“You can’t be deadnamed in a video game”: Transgender and gender diverse adolescents’ use of video game avatar creation for gender-affirmation and exploration

Abstract

Transgender and gender diverse (TGD) adolescents experience mental health challenges at higher rates than cisgender peers due to a combination of minority stress and gender dysphoria. Many TGD youth use video games to cope with stress and access informal networks of support. However, very little is known about the potential positive influence avatar customization has for this group of youth. To address this gap in the literature, in-depth, semi-structured qualitative interviews were conducted with ten TGD adolescents about their experiences with avatar customization. Thematic analysis revealed four primary themes including that (1) video game avatar customization offers a low stakes environment for gender exploration, (2) avatars offer both internal and external validation of gender identity and transition goals, (3) avatars allow players to enact aspirational appearance goals, and (4) video games and avatars offer immersion and escapism for TGD adolescents. These novel findings underscore the range of positive impacts avatar customization can have for TGD adolescents, particularly for youth with gender dysphoria. Video game avatar customization can be a key part of the gender exploration and affirmation for some TGD adolescents.

Keywords:

• Transgender
• avatar
• video games
• non-binary
• gender diversity
• gender identity

Additional information

Notes on contributors

John L. McKenna

John L. McKenna (he/his) is an attending, clinical psychologist at the Gender Multispecialty Service (GeMS) and the Behavioral Health, Endocrinology, Gynecology, and Urology (BEING-U) program at Boston Children’s Hospital. Dr. McKenna also holds an Instructor of Psychology appointment in the Department of Psychiatry at Harvard Medical School (HMS). He is passionate about providing effective and affirming therapeutic services to TGD youth and their families. Dr. McKenna’s research interests include investigating protective factors for transgender and gender diverse youth, and sexual consent negotiation among LGBTQ+ individuals.

Yu-Chi Wang

Yu-Chi Wang (no pronouns/Dr.) is a postdoctoral research fellow in the Division of Adolescent and Young Adult Medicine at Boston Children’s Hospital and the Department of Pediatrics at HMS. As a trans and nonbinary researcher, Dr. Wang uses community-engaged methods to affirm and uplift trans voices, especially from those who experience intersectional marginalizations. Dr. Wang’s research focuses on fostering affirming environments for trans individuals, such as through cooperative board games.

Coleen R. Williams

Coleen R. Williams (they/them) is an attending psychologist with the GeMS Clinic at Boston Children’s Hospital and holds an Instructor of Psychology appointment in the Department of Psychiatry with HMS. Dr. Williams identifies openly as non-binary and is often referred to as “Col” by those who work with them. Their clinical practice and research focuses on gender-affirming care for TGD youth, sports inclusion, and the non-binary experience.

Kerry McGregor

Kerry McGregor (she/her) is an attending psychologist at Boston Children’s Hospital and the associate director of GeMS. In addition to her clinical work with TGD youth ranging in ages from 3-25, Dr. McGregor is passionate about teaching and training. She founded the GeMS clinic’s training program and regularly speaks about gender affirmative care at national conferences and meetings. Dr. McGregor is also an Instructor of Psychology at HMS and engages in research that focuses on the psychosocial benefits of gender affirming healthcare.

Elizabeth R. Boskey

Elizabeth R. Boskey (she/her) is a researcher and a social worker focusing on ethical and access issues in gender-affirming care. Dr. Boskey is also an Instructor of Surgery at HMS and an Instructor of Social & Behavioral Sciences at Harvard T.H. Chan School of Public Health. She served as the research lead for the Center for Gender Affirming Surgery at Boston Children’s Hospital and also has a private practice focusing on working with sexual and gender minority individuals and couples. Dr. Boskey completed the HMS Fellowship in Bioethics in 2019.