly likely to respond to abuse through an activist approach. It is, therefore, important for youth services and educational institutions to provide positive information about trans-spectrum identities to youth, so that they can access the logic behind them to build their resilience. These organizations should also support opportunities for trans-spectrum youth to engage in activism by allowing them a say in their treatment by the institution and involving them in actions to combat discrimination.

Further research could overcome the limitations of this study. For example, researchers could use interviews to better explore what external factors foster resilience for trans-spectrum youth or to better understand self-definitions that could be explored only to an extent in a survey, or develop methods attracting larger numbers of trans-spectrum youth. (While this study had a relatively large number for a youth-based study, the number of trans-spectrum participants was nevertheless a limitation.)

Supporting trans-spectrum youth means supporting youth positioned outside of male/female “norms” and supporting their right to stay outside or move across or between these constructions, and even to dismantle them. It means representing trans-spectrum diversity in safe-sex campaigns and psychology training, and supporting this diversity in education and service provision. This article challenges psychologists, feminists, researchers, educators, safe-sex campaigners, and service providers to embrace the needs of trans-spectrum youth—who demand to be heard and have a right to inclusive efforts.

Last, there is an ethical onus on any individual to whom a trans-spectrum young person discloses their identity to understand the potential impacts of giving a cissexist response. Rather than contributing to the host of negative representations and messages around trans-spectrum identity, it is important to focus on how we can help contribute to affirming conceptualizations of gender diversity and to help trans-spectrum youth build their resilience by contributing to such conceptualizations in their own worlds too.

Additional information

Notes on contributors

Tiffany Jones

Tiffany Jones holds a PhD, BEd (Hons 1), and a BCA. As a published author, she currently researches youth sexualities, policy, education, discourses, and queer theory at the University of New England, Australia.

Lynne Hillier

Lynne Hillier has a PhD in Psychology and has been a pioneer in research on same-sex-attracted youth, conducting investigations in the field and working toward practice-based change for more than 20 years. Now moving into retirement, Lynne held the role of associate professor and postgraduate coordinator at La Trobe University, Australia.

Notes

1. More detailed analysis of identity concepts for all of these survey participants, as expressed in their discussion of their self-definitions, is provided in our paper in a forthcoming trans-spectrum-themed special issue of Feminism and Psychology.

2. See http://deewr.gov.au/national-school-chaplaincy-and-student-welfare-program

3. This sentence shows how researchers can use gender-neutral, third-person personal pronouns in reporting direct quotes from trans-spectrum youth not aspiring to be positioned in traditional male/female or trans identities.