“I knew that I wasn’t cis,I knew that,but I didn’t know exactly”: Gender identity development,expression and affirmation in youth who access gender affirming medical care

Abstract

Background: Research about gender identity development is still in its infancy, especially among youth who experience gender dysphoria and are accessing gender-affirming medical care.

Aims: This article contributes to the literature on how gender identity and gender dysphoria is experienced, expressed and addressed by youth who have started, or are just about to start, a gender-affirming medical intervention.

Methods: The project draws from qualitative interviews with 36 trans children and youth of different ages and stages of puberty. The data were collected in three specialized Canadian clinics that offer gender-affirming care and they were analyzed through inductive thematic analysis.

Results: Two interlinked dimensions of the youth’s lives allow meaning-making of their gender identity: 1) internal or personal and 2) interactional or social processes. Careful analysis reveals three gender identity development pathways that may be taken by youth, from early questioning to the affirmation of their gender identity. A discussion of current models of gender identity development and their limitations concludes the article.     

Age and pre quit-day attrition during smoking cessation treatment

ABSTRACT

The present study aimed to replicate the finding that younger age predicts higher pre quit-day attrition. Our second aim was to explain this relation by examining empirically and theoretically informed age-related risk factors for low smoking cessation treatment engagement. 136 participants (M _age = 44.2 years, SD = 11.3 years; age = 22–64 years) were randomized to 15-weeks of either 1) an exercise intervention (n = 72) or 2) a wellness education control condition (n = 64). First, a logistic regression analysis was employed to test whether younger adults were more likely than older adults to drop prior to quit date. Next, we assessed whether smoking related health concerns, social expectancies, and/or perceived severity of craving affected the strength of the relation between age and attrition, by adding these three variables to the logistic regression along with age. The logistic regression model indicated that younger age and treatment condition were significantly related to the odds of dropping from treatment prior to the scheduled quit date. Further, health concerns, social expectancies, and/or perceived severity of cravings did not account for the effect of age on pre quit-day attrition. These findings highlight the importance of identifying empirically and theoretically informed variables associated with the pre quit-day attrition problem of young smokers.     

How to address the caveat of avoiding direct contact: Reducing prejudice towards gay and lesbian people in five Balkan countries

ABSTRACT

In the Balkans, contact with gays and lesbians is typically hostile or avoided. Drawing from probability samples of young people from five Balkan countries (N = 1046), we examined whether it is possible to transfer the effects of contact with other marginalized outgroups (largest ethnic minority in every country, Roma, the extremely poor and physically disabled) to acceptance of gays and lesbians (secondary outgroup), and whether this relationship could be explained by attitude generalization and increased intergroup trust. Path analyses supported the secondary transfer effect: it confirmed that, while controlling for direct contact, contact with other marginalized groups was related to more acceptance of a secondary group; this relationship was mediated by trust. This was found across all primary groups in the combined samples, while the effect varied for different groups in country samples. The results add to the value of intergroup contact as a mean of prejudice-reduction.     

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.     

Weak Ties for a Weak Population: Expanding Personal Social Networks Among the Unemployed to Increase Job‐Seeking Success

Unqualified middle‐aged and older unemployed people have little chance of finding a suitable job via Internet‐based systems. These individuals have a low education level, fewer technological skills, and low self‐esteem as a result of long‐term unemployment; therefore, their relevant job opportunities diminish. This article describes a successful pilot project among 108 chronically unemployed Jews and Arabs in 5 employment centers in Israel. By sharing each other's lists of acquaintances under the guidance of professional consultants, 41% of them found a job. The results have strengthened the authors' assumption that educating people to use expanded weak personal networks (non‐Internet) to find jobs is both effective and beneficial.     

‘If they didn’t support me,I most likely wouldn’t be here’: Transgender young people and their parents negotiating medical treatment in Australia

Abstract

Background: It is increasingly recognized that transgender young people require affirming medical care, however the provision of such care may be mitigated by the availability of services and the views of parents.

Aims: This study aimed to explore the views of Australian transgender young people (aged 11–17) and their parents with regards to medical treatment.

Methods: Ten qualitative interviews were conducted with parent-child dyads in two Australian states. Thematic analysis was undertaken on responses to interview questions related to family relationships, views about medical treatment (specifically hormone blockers and hormones), and the relationship between medical treatment and sense of self.

Results: Themes developed focused on the importance of strong supportive parent-child relationships, the meaning of and access to hormone blockers, and the meaning of and access to hormones.

Discussion: The paper concludes by discussing the implications of the findings for clinical services, particularly in relation to supporting parents to be affirming of a transgender child, the need to prepare transgender young people and their parents for the passage of time in regards to medical treatment, and the need to focus on expectations in regards to sense of self in relation to medical treatment.     

Family Therapy for Substance Use among Sexual Minority Youth: A Review of Treatment Options

Abstract

Substance use disorders are nearly twice as common among sexual minority youth (SMY) as among their heterosexual peers. Most applied literature about this population suggests interventions on either the individual or community level, and the benefits of family therapy for this population are often overlooked. The present literature review (a) outlines clinical knowledge related to sexual minority youth and substance use (e.g., prevalence rates, contributing factors), (b) discusses the importance of clinical self-awareness around these topics, and (c) outlines clinical behaviors and interventions from literature that may be employed when working with substance-using SMY and their families.     

Therapeutic and counter-therapeutic factors in acute ward settings

Summary

Recent reports suggest that many patients view their admission to a psychiatric acute unit as an unrewarding, distressing or undermining experience. Whilst it could become genuinely therapeutic, in the sense that it could be an opportunity for self-reflection, personal exploration or change, it is often endured as a traumatic event in one's life that should best be forgotten.

This paper explores a psychodynamic understanding of this multi-personal environment in which transference phenomena develop and are usually ‘acted out’. The admission process is examined, as well as the importance of understanding the support and attachment to fellow patients, staff-patient tensions, and relationships between staff and management. Issues about violence and fear, locked wards, and reflective interventions on a unit are discussed, focusing on how to maximise therapeutic opportunities. The multi-disciplinary ward-review is also scrutinised in this light.