What about the family in youth gender diversity? A literature review

Abstract

Background: Previous research has suggested that gender diversity affects everyone in the family, with positive mental health and global outcomes for gender diverse youth reliant on receiving adequate family support and validation. Although the individual mental health, treatment and outcomes for gender diverse youth have received recent research attention, much less is known about a family perspective. Hence, a review of the literature exploring youth gender diversity from a family perspective is warranted.

Aims: To systematically identify, appraise and summarize all published literature primarily exploring gender diversity in young people under the age of 18?years, as well as selected literature pertaining to a family understanding.

Methods: Six electronic databases (CINAHL, MEDLINE, EMBASE, PsycINFO, SCOPUS, Web of Science) were searched for relevant literature pertaining to youth under the age of 18?years.

Results: Research evidence was consistently found to support the beneficial effects of a supportive family system for youth experiencing gender diversity, and a systemic understanding and approach for professionals. Conversely, lack of family support was found to lead to poorer mental health and adverse life outcomes. Few articles explored the experience of siblings under the age of 18?years.

Discussion: This literature review is the first to critically evaluate and summarize all published studies which adopted a family understanding of youth gender diversity. The review highlighted a lack of current research and the need for further targeted research, which utilizes a systemic clinical approach to guide support for gender diverse youth and family members.     

Racial exclusion causes acute cortisol release among emerging-adult African Americans: The role of reduced perceived control

ABSTRACT

Racial discrimination contributes to stress-related health disparities among African Americans, but less is known about the acute effects of racial exclusion on the hypo-pituitary-adrenocortical response and psychological mediators. Participants were 276 Black/African American emerging-adults (54% female; M _age = 21.74, SD = 2.21) who were randomly assigned to be excluded or included by White peers via the game Cyberball. Racial exclusion (vs. inclusion) predicted: greater negative affect (F(1, 276) = 104.885, p < .0001), lower perceived control (F(1, 276) = 205.523, p < .0001), and greater cortisol release (F(1, 274) = 4.575, p = .033). Racial exclusion’s impact on cortisol release was mediated by lower perceived control (95% CI: .027, .112), but not negative affect (?.041, .013). These findings suggest that racial exclusion contributes to acute cortisol release, and that reduced perceived control is a consequence of racial discrimination that has important implications for the health of those who experience discrimination.     

Friendlessness and theory of mind: A prospective longitudinal study

Chronic friendlessness in childhood predicts adverse mental health outcomes throughout life, yet its earliest roots are poorly understood. In theory, developing a theory of mind (ToM) should help children gain mutual friends and one preschool study (Peterson & Siegal, 2002. Br J Dev Psychol, 20, 205) suggested a cross‐sectional connection. We therefore used a 2‐year prospective longitudinal design to explore ToM as a predictor of mutual friendship in 114 children from age 5 to 7 years after controlling potential confounds including language ability and group popularity. Confirming friendship's distinctiveness from group sociometric status, numerous group‐rejected children (53%) had a mutual friend whereas 23% of those highest in group status did not. Five‐year‐olds with a mutual friend significantly outperformed their friendless peers on a comprehensive ToM battery (basic and advanced false belief). Longitudinally, chronically friendless 7‐year‐olds (no friends at either testing time) stood out for their exceptionally poor Time 1 ToM understanding even after controlling for group popularity, age, and language skill. Extending previous evidence of ToM's predictive links with later social and cognitive outcomes, these results for mutual friendship suggest possible interventions to help reduce the lifelong mental health costs of chronic friendlessness.     

From fancy to reason: Scaling deaf and hearing children's understanding of theory of mind and pretence

We examined deaf and hearing children's progression of steps in theory of mind (ToM) development including their understanding of social pretending. Ninety‐three children (33 deaf; 60 hearing) aged 3–13 years were tested on a set of six closely matched ToM tasks. Results showed that deaf children were delayed substantially behind hearing children in understanding pretending, false belief (FB) and other ToM concepts, in line with their delayed uptake of social pretend (SP) play. By using a scaling methodology, we confirmed previous evidence of a consistent five‐step developmental progression for both groups. Moreover, by including social pretence understanding, both deaf and hearing children's ToM sequences were shown to extend reliably to six sequential developmental steps. Finally and focally, even though both groups' sequences were six steps long, the placement of pretence relative to other ToM milestones varied with hearing status. Deaf children understood social pretending at an earlier step in the ToM sequence than hearing children, albeit at a later chronological age. Theoretically, the findings are relevant to questions about how universal developmental progressions come together along with culturally distinctive inputs and biological factors (such as hearing loss) to set the pace for ToM development.     

Using circular questions to explore individual family member experiences of youth gender dysphoria in Australia

Abstract

Background: The number of young people reporting gender dysphoria is increasing worldwide, with gender dysphoria known to affect everyone in the family in unique ways. Previous research has highlighted the importance of family support and understanding; however, much less is known about individual and collective family member experiences, particularly for siblings under the age of 18?years.

Aims: This study sought to identify, describe and interpret individual family member experiences of youth gender dysphoria using semi-structured interviews, incorporating circular questioning, within a whole of family, clinical and wider social context.

Methods: Thirty-five individual family members living in Australia (nine young people aged 12-17?years experiencing gender dysphoria, 10 mothers, eight fathers, and eight siblings aged 11-17?years) were interviewed, exploring positive and negative experiences of youth gender dysphoria, within and outside of the family. Family relationships, support and healthcare experiences were also explored.

Results: All participants reported a mixture of positive and negative experiences of youth gender dysphoria. Levels of acceptance tended to change with the duration of transition, with most family members adapting with time. Siblings reported mixed experiences within the same family, with some struggling to adapt. Most family members felt that including the whole family in the healthcare of the young person was important, although dependent on individual circumstances and family context. Specialist gender care experiences were unanimously positive, although services were considered difficult to access.

Discussion: Family members reported shared and individual positive and negative experiences of youth gender dysphoria across social contexts. Accepting and facilitating gender transition for young people appeared to improve individual and family functioning. Most participants valued a whole of family approach within specialist healthcare. The use of circular questioning in the study helped dispel assumptions and facilitated curiosity for others’ experiences in the family.