Trans,gender diverse and non-binary adult experiences of social support: A systematic quantitative literature review

Abstract

Background: Trans, gender diverse and non-binary (TGDNB) adults experience significant health disparities relative to their cisgender peers. While social support is a known health-protective factor within the general population, no systematic reviews of TGDNB experiences of social support exist.

Aim: To systematically review prior research of social support for TGDNB adults. We sought to assess the defining characteristics of the research, the participants and the research findings, mapping emerging trends across disciplines.

Methods: Six electronic databases (PubMed, MEDLINE, CINAHL, Web of Science, LGBT Life and PsycNet) were searched for literature pertaining to TGDNB adults, social support, and health or well-being published in the past decade.

Results: The findings illustrate a predominance of USA-based quantitative research that measures social support of friends, family and a singular intimate partner. The majority of participants were white, binary-identified transgender women and TGDNB people living in metropolitan settings. Social support was commonly reported as a protective factor, with TGDNB peer support the most frequently reported correlate of health and well-being for TGDNB adults.

Discussion: The results suggest standardized inventories do not capture the emic nature of social support for TGDNB adults. A key opportunity lies in an inductive, hypothesis-forming approach to the study of what is socially supportive for TGDNB adults. In turn, this knowledge will enable the appropriate measurement, implementation and interpretation of social support studies.     

The Gender Congruence and Life Satisfaction Scale (GCLS): Development and validation of a scale to measure outcomes from transgender health services

Background: It is vital that the treatment offered at transgender health services can be evaluated to ensure a high quality of care. However, the tools currently used to evaluate treatment at transgender health services are limited by mainly focusing on mental health or because they have been developed for binary transgender people only. This study therefore aimed to develop and validate a tool that addresses these limitations. The Gender Congruence and Life Satisfaction Scale (GCLS) was developed through reviewing the literature, conducting interviews with transgender people, and holding discussions with experts working in transgender healthcare. An initial pool of items was developed and feedback on these was obtained. The tool was then validated.

Method: For the validation of the tool, a total of 789 participants (451 transgender [171 transgender females, 147 transgender males, 133 people identifying as non-binary], and 338 cisgender [254 females, 84 males]) were recruited from the United Kingdom to test the factor structure and validity of the GCLS.

Results: Exploratory factor analysis retained 38 items which formed seven subscales (psychological functioning; genitalia; social gender role recognition; physical and emotional intimacy; chest; other secondary sex characteristics; and life satisfaction). These seven subscales were found to have good internal consistency and convergent validity. The GCLS was also found to be capable of discriminating between groups (e.g., people who have and have not undergone gender affirming medical interventions). Transgender and cisgender subscale norms are provided for the GCLS.

Conclusion: The GCLS is a suitable tool to use with the transgender population to measure health-related outcomes for both clinical and research purposes.     

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.     

Expressive suppression and financial risk taking: A mediated moderation model

This research aimed to investigate the relationship between the habitual use of expressive suppression, a type of emotion regulation strategy, and risk taking in the financial domain. It also attempted to further examine gender as a possible moderator of this relationship and to explore the anticipated emotion related to negative potential outcomes as the mechanism behind this moderated effect. Two studies were conducted for these purposes. In Study 1, a total of 657 college students completed a test battery, including both the Emotion Regulation Questionnaire and the Grable and Lytton Risk Tolerance Scale. The results showed that expressive suppression was negatively related to financial risk taking, and gender moderated this relationship. In Study 2, 441 college students took a test battery including both the Emotion Regulation Questionnaire and a financial investment allocation task. The results replicated the findings in Study 1 and indicated that the anticipated emotion related to negative potential outcomes fully mediated the moderated effect of gender in the suppression-financial risk taking association. These findings implied the importance of considering gender differences in the prediction of financial choices from the perspective of emotion regulation.     

Long-Term Self-Regulation Moderates the Role of Internal Resources for Resilience in Positive Youth Development in Portugal

Abstract

Positive Youth Development (PYD) presents a strength-based conception of transition to adulthood that has been well-supported by literature to date. However, research is needed to integrate the pathways to PYD and the possible moderators. This study aimed to analyze the relationships between internal resources for resilience and PYD and to examine the moderating role of short-term and long-term self-regulation by gender. To reach this overall aim, a cross-sectional study was performed with a national sample of 2700 youths (73.3% girls; M_age = 21.3, SD?=?2.79) from Portugal, who completed self-report measures. Regression-based moderation models were developed. Results indicated that greater presence of internal resources for resilience was related to higher PYD. Long-term self-regulation and gender moderated this relationship, such that a greater effect was observed in men with high levels of long-term self-regulation. These results highlight the need to integrate prevention and promotion paradigms to foster healthy development in youth, as well as the importance of taking self-regulation skills and gender into account in program design.     

Intersections of Queer art and African Indigenous Culture: The Case of Inxeba (The Wound)

ABSTRACT

This article assesses some recurrent criticisms based on respect for traditional culture levelled at artworks that thematise non-heteronormative gender positionalities in South Africa. More specifically, it reconsiders the stormy, local reception of the South African movie Inxeba (The Wound), a queer love story set in the context of the male initiation rites of the Xhosa community. The article focuses on criticisms of the movie based on the alleged misrepresentation and misappropriation of indigenous cultural practices. It aims to reflect on the complicated knot of problems that queer artists and activists have to navigate in South Africa, including entrenched heteronormative traditions, but also multiculturality and racial privilege. New ways of negotiating these problems are proposed through the development of a more complex topographical account of the intersections of multiple forms of marginality, as well as through the application of multiculturalist theories regarding ways to assist oppressed minorities in traditional cultures.     

Mental health and quality of life in non-binary transgender adults: a case control study

Abstract

Background: The social challenges that non-binary people experience, due in part to social intolerance and the lack of validation of non-binary gender identities, may affect the mental health and quality of life of this population. However, studies that have distinguished between non-binary and binary transgender identities are lacking.

Aim: To compare the mental health and quality of life of a community sample of non-binary transgender adults with controls (binary transgender people and cisgender people) matched on sex assigned at birth.

Method: A total of 526 participants were included. Ninety-seven were classified as non-binary and were compared with two control groups: 91 people classified as binary and 338 cisgender people. Only transgender people not on gender affirming hormone treatment or who had not undergone gender affirming surgery were included. Participants were invited to complete an online survey that included mental health and quality of life measures.

Results: Non-binary people reported significantly better mental health than binary transgender people, but worse than cisgender people. Overall, there were no significant differences in quality of life between non-binary and binary transgender participants assigned male at birth and transgender females, but non-binary assigned males at birth had better scores on the psychological and social domains of quality of life than transgender males. Quality of life was better across all domains in cisgender people than transgender groups.

Conclusion: There is an inequality with regard to mental health and quality of life between non-binary (and binary) transgender people and the cisgender population that needs to be addressed. The better mental health scores in non-binary people may reflect lower levels of body dissatisfaction among the non-binary population. Mental health problems and poor quality of life are likely to have social causes and hence legislative measures and broader government-led inclusive directives should be put in place to recognize and to validate non-binary identifying people.