Two new studies on transgender and gender nonconforming youth have been published in last month’s volume of Pediatrics that provide further evidence that young people need to be accepted and affirmed for their identities. Not only do they face severe mental health consequences from stigma, but they are at higher risk for family abuse as well.
The first study (full article) found that young people who experience gender dysphoria but cannot access treatment face higher rates of psychiatric problems. Many of the kids in this study (21.6 percent) already had a history of self-mutilation or attempted suicide before seeking treatment, but helping them achieve congruence between mind and body alleviated the mental health burden. The study recommended that doctors and counselors work with families to affirm gender variation so that it does not become a source of internal conflict for the transgender child.
This approach is not without its own challenges, as the second study (full article) found that stigma against gender variation is often too close to home. In fact, gender nonconformity is a high risk factor for children to be sexually, physically, or psychologically abused, and that abuse can lead to a lifetime of post-traumatic stress disorder that often goes untreated. The abuse can reflect parents’ discomfort with gender nonconformity, their homophobia, or a sense that their own parenting is to blame.
An accompanying editorial highlights the fact that not all young people who question or explore their gender are truly transgender, but the available research indicates the importance of affirming that exploration and assessing potential challenges the child might face:
The pediatrician or family medicine doctor should be on the lookout for the child who is gender nonconforming… The pediatrician who observes gender nonconformity should address the issue straightforwardly and look for a number of associated psychosocial problems including abuse, PTSD, difﬁculty in school, depression, or increased anxiety. Referral to and working with the mental health professional provides a good safety net for the child as he/she struggles with exploration of gender orientation, gender, and gender role as well as the related conditions. If indicated, adolescent patients might be referred to a pediatric endocrinologist for help in getting a better long-term physical outcome.
Though conservatives consistently object to any discussion of LGBT issues with young people, it seems it is young people and their families who need those conversations most.