A qualitative inquiry into the oppression experienced by Australian transgender and gender expansive teens

Abstract

Background

Transgender and gender expansive (TGE) teens in Australia face significant challenges due to oppression, yet limited research focuses on the psychological and social impacts on this demographic.

Aim

To investigate the impact of oppression on the psychological well-being and social experiences of TGE teens in Australia.

Method

Sixteen participants aged 14–17 were recruited through online platforms (e.g. Instagram) and organizations across Australia. Individual online semi-structured interviews lasting 60–120 min were conducted. Interpretive Phenomenological Analysis, utilizing both inductive and deductive reasoning, was employed to analyze the narratives. The study adhered to ethical protocols approved by the Institutional Review Board.

Results

Two superordinate themes emerged from the analysis: (1) oppression and psychological well-being, and (2) navigating social constraints and self-expression. The findings highlight the influence of oppressive experiences (e.g. misgendering, transphobia, and lack of support) on mental health (e.g. suicidal ideation, addiction, depression) and behaviors (e.g. delayed gender identification). Despite these challenges, participants demonstrated resilience (e.g. self-advocacy) to navigate oppressive environments.

Conclusion

This study adds to prior research by highlighting the nuanced impacts of misgendering, transphobia, and lack of support, illustrating how these experiences contribute to a range of mental health issues and challenges in self-esteem and identity development. Despite potential limitations in self-reporting and sample size, the study offers valuable perspectives on the resilience and adaptive strategies employed by TGE teens. Future research should delve into the intersectionality of these experiences, the long-term effects of oppression, and the efficacy of targeted interventions.

Keywords:

• gender expansive
• mental health
• oppression
• teen
• transgender

Transgender and gender expansive¹ (TGE) individuals confront distinctive mental health challenges characterized by heightened rates of depression, self-harming behaviors, suicidality, anxiety, and posttraumatic stress disorder (Connolly et al., 2016; Flentje et al., 2016; Klemmer et al., 2021; Oswalt & Lederer, 2017; Reisner et al., 2016). Unlike their cisgender counterparts, TGE individuals possess unique health needs, related to gender transitioning, encountering stigma, invalidation, and discrimination (Gridley et al., 2016), which exacerbates their mental health disparities (Bockting et al., 2020; Moagi et al., 2021; Sloan & Shipherd, 2021; Valente et al., 2022). For example, discriminatory experiences create environments fraught with fear, challenging beliefs, safety, and identity (Diamond & Alley, 2022; Riley, 2018; Romanelli & Hudson, 2017).

Yet existing literature often fails to delve deeply into how the unique health needs of TGE individuals are met or unmet within various settings, including medical environments, and how these experiences affect TGE individuals’ mental health. This study aims to fill this gap by exploring the nuanced experiences of TGE teens in Australia, focusing on their encounters with oppression and its impact on their mental health and identity.

Research on TGE teens is imperative, as developmental stages are marked by escalating mental health problems and high-risk behaviors, including substance use (Hatchel et al., 2019; Newcomb et al., 2020; Olson-Kennedy et al., 2019). Psychosocial stressors, compounded by factors such as a lack of social support (e.g. family and peer) and violence, disproportionately impact TGE teens during the transition to independent adulthood (Johns et al., 2018; McCann et al., 2021; Wittlin et al., 2023). Younger TGE individuals (16 plus) are particularly vulnerable and report higher rates of anxiety and mental health issues compared to older TGE individuals (Puckett et al., 2022; Seelman et al., 2017), highlighting the need for more research on teen populations. Parental reports indicate a higher likelihood of suicide talk and attempts among TGE teens compared to their cisgender siblings (Katz-Wise et al., 2018; Tankersley et al., 2021). Moreover, TGE teens have higher mental health difficulties, such as, increased rates of depression, suicidality, and substance use compared to cisgender sexual minority peers (Eisenberg et al., 2017; Perez-Brumer et al., 2017). Consequently, teen TGE people are particularly vulnerable.

In this study, oppression is defined as the unjust treatment or exercise of power over individuals (Pease, 2022). TGE teens often face challenges related to gender transitioning (Edwards-Leeper et al., 2016; Ehrensaft et al., 2018; Katz-Wise et al., 2017). They experience stigma, invalidation, and discrimination within medical environments (Call et al., 2021; Chong et al., 2021; Johnson et al., 2020). Barriers to obtaining affirming treatment include overt bias, lack of practitioner knowledge regarding TGE-specific healthcare needs, and structural oppression within healthcare systems (Chang et al., 2018; Goulding et al., 2023; Kcomt et al., 2020; Noonan et al., 2021; Soled et al., 2022).

Research indicates that oppression, encompassing systematic oppression, stigma, and discrimination, is linked to higher levels of psychological stress, such as depression, anxiety, and suicidal ideation (Reisner et al., 2016; Valente et al., 2022). Discrimination and bigoted environments foster fear by challenging beliefs, sense of safety, and identity (Anderson, 2020; Michelson & Harrison, 2020). Health disparities and poor mental health outcomes among TGE teens are often attributed to experiences of stigma, discrimination, and victimization (Moagi et al., 2021; Valdiserri et al., 2019).

Given limited data on the impact of oppression and evolving forms, understanding oppression during formative developmental years is crucial, necessitating the understanding of appropriate preventative and support services (Austin, 2016; Coleman et al., 2022; Levitt & Ippolito, 2014). Notably, gender-affirming treatment stands out as a significant factor in improving the health and well-being of TGE teens (Connolly et al., 2016; Coleman et al., 2022). However, barriers to affirming treatment, including stigma, lack of healthcare practitioner knowledge, and structural oppression within healthcare systems, persist in Western societies (Pampati et al., 2021; Kuzma et al., 2019; Puckett et al., 2018; Velasco et al., 2022). In examining TGE teens, researchers bear ethical responsibilities, as underscored by Nagoshi et al. (2023). These responsibilities encompass sensitivity to diverse identities, acknowledgment of intersectionality, transparency, appropriate language/pronoun use, and respect for transgender spaces.

The mental health of Australian TGE teens continues to face educational challenges, the reinforcement of gender binaries, and experiences of marginalization (Grant et al., 2021; Riseman, 2019; Ussher et al., 2022). The oppression TGE teens face is manifested in various settings, including schools, where gender norms can lead to verbal and physical abuse. Educational institutions, particularly those with strong religious affiliations, may present additional barriers through enforced gender stereotypes and inadequate gender-inclusive education, contributing to negative mental health outcomes (Jones et al., 2016). Moreover, educational staff professional development (Bartholomaeus & Riggs, 2017; Meyer & Leonardi, 2017) and improved education for healthcare providers tailored to TGE specific needs (Bartholomaeus & Riggs, 2017; Eisenberg et al., 2020; Riggs & Bartholomaeus, 2016) are essential.

Current study

While previous research has explored the effects of oppression on TGE teens, there is a need for more in-depth study within this field. This study explicitly focuses on the experiences of TGE teens within the Australian context. This study seeks to contribute to this growing body of research by specifically delving into the experiences of TGE teens within the Australian context. The research objectives are twofold: first, to investigate the oppressive encounters faced by TGE teens, and second, to broaden the scope by including identities beyond the binary transgender spectrum, such as genderqueer individuals. This study operates within an exploratory and inclusive framework, aiming to address a notable gap in the existing scholarly discourse.

Employing an intersectional framework and leveraging Interpretative Phenomenological Analysis (IPA; see Smith and Fieldsend (2021) for an outline of IPA), the current paper undertakes an in-depth exploration of the narratives of TGE teens. It delves into how these individuals experience their gender identities in conjunction with other intersecting aspects of their identities, elucidates the nature of the oppressions they encounter, examines their sense-making processes concerning these experiences, and assesses the impact of their resistance to oppression. This focused inquiry sheds light on the diverse forms of oppression experienced by TGE teens and the resultant impact within the prevailing Australian sociocultural climate. The outcomes of this study aim to enhance the understanding and awareness of the distinctive challenges faced by TGE teens, offering valuable insights into the multifaceted ways in which they navigate and are affected by oppression through the lens of their narratives.

Aims

Consequently, the overarching research question guiding this study is as follows: “How do the experiences of oppression that TGE teens encounter impact their mental health and contribute to shaping their self-perception?” This inquiry seeks to contribute to a more nuanced understanding of the multifaceted challenges faced by TGE teens in Australia and their subsequent impact on self-identity.

Method

Study design

This present research paper adopted a qualitative methodological approach centered on semi-structured interviews to capture the nuanced dimensions of lived experiences with oppression. These interviews were meticulously organized, featuring a systematic categorization into distinct subheadings. This deliberate structuring aimed at fostering a thorough investigation into the multifaceted repercussions of oppression, indicating its effects on participants’ mental health self-perceptions. The interview protocol, a pivotal component of the study design, was developed to promote several critical aspects: inclusivity, affirmativeness, age-appropriateness, and impartiality. By adhering to these methodological considerations, we sought to cultivate an environment conducive to capturing and comprehending the diverse narratives surrounding the impact of oppression on the lived experiences of our participants.

Interpretative phenomenological analysis

Our chosen research methodology for this investigation aligns with the foundational principles of IPA (Eatough & Smith, 2017; Smith & Fieldsend, 2021). IPA, an established and respected qualitative research approach, focuses on a nuanced exploration of converging and diverging factors, intricately weaving in contextual information encompassing cultural, economic, social, and educational dimensions to construct meaning from and analyze participants’ experiences (Willig, 2017). Embracing an idiographic and double-hermeneutic framework, IPA facilitates a profound exploration of individual differences, allowing for in-depth insights. This methodology not only unveils a comprehensive understanding of participants’ experiences of oppression but also delves into how they derive meaning from these encounters personally. Moreover, it sheds light on the intricate process by which researchers themselves derive meaning from the narratives presented by the participants. Importantly, IPA’s inclusivity stands out, providing a robust framework for capturing the diverse experiences of oppression (Chan & Farmer, 2017).

Participants

This selection criteria targeted individuals in Australia who had encountered oppression, ensuring a comprehensive understanding of their experiences. Eligible participants included those who: (a) fell within the age bracket of 14 to 18 years; (b) identified within the transgender or gender expansive umbrella; (c) expressed a realistic willingness to engage in a 60 to 90-minute interview, either online or face-to-face; and (d) provided consent for their responses to be de-identified and used for research purposes. No exclusion criteria were provided as we wanted to be as inclusive as possible.

The final sample comprised TGE teens aged between 14 and 17 (M = 16.13 years, SD = 0.88 years). During the interviews, participants were offered the choice to select a pseudonym or, alternatively, Author 1 assigned a pseudonym to represent their identities while upholding confidentiality. Additional participant details are presented in Table 1.

Table 1. Participant information.

Pseudonym	Age	Gender Identity	Pronouns	Sexual Orientation	Ethnicity	Religion	Economic Status	Education	Location	Other
Abigail	17	Girl/woman	She/Her	Homosexual/gay/ lesbian	White, Persian	None	Above average	Year 12, private, Catholic	WA
Aidan	17	Non-binary	They/Them	Queer	Australian	Agnostic	Above average	Year 12, Government	VIC	BPD, Neurodivergent tendencies
Allen	16	Gender queer	They/She	Bisexual	Chinese	Agnostic	Average	Year 12, Government, select entry, single sex	NSW
Bowery	16	Transgender	They/He	Aromatic/asexual spectrums	White Australian, Indigenous Japanese, Jewish	Non-theistic satanist	Below average	Year 11, Government	QLD	Autistic, ADHD, Tourettes syndrome, physical disability
Cam	16	Gender queer	They/Them	Asexual	White	Atheist	Above average	Withdrew year 10	VIC	Autistic, Physical disability, PTSD
David	14	Transgender	He/Him	Homosexual/gay/ lesbian	Australian	Agnostic	Above average	Year 9	QLD	Autistic, Dyscalculia,
Freddie	17	Gender queer	He/She	Asexual	N/A	Not religious	Average	Year 12, Government, coeducational institution	QLD	Autistic, ADHD
Jack	15	Transgender	He/Him	Unsure	Anglo-Australian	Atheist	Average	Year 10, Government, coeducational institution	SA	ADHD, Autistic
Jayden	16	Transgender man	He/Him	Homosexual/gay/ lesbian	Australian, Vietnamese, Spanish	Atheism	Average	Withdrew Year 10	NSW
Jesse	16	Non-binary	They/Them	Panromantic/ asexual	Unknown	Spiritual	Poor	Year 11, Government	VIC
Karl	17	Gender queer	He/She	Pansexual, aroace	N/A	Not religious	Average	Year 12, Government/ coeducational institution	QLD	Autistic
Ken	16	Gender fluid/exploring	He/Him	Bisexual	Indian	Catholic	Above average	Year 11, Government	SA
Mushu	17	Transgender	He/Him	Bisexual	Vietnamese	Agnostic	Above average	Year 12, Government	VIC
Peter	17	Non-binary	They/It	Omnisexual	Dutch, White Australian	Atheist	Above average	Year 12, Government, coeducational institution	NSW	ADHD, Autistic
Richard	15	Transgender	He/Him	Bisexual	Caucasian	Atheist	Above average	Year 10	ACT	ADHD
Zoro	16	Gender queer	They/Them	Bisexual	White Australian	Non practising Catholic	Average	Year 11, Catholic, coed	SA

Note. ADHD = Attention-deficit/hyperactivity disorder; PTSD = Posttraumatic stress disorder; BPD = Borderline personality Disorder; ACT = Australian Capital Territory, NSW = New South Wales, QLD = Queensland, SA = South Australia, VIC = Victoria, WA = Western Australia.

Methodological approach

Upon approval from the Human Research Ethics Committee, participants were recruited using a deliberate convenience sampling strategy. Prospective participants, including legal guardians in cases involving minors aged 15 and under, carefully reviewed the provided documents and expressed their voluntary agreement by submitting a signed consent form to Author 1. Consistent with the tradition of IPA studies, which often feature small sample sizes to delve deeply into individual cases (Alase, 2017), our study did not adhere to a fixed rule on sample size. However, aligning with the guidelines proposed by notable IPA researchers (Smith & Fieldsend, 2021), we aimed to recruit up to 16 participants, considering the age of the cohort.

Before the interviews, potential participants completed a demographic questionnaire (including educational level, age, gender identity) that also featured an open-ended question about their experiences of oppression (e.g. “Have you encountered any form of oppression, such as discrimination or mistreatment, based on your identity?”). Potential participants’ who responded with experiencing oppression (self-defined) were invited to participate in an online interview. All participants elected to engage in online interviews via Zoom (rather than face-to-face), lasting approximately 55 − 123 min. The interview schedule encompassed three main topics: “participant identity,” “participant intersectionality,” and “participants’ experiences and perceptions of oppression.” Sample questions included “How do you feel about your gender identity (e.g. gender fluid)?” “Do these values impact your gender identity?” and “How did you behave when you experienced oppression?”). Oppression was not explicitly defined, allowing participants to interpret and describe their experiences based on their personal understanding and context. This approach was intended to promote inclusivity and capture a diverse range of perspectives and experiences.

The interviews were audio recorded via Zoom and transcribed using a digital transcription service (Otter; https://otter.ai/), and manually verified for accuracy. The iterative data collection and analysis process occurred simultaneously (Eatough & Smith, 2017). Post-transcription, participants received their transcripts for accuracy verification and were given an opportunity for edits to promote an authentic representation of their experiences. Transcribed interview data underwent the coding process employing NVivo (NVivo 14, released 2023), specialized qualitative data analysis software. Anonymity was preserved using pseudonyms, and any sensitive information, such as school names, was de-identified.

Data analysis

The data analysis adhered to the IPA protocol outlined by Smith and Fieldsend (2021). IPA facilitates an in-depth exploration of participants’ lived experiences articulated in their own words. Well-suited for navigating complex and emotionally nuanced subject matter, IPA guided the analytical process through seven comprehensive phases. First, Author 1 thoroughly examined the raw data by repeatedly reading the transcripts to grasp the core of participants’ stories and identify key conceptual, descriptive, and linguistic features. This led to identifying initial emergent themes that highlighted important aspects of the participant’s experiences.

These themes were then refined and organized into clusters to unveil comprehensive connections and patterns within the data. The process continued with creating superordinate and subordinate themes, enabling a nuanced exploration of overarching and specific themes within the dataset. The identified themes were integrated into a coherent narrative, presenting a rich and contextually embedded account of participants’ experiences. Further refinement of themes aimed to capture the essence of lived experiences while preserving individuality. Lastly, an interpretative process was undertaken by theorizing and deriving meaning from the findings, aligning them with the study’s research questions and broader theoretical framework.

Researcher roles and methodological rigor

The lead researcher (Author 1) managed interviews, transcriptions, and analyses. Authors 2 and 3 provided training and joined reflexive discussions to address biases and enhance methodological rigor. Triangulation was employed to promote consensus on themes for a trustworthy representation of TGE teens that Author 1 might have overlooked in the initial analysis (Natow, 2020). Author 1 consciously aimed to avoid personal biases, supported by reflexive discussions with Authors 2 and 3. Reflexivity aims to maintain vigilance against biases (Olmos-Vega et al., 2023). However, IPA acknowledges researchers’ inherent involvement in the process as it is grounded in subjectivist epistemological assumptions (Cuthbertson et al., 2020).

To enhance transparency and facilitate the evaluation of this study, it is important to disclose the researchers’ identities and discuss how these may have influenced the research process. The principal investigator is a heterosexual, non-binary, white individual who is able-bodied, autistic, neurodivergent with ADHD, non-religious, from an upper-middle-class background, and highly educated. The second researcher is a cisgender, gay man, non-religious, and an immigrant. The third researcher is a cisgender, heterosexual woman who is non-religious, dyslexic, and the first in her family to achieve tertiary education. Throughout the research, we continuously reflected on our biases, emotions, and preconceptions and how these might intersect with the study data. Our discussions around these reflections were collaborative, aiming to critically assess our positionalities and their impact on the research.

Results

The data identified two superordinate themes and six subordinate themes. These themes are explored in this section and displayed in Table 2, accompanied by participant excerpts. The results of this study focus on how oppression impacts participants. Participants’ experiences of oppression varied (e.g. depending on the environment) but included shared experiences such as misgendering, transphobia, and lack of support. Additionally, participants suggested oppression had impacted areas such as their mental health, sense of safety, and identity development.

Table 2. Summary of superordinate and subordinate themes.

Superordinate theme	Theme description	Subordinate themes
Oppression and Psychological Well-being	This theme delves into the intricate relationship between oppression and the psychological well-being of TGE teens. It encompasses the exploration of mental health, self-esteem, and identity development as integral components affected by the oppressive environments.	Mental health Self-esteem Identity development
Navigating Societal Constraints and Self-Expression	This theme focuses on the challenges TGE teens face in navigating societal norms and expressing their identities within educational settings. It includes the examination of gender-affirming behaviors, sense of safety, and self-expression/body image as subthemes that illustrate the impact of oppressive structures on the daily experiences and identity development of these individuals.	Sense of safety Self-expression/body image Gender affirming behaviors

Note. TGE = transgender and gender expansive.

Theme 1: Oppression and psychological well-being

Mental health: the intricate dance of conforming and dysphoria

Responses highlighted that the mental health toll of oppressive experiences encompasses a spectrum, including suicidal ideation, addiction, hopelessness, depression, burnout, anxiety, loneliness, sadness, guilt, panic attacks, body dysphoria, self-harm, and reduced school engagement. The participant’s personal accounts explored the nuanced interplay between individual identity and societal norms, as demonstrated in their past struggles with gender dysphoria. Richard’s experiences underscore the emotional toll of conforming to societal cisnormativity. Their struggle with gender dysphoria reveals the intricate relationship between personal identity and societal expectations. Zoro reflects on the complexities of self-expression and safety,

Um, yeah, it’s been a bit better in recent years [confidence in their appearance and self-expression]. But especially when I was still like a baby queer, I like didn’t know what the right way of expressing myself was in like the safest way, that a 13-year-old could.

Karl’s journey emphasizes the profound effects of misgendering on mental well-being. The emotional impact and frustration when misgendering persists, reflects the intricate dynamics of navigating societal perceptions. Karl expresses, “It makes them feel gross. And I just don’t want to like, I just don’t want to like be in that space anymore. I just don’t want to be perceived and stuff. It’s terrible.” Peter’s frustration in the face of discrimination and transphobia underscores the emotional toll of societal biases. The struggle to watch videos on transphobia reveals a negative emotional impact (e.g. dysregulation); for example, Peter laments, “I struggle to watch videos that are on transphobia, like people who are debating it, because I get so frustrated…”.

These narratives illustrate the profound impact of societal oppression on one’s mental health. The participants’ experiences reveal how societal expectations and discriminatory practices exacerbate feelings of anxiety and depression, making it crucial to address these issues to improve mental well-being among TGE individuals.

Self-esteem: Navigating pronouns and cultivating confidence

The intricate tapestry of self-esteem is developed from participants’ personal identity and societal expectations. Within this complex weave, themes emerge, encompassing reduced self-worth, negative self-beliefs, compromised family boundaries, downplayed negative educational experiences, diminished confidence shaped by societal norms, pervasive self-doubt, a sense of inadequacy, challenges in forming close bonds, lingering trust issues, diminished ability to be vulnerable, and a perception of being an inconvenience to others.

Jack’s exploration of self-esteem resonates with the emotional impact of misgendering, revealing stress and frustration when others struggle with pronouns or misgendered them, “I got constantly misgendered and stuff. I was really depressed. And that was rough”… “But I’m very used to it, which is kind of sad, and it’s kind of helpful”. This highlights the importance of societal language on an individual’s self-esteem and mental well-being, showing how misgendering and pronoun misuse are forms of oppression that deeply affect self-worth. Mushu candidly expressed

And it got to the point where I think he started to actively discriminate against me. And I just kind of went up to him in the middle of recess, and I was just like, I was like, mate you fuck off! In the most like bogan accent kind of accent. And, I guess that kind of like, established myself, me to him that, you know, you don’t fuck around with this kid, you know, otherwise, you know, I’ll fucken bash ya. Not… really the most peaceful or sound decision to make, but that’s how I dealt with it. And it’s kind of, kind of worked out for me in a way.

Participants’ responses illustrate how societal oppression forces individuals to adopt defensive and sometimes aggressive behaviors to protect their self-esteem and assert their identity. Additionally, Zoro’s reflections on the evolution of confidence and ongoing struggles in self-expression offer insight into the journey of self-esteem development. The complexities of expressing oneself safely underscore the challenges faced by gender expansive individuals in building and maintaining self-esteem. Zoro notes, “It’s as diverse as it can be with Catholic ed. Like, you don’t like openly see it as much, because obviously like the uniform rules, like the presentation rules as well restrict a lot of the expression.” additionally, they experienced negative self-reflection, commenting, “For me, it used to be more of the ‘am I not passing enough? Do I not look enough like how I feel like I should present myself?”

These reflections show how institutional rules and societal norms contribute to self-doubt and hinder authentic self-expression, further impacting self-esteem.

Identity development: Adaptive strategies

Participants showed resilience in identity development amid oppression. Richard highlighted multifaceted challenges in gender dysphoria, while Zoro found empowerment in cisnormative themes within the school musical. Freddie’s Live Action Role Play (LARP) LARPing experiences revealed strategic choices in unsupportive environments, such as

In a weird way, the kind of, like validation. I get from like, if I pass as a male, like that gender euphoria, would be about the same kind of validation. I just feel internally when I’m holding a sword. Yeah.

And

a lot of people just get called by their character names. So I started introducing myself as Nat because I had that backup option of just pretending it was a shortened version of the character name. If my parents or anyone else were to, for whatever reason, um, hear someone refer to me as Nat.

These strategies illustrate the adaptive measures individuals take to affirm their identities and find validation within oppressive environments. Oppression’s impact on safety was complex, with participants expressing fear, lack of control, and reduced safety. Feeling unsafe extended to home, school, and the community. Diminished trust, safety in diverse spaces, and avoidance of specific locations underlined the link between oppression and safety in identity exploration.

Facing oppression resulted in disliking one’s gender identity, choosing identity based on reactions, hindering exploration, self-misunderstanding, feeling incomplete, lack of self-acceptance, self-doubt, premature mental maturity, and identity loss.

Examining identity development, Ken’s adaptive identity in social contexts reflects resilience. His ability to navigate underscores the strength in transgender identity development. Ken shares, “Um, more so that nothing’s going to change, sort of thing…”. Peter’s journey in understanding gender identity and the internet’s role in language and understanding showcases identity’s intersectionality. The internet has become crucial, impacting self-perception. Peter reflects, “The internet. Simple the internet. I feel like there’s a lot of things I just like, as time went on, I spent more time on the internet and just in rabbit holes…”.

These insights underscore how oppressive societal structures shape the self-esteem and identity development of TGE individuals. Examining their experiences reveals that societal norms and language significantly impact their confidence and self-perception. The narratives highlight the importance of supportive environments and the internet as critical resources in navigating identity and building resilience amidst oppression.

Theme 2: Navigating societal constraints and self-expression

Sense of safety: Balancing authenticity and potential discrimination

Facing oppression shaped participants’ sense of safety (e.g. Allen, “It’s at home where I feel less safe doing such things [self-expression],” resulting in fear (e.g. Abigail, “And also fear about how people [school peers] feel about me being trans.”), perceived lack of control (e.g. David, “I wish I could just be a person, but I can’t, fucking hell.”), desire to escape (e.g. Allen’s response to moving out of home, “Yes, as soon as possible.”), and diminished trust in familiar settings (e.g. Ken in response to their sibling, “feel kind of bad, but also like, sort of like, I don’t trust her [sister].”. These experiences are highlighted in Bowery’s report,

Because I felt very homicidal. I felt very upset. And I knew I needed help. And she said, No, you don’t need help. There were people in the ER who need more help than you. Um, so yeah, I was forced to leave. And the thing is, I was so scared. Because I was so, like, scared. I was so scared that I was like, you know, terrified, and I couldn’t walk because I was just terrified. And then, and they were like, we’re gonna get security guards. And I was like, That’s not helpful. That makes me more scared. You’re treating me like, I’m sort of, like, I’m sort of a criminal. I didn’t do anything. I’m asking for your help before I end up doing something bad.

Heightened vigilance, discomfort around specific demographics (e.g. elderly people), and selective avoidance added complexity to their safety journey amid oppression.

The exploration of safety highlighted the intricate balance between authenticity and potential discrimination. Richard’s cautious anticipation of oppression and Jesse’s strategic online disclosure illustrated challenges in preserving safety amid societal expectations. Freddie’s decision to delay social transition until after school emphasized societal norms’ profound impact on safety perceptions,

The other kids in my grade haven’t been particularly great towards the couple of other trans kids that have come out. And I figured, you know, since I’m nearly done with school anyway, I’ll probably just socially transition once I finish.

Furthermore, Freddie commented,

If I need to use a bathroom I use like the, um, gender-neutral disabled bathroom, instead of the men’s there. Um… Also, yeah, that expectation to adhere completely to a binary, I guess. And being caught like halfway between that transition, where I’m, far from being entirely feminine presenting, but I’m also, not at a stage where I can, or, I guess want to just just yet. Passes as, um, a binary male.

Delving deeper, Jesse’s ongoing self-discovery emphasized the role of affirming environments in shaping safety. The acknowledgment of navigating societal expectations showcased the impact on safety in expressing one’s identity. Jesse reflected,

It differs from the stereotypes and the negative side of how people view us, they get put down called a liar, and they get told more and more other stuff, and keep getting constantly, ugh, don’t know, just keeping constantly pushed, to be made out, to be someone, to be the bad guy in this situation. And that’s what’s even more of a negative impact and make more people scared to, speak or say what their own experiences are.

Extending the exploration, Freddie’s decision to delay social transition reflects societal expectations’ impact on safety, aiming to avoid potential discrimination. Freddie noted

I’ll probably just socially transition once I finish (school). Um, the parents, it was just a similar reason, like, I am not ready to socially transition until I finished school. And having people who are like there, knowing every aspect of my life, aware of a different gender identity just probably wouldn’t help.

These narratives suggest how oppression impacts participants’ sense of safety and the need for an affirming environment to mitigate the impact of discrimination and foster a sense of security and well-being among TGE individuals.

Self-expression/body image: Challenging norms and frustrations

Participants grappled with self-expression and body image challenges shaped by societal norms alongside parental and financial barriers. Oppression resulted in reduced use of affirming facilities, hindered expression, a desire to alter their appearance, feelings of inadequacy, delays in gender-affirming care, and pressure to ‘pass.’ Decision-making, future planning, and activity avoidance due to dysphoria were also affected. Richard’s frustration with presenting as masculine and Zoro’s quest for safe expression highlighted ongoing struggles with societal expectations. Peter’s dissatisfaction with gendered shopping experiences emphasized the profound impact of norms on individual expression.

In self-expression/body image, Zoro’s paradoxical experience in the school musical highlighted the impact of cisnormative settings. The tension between empowerment and disconnect underscored challenges in expressing authentically within traditionally cisnormative themes. Zoro shares, “I’m in my school’s musical this year, which is Grease. So it like kind of sucks. Because I hate Grease. But like, I got one of the lead male roles. So that’s really fun.” Further exploring self-expression/body image, Peter’s frustration with gendered shopping experiences highlighted limitations imposed by societal norms. The struggle with binary categories reflects the broader challenge of navigating societal expectations. Peter expresses, “It sucks, because so many things are either for men or for women. Like if you go shopping, it’s like there’s a men’s section, the women’s section. What about the human section?”

Adding to these narratives, Cam and Jayden’s experiences further illustrate the multifaceted obstacles individuals face seeking to resonate their legal identity with their gender expression. Cam directly addresses the legal hurdles, stating, "I want to but there’s legal complications with former, father, crap. That means that I can’t do that until about 18." This highlights the legal difficulties and the impact of not having supportive parental figures in navigating the legal system for a name change, a crucial step in affirming one’s gender identity. Furthermore, Jayden’s journey sheds light on the role of parental and financial barriers in accessing name change procedures. They recount

First it was like not we’re not doing that nah [from their parents]. And then. And then it became a sort of like, we’re only going to do it if you pay for it. And then, you know, my principal was like, Oh, I’ll pay for it. And then, like, he told me this at school. And then I just started like, I just ran up to my friend I started crying. I was like, Oh, my God, guys, John. Oh, sorry, that’s his name. John is going to help me with my name change”.

This is a depiction of the emotional rollercoaster and the significance of external support. It highlights the challenges of self-advocacy against parental opposition, but also the significant impact that support and validation from allies can have on an individual’s journey toward self-expression and alignment with their gender identity. These insights indicate how oppressive societal structures shape the self-expression and body image experiences of TGE individuals. Demonstrating the critical role of supportive environments and the need for systemic change to enable authentic self-expression and improved body image among TGE individuals.

Gender-affirming behaviors: Negotiating disclosure and support

Participants revealed a reduced inclination for gender-affirming care but expressed an increased desire for corresponding treatment and support, reflecting the complex interplay with one’s needs and oppressive societal norms. For example, they expressed aspirations for legal name changes but were fearful of disclosing their identity to others, a fear rooted in societal stigma and discrimination. Additionally, they reported a reduced use of gender-affirming facilities like bathrooms to avoid revealing their gender identity to others, illustrating how oppression forces them to prioritize safety over their needs. Fatigue-induced limitations in accessing gender-affirming services were reported, alongside a heightened yearning for supportive gender-affirming communities. Experiences such as being forced to compete in sports based on assigned birth sex were highlighted, illustrating the impact of institutional oppression on individual identities. For instance, in Mushu’s commented,

I remember that point when [at school] a lot of people like did not want to be like, participate in sports with me or the I wouldn’t be let on to join sports teams, because it was just like, oh, well, this person doesn’t identify as a girl. So why should we let them play with the girls, which, in a way did kind of validate my gender identity, because he was kind of like, Ah, cool. They see me as a guy, but also at the same time, it was just like, oh, well, I’m in the school, still, So you may as well, include me at least.”

Moreover, delayed social transition emerged as a significant theme. Freddie expressed,

I’m a state representative [in a sporting team], so it’s pretty intense. I was hoping to make like, national team for next year. But I’m not quite sure what I’ll be doing in terms of socially transitioning then. Because while I’m pretty good at the, in the women’s competition, I don’t think I’d be able to hold off as well in the men’s competition.

The narratives showcased adaptive responses to oppressive environments. Richard’s pursuit of a supportive community and Jesse’s online identity disclosure emphasized the crucial role of affirming environments in fostering coping mechanisms. Freddie’s strategic approach to selective disclosure highlighted complexities in navigating social spaces amidst oppression, while Allen’s struggles with self-advocacy and respect within relationships underscored intricate dynamics of interpersonal connections.

Abigail’s narrative highlighted the significance of supportive communities in shaping positive self-perception, stating,

A big part of the reason I think that I’ve been able to become like this is because I do have parents who aren’t completely stone walls, you know I can advocate for myself and have a response. So…. which is good because that’s well taken to the world.

Freddie’s strategic and methodological approach toward self-disclosure reflected the impact of societal expectations on gender-affirming behaviors and acceptance

The close friends, I think, like one from school, and then the others were early people I’d met online who were also gender diverse. And then, at my LARP club, that was one, I started going there at a time where I’d, kind of, become more confident in my identity, I guess. So when I started there, I saw that as an opportunity to, introduce myself, straight from the start as a male … Um, for the most part, the people I’ve told, have been supportive, but that’s also because. I mean, I’m still, I’d still consider myself mostly closeted. I only tell the people who I know will be supportive.

These insights suggest how oppressive structures shape the experiences and strategies of TGE people in their pursuit of affirmation and support.

Discussion

The participant’s narratives shed light on the impact and adverse effects of experiencing oppression on aspects of TGE teens, including their mental health, self-esteem, and sense of safety. Unique experiences underscore the intricate interplay between environments, gender identity journeys, and individuality. The discussion explores how the results align with and surpass existing literature, addressing the research question.

Mental health

The mental health challenges encountered by TGE teens underscore a spectrum of significant issues, ranging from acute concerns like suicidal ideation to pervasive struggles such as anxiety. Our study explored how cisnormative societal expectations and prejudices intensify the personal challenges faced by TGE individuals, thereby compounding their mental health struggles. Previous studies emphasize the mental health difficulties linked to oppressed TGE identities, encompassing gender dysphoria, disordered eating, anxiety, depression, and trauma (Hatchel et al., 2019; Saltis et al., 2023; Turban & Ehrensaft, 2018). The profound impact of misgendering aligns with research associating misgendering with psychological distress and heightened anxiety in same-aged and older populations (McLemore, 2018; Jacobsen et al., 2023).

In addition to well-documented challenges like suicidal ideation, addiction, and self-harm (Clark et al., 2014; Connolly et al., 2016; Reisner et al., 2015), our research sheds light on less-explored dimensions, including increased fatigue, heightened stress, reduced school engagement, and body dysphoria. TGE teens narratives illustrate the emotional strains associated with conforming to societal cisnormativity, aligning with previous studies on the distress caused by adhering to binary norms (McBride, 2020; McBride & Neary, 2021). The significant toll exacted by pervasive societal biases on TGE teens underscores the urgent need for nuanced interventions and supportive spaces to alleviate the multifaceted psychological impact. Such as TGE teens frustrations and emotional distress in the face of discrimination and transphobia, which aligns with existing literature (Johns et al., 2021). It is important to note that while we recognize the ability of marginalized individuals to overcome and transform their adversity, we must not hold them responsible for the barriers they encounter (Hart et al., 2016).

Research indicates that gender affirmation plays a pivotal role in promoting psychological well-being, evidenced by an improved quality of life (Passos et al., 2020; van Leerdam et al., 2023) and a reduction in anxiety, stress, depression, and suicidality (Fontanari et al., 2020; Hughto et al., 2020; Puckett et al., 2022; Russell et al., 2018; van Leerdam et al., 2023). TGE teens face elevated rates of psychological distress, anxiety, depression, suicidality, self-harm, social exclusion, gender dysphoria, eating disorders, and feelings of unsafety at school (Aitken et al., 2015; Hatchel et al., 2019; Holt et al., 2023; Turban & Ehrensaft, 2018). Notably, supportive environments that validate their identities are associated with decreased rates of depression, anxiety, suicidal ideation, and attempts (Ehrensaft, 2014; Hatchel & Marx, 2018; The Trevor Project, 2023; Turban & Ehrensaft, 2018), leading to improved mental health outcomes.

Self-esteem: Navigating societal pressures

The complex interplay between personal identity and societal norms is crucial to understanding self-esteem in TGE teens. Participants grapple with multifaceted challenges, including diminished self-worth and compromised family boundaries, underscoring the crucial need for interventions addressing the impact of societal language on self-esteem. For example, TGE teens with low self-esteem can turn to disordered eating to cope with stressors, such as bullying (Lawrence et al., 2023), and experiences of victimization contribute to lower self-esteem (Watson et al., 2019).

TGE teens narratives illustrated the emotional toll of misgendering on self-esteem, shedding light on the stress and frustration tied to pronoun struggles. Research has indicated when others refuse one’s gender identity, it causes distress and affects their self-esteem (Reyes et al., 2023). Misgendering negatively impacts self-esteem, while appropriate pronoun usage enhances it. Participants’ reflections reveal the difficulty of safely expressing diverse identities, particularly within constraints like those imposed by Catholic education. Reduced confidence or self-belief can significantly undermine self-esteem, and internalized transphobia is a key factor contributing to this negative impact (Austin & Goodman, 2017). This, in turn, extends its influence on overall health and well-being (Austin & Goodman, 2017; Bockting et al., 2020; van den Brink et al., 2020).

Confidently expressing one’s identity fosters healthy coping mechanisms, such as community connectedness and positive self-regard (Barr et al., 2016; Dziengel, 2015). Conversely, the lack of appropriate language and societal recognition deprives TGE individuals of essential resilience strategies and opportunities to build self-esteem. Barriers adversely affect self-esteem, contributing to the perception that TGE teens are undervalued by society and the medical system (Gridley et al., 2016; Nahata et al., 2017). Systematic reviews emphasize the critical role of self-esteem as a protective factor for TGE teens, calling for interventions that foster positive self-perception (Tankersley et al., 2021).

A synthesis of our participants’ narratives reveals intricate dynamics between personal identity, societal expectations, and self-esteem dimensions in TGE teens, contributing to a deeper understanding of their challenges and resilience. These insights collectively contribute to a nuanced understanding of the self-esteem challenges faced by TGE teens as they navigate the complex intersection of personal identity and societal pressures. The importance of gender affirmation emerges as a powerful mitigating factor, associated with lower internalized stigma, higher self-esteem, and stronger self-concept clarity (Doyle et al., 2021; Glynn et al., 2016; Puckett et al., 2022). Additionally, socially transitioned TGE children (6 − 14 years old) have shown no significant difference in self-worth compared to age and gender-matched controls or siblings (Durwood et al., 2017), suggesting social transitioning can improve one’s self-esteem. TGE teens actively reminding themselves of self-worth, value, hopes, and beliefs is a crucial coping mechanism in the face of societal challenges (Bockting et al., 2020; Owens et al., 2023; Singh et al., 2014; Smith et al., 2022), underscoring the importance of self-affirmation in navigating the complexities of being TGE.

Self-expression and body image: Navigating societal norms and shopping frustrations

The self-expression and body image experiences of TGE teens are interwoven with societal norms and impacted by oppression, as appearance and body satisfaction are central to one’s identity. These cisnormativity norms substantially influenced our participants, resulting in constrained facility use, obstructed expression, and a yearning to alter appearance among TGE teens. This further fostered feelings of inadequacy and contributed to delays in accessing gender-affirming care. Specific forms of oppression, notably misgendering, prompt behavioral shifts, compelling individuals to endure physical discomfort to alleviate emotional distress (Galupo et al., 2020). This pattern of behavior has also been indicated in previous research where oppression (e.g. misgendering) triggers body dysphoria, increasing depressive and psychological distress symptoms (Cooper et al., 2020; Julian et al., 2021; Reyes et al., 2023).

A pervasive theme surfaces in the pressure to ‘pass’ and conform to binary standards, impacting decision-making and future planning and inducing activity avoidance oppressive outcomes, such as dysphoria. The struggles of navigating conformity to masculine norms and the quest for safe expression underscore ongoing challenges imposed by societal expectations, emphasizing the vital need for spaces facilitating authentic self-expression. Challenges to authentic self-expression occurred particularly within conservative families, non-accepting schools, and non-affirming faith-based environments, with similar findings to ­previous research (Austin et al., 2023). Our participants highlighted the significance of alternative platforms, such as LARP club and theater, as judgment-free outlets for TGE teens, underscoring the role of these spaces in fostering authentic self-expression. For example, previous studies have indicated social media is a pivotal tool in TGE teens navigation and identity development (Cipolletta et al., 2017). Moreover, social media offers unique opportunities for authentic self-expression, which may not always be possible offline (McInroy & Craig, 2015).

TGE teens commented on paradoxical experiences in an educational environment, such as the musical production of Grease, which highlights the tension between empowerment and disconnection, exemplifying the intricate negotiation of their identity within a cisnormative normative structure, creativity, and self-expression. LGBTQ+ teens seek out LGBTQ+ content on digital media for self-expression and to negotiate sexual feelings (Byron et al., 2019; Clarke et al., 2018; Hanckel et al., 2019), for information on LGBTQ+ sexual health and relationships (Ferfolja & Ullman, 2017; Greene et al., 2015; Hobaica et al., 2019) and to find connections in digital spaces (Byron et al., 2019; Cannon et al., 2017).

Further exploration into self-expression and body image highlights our participants’ discontent with gendered shopping experiences, as they illustrated the constraints imposed by societal norms. Binary clothing options (men’s and women’s) often do not accommodate or reflect the self-expression needs of TGE (e.g. body image, identity, or values) people (Nelson & Hwang, 2021). Clothing can be the dual purpose of constructing an image and expressing individuality while strategically modifying, concealing, or revealing body size and shape to resonate with gender identity ideals or expression of femininity or masculinity. This highlights elevated body dissatisfaction among TGE individuals due to incongruence with their assigned gender at birth, compounded by societal expectations for gender-conforming appearances (Jones et al., 2016; Strübel & Goswami, 2022). Many strive for conventional attractiveness or cisnormative expressions to mitigate social stigma (Mizock & Hopwood, 2016). Research suggests that body image concerns in this population hinge on their position in the transition and self-acceptance journey (McGuire et al., 2016). The frustration with binary categories reflects a broader challenge in navigating societal expectations, leaving TGE teens confined by conventional gendered distinctions. Enabling social transition is crucial for creating safe, affirming environments that facilitate healthy identity development (Olson et al., 2016).

TGE teens were refused to partake in certain educational activities due to their gender identity, such as sporting and educational extracurricular activities. The barrier of not being able to express or engage in their interests resulted in a lack of control and negative mental health outcomes (e.g. reduction in mood). Previous studies have indicated that restrictions against TGE athletes on gender-congruent sports teams contribute to heightened body image concerns, emphasizing the impact of external factors on self-perception (Call et al., 2021; Clark & Kosciw, 2022; Jones et al., 2016; Genel, 2017). Internalization of oppressive comments is linked to increased body surveillance and dissatisfaction (Brewster et al., 2019)

This study’s participants conveyed the impact of financial barriers as substantial obstacles to authentic self-expression, hindering access to essential items like chest binders, gender-affirming clothing, hormones, and surgeries, similar to previous findings (Austin et al., 2023). Supportive social relationships and environments are instrumental in facilitating the healthy development of transgender identity (Lewis et al., 2021). Regrettably, our participants encountered adverse social reactions, particularly within familial contexts, upon expressing their gender identity, thereby influencing their decisions regarding self-expression. Aligning with existing research, the unsupportive responses from families, exemplified by rejection, significantly shape TGE teens self-expression and mental well-being (Reyes et al., 2023).

The examination of self-expression and body image among TGE teens illuminates the pervasive influence of societal norms, offering valuable insights into the intricate interplay between individual identity, societal expectations, and the challenges faced by TGE individuals in authentically expressing themselves within normative frameworks. These constraints underscore the urgent need for more inclusive and diverse representations to challenge societal expectations and nurture authentic self-expression. Conceptualizing TGE identity as a dynamic interplay between internal and external influences underscores the importance of acknowledging and addressing both dimensions (Doyle, 2022).

Adaptive responses to oppression

Our study unveils the negotiation of gender-affirming behaviors among TGE teens within oppressive environments, revealing their approach characterized by a reduced inclination to access (e.g. due to anticipated oppression) yet an increased desire for gender-affirming treatment and support. Corresponding with existing literature, TGE teens facing harassment, violence, and discrimination employ a range of coping strategies, including avoidance, risk-confronting, and empowerment strategies (Kosciw et al., 2016; Russell et al., 2011; Ybarra et al., 2014).

Expressions of a yearning for legal name changes alongside a reduction in the use of gender-affirming facilities among our participants underscore the multifaceted nature of their experiences. In navigating disclosure, TGE individuals strategically choose when and how to do so, diverging from binary outness models common among other stigmatized groups (Lewis et al., 2021). The reported barriers in accessing gender-affirming services due to fatigue (e.g. consistent self-advocacy or resilience burnout) emphasize the challenges faced by TGE teens in their pursuit of affirmation.

Participants’ experiences within sports competitions illustrate the complexity of gender-affirming behaviors, depicting both validation of gender identity and exclusionary practices within school settings. While authentic self-presentation positively influences psychological well-being, not all transgender individuals universally express or disclose their identities, particularly in contexts marked by prevalent stigma (Bockting et al., 2020; Hughto et al., 2020). The strategic disclosure management of one’s identity often stems from the imperative to avoid prejudice, discrimination, and violence in potentially hostile social environments (Bränström & Pachankis, 2021; Brumbaugh-Johnson & Hull, 2019). Importantly, asserting oneself through direct communication of one’s needs and views, particularly in the face of hostilities, enables the recognition of one’s needs and identities while resisting mistreatment (Bockting et al., 2020; Matsuzaka, 2018; Smith et al., 2022).

Participants’ narratives introduce the concept of delayed social transition, reflecting the challenges of balancing personal identity with societal expectations, especially in competitive environments. Adaptive responses to oppressive environments are evident in participants’ narratives, underscoring the pivotal role of affirming environments in fostering coping mechanisms. Increased affirmation of identity among TGE individuals correlates with greater self-certainty (Doyle et al., 2021; Hetzel & Mann, 2021), improving decision-making processes. However, fear of negative reactions leads some to refrain from expressing their gender identity (Abreu et al., 2022; Golden & Oransky, 2019) or accessing care (Chong et al., 2021; Hunt et al., 2020). Participants gravitated toward online and diverse spaces where they could freely express their identity (e.g. LARP), aligning with previous research highlighting the crucial role of online spaces for TGE individuals (Rothbaum et al., 2022).

This deepens our understanding of the adaptive strategies employed by TGE teens to navigate their gender identities in the face of oppression. Adaptive coping strategies empower individuals to confront cisnormative constraints, fostering comfort and pride in their gender identity (Alanko et al., 2019). For TGE teens, conscious decision-making and asserting control over life decisions represent forms of personal agency contributing to their well-being (Asakura, 2016; Shelton et al., 2018). Recognizing and studying these adaptive coping strategies and personal agency are crucial for understanding the experiences of TGE teens.

Limitations and implications for future research

While our study provides valuable insights into the impact of oppression on TGE teens, certain limitations should be acknowledged. Firstly, the study’s reliance on self-reporting may introduce bias, as participants might underreport or overemphasize certain experiences. The sample size and demographics of our participants may also limit the generalizability of our findings, as experiences within the TGE community can vary based on factors such as age, race, socioeconomic status, and geographic location. Moreover, the cross-sectional nature of our study captures a snapshot of experiences, but a longitudinal examination could offer a more nuanced understanding of the evolving dynamics of oppression on TGE teens. The diverse interpretations of oppression among participants (e.g. “Mistreatment and bullying” and “I’ve faced racism, transphobia, homophobia, ableism and possibly more”) and their varied experiences present a limitation, making it challenging to draw generalized conclusions about the nature and impact of oppression on the TGE community. Additionally, the study predominantly focuses on those between the ages of 14 and 17; capturing teen TGE individuals will be important for early support and intervention.

Building on the current study, future research should explore the intersectionality of identities within the younger TGE population, considering how factors such as race, neurodivergence, and geographic location intersect with gender identity to shape experiences of oppression. Longitudinal studies can provide a deeper understanding of the long-term impact of oppression and the efficacy of adaptive coping strategies over time. Comparative research across diverse cultural contexts would contribute to a more comprehensive understanding of how societal and cultural nuances influence the experiences of TGE teens. Additionally, there is a need for research that explores the effectiveness of various interventions, including support groups, educational programs, and mental health services, in mitigating the adverse effects of oppression on the mental health and well-being of TGE teens. Finally, developing and evaluating culturally competent and inclusive interventions and acknowledging the unique needs of TGE individuals would be essential for informing supportive policies and practices.

Conclusion

The participant narratives convey the adverse impact of oppression on their mental health, revealing a continuum of challenges ranging from anxiety and depression to heightened risks of self-harm and suicidal ideation. Moreover, the study sheds light on the complex interplay between societal pressures, gender dysphoria, and the internal struggles faced by these individuals. Our exploration of coping strategies, including avoidance, strategic disclosure, and the creation of affirming environments, highlights the adaptive responses employed by TGE teens to navigate oppressive contexts. It emphasizes the pivotal role of supportive spaces and nuanced interventions in alleviating the multifaceted psychological impact of oppression.

While acknowledging the limitations of our study, we advocate for future research that delves into the intersectionality of identities within the TGE teen population. Longitudinal studies, comparative research across additional cultural contexts, and investigations into the efficacy of interventions tailored to the unique needs of TGE individuals can contribute to a more comprehensive understanding and inform supportive policies and practices. In the pursuit of a more equitable and affirming world, it is imperative to amplify the voices of TGE teens, recognize the adaptive strategies they employ, and work collectively toward dismantling oppressive structures. Our study contributes to this ongoing dialogue, calling for continued research, advocacy, and the implementation of inclusive policies that foster environments conducive to the well-being and flourishing of TGE teens.

Informed consent

Informed consent was obtained from all individual participants included in the study.

Statement of human rights

The project was considered by the Monash University Human Research Ethics Committee. The Committee was satisfied that the proposal meets the requirements of the National Statement on Ethical Conduct in Human Research and has granted approval.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Additional information

Funding

The author(s) reported there is no funding associated with the work featured in this article.

Notes

1 “Gender expansive” includes identities such as genderqueer, nonbinary, gender non-conforming, or genderfluid (Delozier et al., 2020; Farmer et al., 2020).