Family Functioning and Mental Health of Transgender and Gender-Nonconforming Youth in the Trans Teen and Family Narratives Project

Abstract

Transgender and gender-nonconforming (TGN) youth are at increased risk for adverse mental health outcomes, but better family functioning may be protective. This study describes TGN youth’s mental health and associations with family functioning in a community-based sample. Participants were from 33 families (96 family members) and included 33 TGN youth, ages 13 to 17 years; 48 cisgender (non-transgender) caregivers; and 15 cisgender siblings. Participants completed a survey with measures of family functioning (family communication, family satisfaction) and mental health of TGN youth (suicidality, self-harm, depression, anxiety, self-esteem, resilience). TGN youth reported a high risk of mental health concerns: suicidality (15% to 30%), self-harm (49%), clinically significant depressive symptoms (61%); and moderate self-esteem (M = 27.55, SD = 7.15) and resiliency (M = 3.67, SD = 0.53). In adjusted models, better family functioning from the TGN youth’s perspective was associated with better mental health outcomes among TGN youth (β ranged from −0.40 to −0.65 for self-harm, depressive symptoms, and anxious symptoms, and 0.58 to 0.70 for self-esteem and resiliency). Findings from this study highlight the importance of considering TGN youth’s perspectives on the family to inform interventions to improve family functioning in families with TGN youth.

unding and Acknowledgments

The Trans Teen and Family Narratives Project was funded by a grant from the Eunice Kennedy Shriver National Institute of Child Health and Human Development (K99HD082340), awarded to Dr. Katz-Wise. Drs. Katz-Wise and Austin were also funded by the Maternal and Child Health Bureau, Health Resources and Services Administration, Leadership Education in Adolescent Health Project (6T71-MC00009). We would like to thank the many people and organizations who have contributed to this project, including Laura Bogart, Roberta Goldman, Milagros Rosal, Annie Pullen Sansfaçon, Melissa MacNish, the Harvard CFAR Community Advisory Board, the Fenway Youth Community Advisory Board, Kyle Megrath and Athena Edmonds at Greater Boston PFLAG, Shannon Sennott at TransLate Gender, Nick Teich at Camp Aranu’tiq, Julian Dormitzer at the Massachusetts Commission on LGBTQ Youth, Mason Dunn at the Massachuetts Transgender Political Coalition, Effie Molina and the LGBT Liaisons at the Massachusetts Department of Children and Families, Lori Davison at PFLAG Hartford, the Parents of Transgender* Kids Facebook page, Susan Maasch at the Trans Youth Equality Foundation, Eli Godwin, Meghan Doherty, Jax Gonzalez, Rachel Kahn, Julia Medzhitova, LB Moore, Kate Oeser, Elena Rossen, Caterina Stamoulis, and Kate Thomson. We would also like to thank the Division of Adolescent/Young Adult Medicine at Boston Children’s Hospital and the Sexual Orientation and Gender Identity and Expression (SOGIE) Research Working Group. Finally, we would like especially to thank the families who have participated in the Trans Teen and Family Narratives Project.