Jenifer K. McGuire

Young Adult Psychological Outcome After Puberty Suppression and Gender Reassignment

BACKGROUND: In recent years, puberty suppression by means of gonadotropin-releasing hormone analogs has become accepted in clinical management of adolescents who have gender dysphoria (GD). The current study is the first longer-term longitudinal evaluation of the effectiveness of this approach. METHODS: A total of 55 young transgender adults (22 transwomen and 33 transmen) who had received puberty suppression during adolescence were assessed 3 times: before the start of puberty suppression (mean age, 13.6 years), when cross-sex hormones were introduced (mean age, 16.7 years), and at least 1 year after gender reassignment surgery (mean age, 20.7 years). Psychological functioning (GD, body image, global functioning, depression, anxiety, emotional and behavioral problems) and objective (social and educational/professional functioning) and subjective (quality of life, satisfaction with life and happiness) well-being were investigated. RESULTS: After gender reassignment, in young adulthood, the GD was alleviated and psychological functioning had steadily improved. Well-being was similar to or better than same-age young adults from the general population. Improvements in psychological functioning were positively correlated with postsurgical subjective well-being. CONCLUSIONS: A clinical protocol of a multidisciplinary team with mental health professionals, physicians, and surgeons, including puberty suppression, followed by cross-sex hormones and gender reassignment surgery, provides gender dysphoric youth who seek gender reassignment from early puberty on, the opportunity to develop into well-functioning young adults.

Factors Associated With Desistence and Persistence of Childhood Gender Dysphoria: A Quantitative Follow-Up Study

OBJECTIVE To examine the factors associated with the persistence of childhood gender dysphoria (GD), and to assess the feelings of GD, body image, and sexual orientation in adolescence. METHOD The sample consisted of 127 adolescents (79 boys, 48 girls), who were referred for GD in childhood (<12 years of age) and followed up in adolescence. We examined childhood differences among persisters and desisters in demographics, psychological functioning, quality of peer relations and childhood GD, and adolescent reports of GD, body image, and sexual orientation. We examined contributions of childhood factors on the probability of persistence of GD into adolescence. RESULTS We found a link between the intensity of GD in childhood and persistence of GD, as well as a higher probability of persistence among natal girls. Psychological functioning and the quality of peer relations did not predict the persistence of childhood GD. Formerly nonsignificant (age at childhood assessment) and unstudied factors (a cognitive and/or affective cross-gender identification and a social role transition) were associated with the persistence of childhood GD, and varied among natal boys and girls. CONCLUSION Intensity of early GD appears to be an important predictor of persistence of GD. Clinical recommendations for the support of children with GD may need to be developed independently for natal boys and for girls, as the presentation of boys and girls with GD is different, and different factors are predictive for the persistence of GD.

Adolescent Sexual Risk and Multiple Contexts : Interpersonal Violence, Parenting, and Poverty

In this study we estimated the combined effects of violence experiences, parenting processes, and community poverty on sexual onset, alcohol or other drug (AOD) use at last sex, multiple sex partners, and prior pregnancy in a sample of 7th-, 9th-, and 11th-grade adolescents (n = 7,891), and the subsample of sexually experienced adolescents (n = 2,108). Multilevel multivariate logistic regression analyses revealed that having experienced any interpersonal violence, and low levels of perceived parental warmth and parental knowledge predicted sexual onset. Adult sexual abuse or peer sexual coercion increased the odds for AOD use at last sex and having multiple sexual partners. When demographic, violence experiences and parenting behaviors were accounted for, poverty was not associated with sexual onset, AOD use at last sex, or multiple sex partners. Results suggest prevention efforts to reduce teen dating violence may be especially important to diminish sexually risky behaviors among adolescents.

LGBTQ-inclusive curricula: why supportive curricula matter

There is growing attention to lesbian, gay, bisexual, transgender, queer and questioning (LGBTQ) issues in schools, including efforts to address such issues through the curriculum. This study examines whether students’ perceptions of personal safety and school climate safety are stronger when curricula that include LGBTQ people are present and supportive. LGBTQ and straight middle and high school students from California (1232 students from 154 schools) participated in the 2008 Preventing School Harassment survey. They reported their experience of LGBTQ-inclusive curriculum, its level of supportiveness and perceptions of safety. Multilevel methods allowed for an examination of differences between individuals in the same school while controlling for differences between schools. LGBTQ-inclusive curricula were associated with higher reports of safety at the individual and school levels, and lower levels of bullying at the school level. The amount of support also mattered: supportive curricula were related to feeling safer and awareness of bullying at the individual and school levels. The implications of school- versus student-level results for educational policy and practices are discussed.

Body image in transgender young people: Findings from a qualitative, community based study.

The goal of this study was to examine the ways in which transgender youth experience their bodies with regard to gender and body size. Ninety transgender youth and young adults completed in-depth interviews in eight metropolitan areas of the United States, Canada, and Ireland. Using a queer perspective, qualitative analyses revealed two broad conceptual categories: body dissatisfaction and body satisfaction. Within these categories, participants focused on body issues related to gender characteristics and body size. Findings revealed evidence of self-criticism and social distress related to body image dissatisfaction and self-acceptance and social acceptance related to body image satisfaction. Data demonstrated how gender, body size, and the intersection of gender and body size influenced personal perceptions of body dissatisfaction and satisfaction. Developmental processes were evident: participants further along in consolidating a gender identity described gaining a sense of social awareness, self-acceptance, and body satisfaction reflecting a sense of resilience.

A Person-Centered Approach to the Multifaceted Nature of Young Adult Sexual Behavior

Young adult sexual relationships were examined using a multifaceted, person-centered approach with data from Wave 7 (aged 20–21; N = 1,126) of the Michigan Study of Adolescent Life Transitions. The study utilized hierarchical cluster analyses based on the following measured variables: frequency of sex, importance of regularly having sex, satisfaction with sex life, experience of coercion for sex, and sexual risk reduction. Five distinct clusters emerged for females (Satisfied, Moderate, Active Unprotected, Pressured, and Inactive) and represented patterns such as more partners paired with less risk reduction (Active Unprotected), high satisfaction paired with frequent sex and high-risk reduction (Satisfied), or higher levels of coercion paired with low satisfaction and low-risk reduction (Pressured). Similar clusters emerged for males, with one additional cluster: the Dissatisfied cluster. Clusters differed with respect to relationship status, marital status, and psychological well-being (both males and females) and parental divorce, living situation, and sexual orientation (females only).

COPARENTING IN THE DIGITAL ERA: EXPLORING DIVORCED PARENTS’ USE OF TECHNOLOGY

Abstract Purpose The current study was designed to examine how and why divorced parents use computers and the Internet for communication with their coparent and with their child(ren). Methodology/approach The current study utilized the uses and gratification perspective. A subsample of 178 divorced parents with at least one child aged 25 or younger from a larger research project participated. Parents were recruited to participate in a 15-minute online survey through email listservs with a nationwide and demographically diverse reach. Findings Analyses revealed that divorced parents are active users of technology, for communicating with their child(ren) as well as with the child(ren)’s other parent. In addition, parents were comfortable using the Internet and accessing online parenting information, citing few barriers to use. Research limitations/implications We did not capture the reasons for communicating or the content of communication. Future research should use innovative methodologies and measures to better understand the use of specific technologies and tools to negotiate boundaries between coparents living apart. In addition, a larger, more diverse sample might reveal different patterns of divorced parents’ technology use. Practical implications Technology allows for asynchronous communication, staying up to date, making plans, and making decisions with minimal interaction, and thus maintaining boundaries. Our evidence suggests technology could help parents find areas of agreement around their children’s lives in a less contentious environment. Originality/value This study provides the essential groundwork for further examination of ways to support coparent communication via technology.

Gender identity development, a biopsychosocial perspective

From the first time individuals described a felt incongruence between their assigned and their experienced gender, people have been interested in the origins of gender dysphoria and transsexualism. This chapter focuses on the various theories and research evidence about gender identity development, which have often pointed to a biological, a psychological, or a social factor as determining one’s gender identity. Over time, differing views prevailed, although the multiple perspectives also developed parallel to one another. Two distinct lines of research on gender identity development emerged: those focused on “normative” development and those focused on nonnormative or gender-variant development. The chapter first describes the multiple factors (biological, psychological, and social) that were studied in both lines of research. After that, current studies are presented that give evidence for a complex interaction of biological, psychological, and social factors in gender identity development. Recent findings from neuroimaging and genetic studies of individuals with gender dysphoria provide evidence that nature is of importance. Its exact role however remains largely enigmatic.

Perspectives of Mothers of Transgender and Gender-Nonconforming Children With Autism Spectrum Disorder

ABSTRACT This study represents findings from interviews at two time points with three mothers of transgender and gender-nonconforming (TGNC) children (ages 8 to 12 years at T1) with autism spectrum disorder (ASD). Of interest was the mothers’ experiences of raising a TGNC child with ASD, and whether/how the children’s autism played a role in their understandings of their children’s gender identities and expressions. The mothers’ fear of a transphobic/cisnormative society and wondering about whether their children’s ASD influenced or caused their children’s gender variance were barriers to fully embracing their children’s gender nonconformity. Unclear causes of children’s social/emotional difficulties and lack of adequate resources and support were identified challenges. Positive interventions and resources were also discussed. Recommendations for clinicians and other professionals who serve TGNC youth with autism and their families are presented.

Institutionalising science‐based practices in children's services

Over the past 30 years, researchers have documented effective, theory‐based programmes and practices that improve the health and well‐being of children. In order to produce measurable improvements in public health, such practices must be institutionalised; however, there are a number of barriers to translating what we know from science to what we do in practice. In the present article, we discuss a number of those barriers, including: cultural differences between those who espouse a public health, prevention science approach versus those who espouse a strengths‐building, health promotion approach; practical difficulties in documenting the evidence base for existing or newly developed programmes and practices; and inflexibility of standardised programmes and resulting insensitivity to local contexts. We discuss common ground between prevention and promotion perspectives and highlight emerging methods that facilitate the adoption of science‐based practice into community‐based services.