Background : Transgender adolescents consistently report higher rates of adverse mental health outcomes compared to their cisgender peers. Parental support is a recognized adolescent protective factor; however, little is known about the specific parental behaviors and attitudes that transgender adolescents perceive as most or least supportive. We qualitatively explored perceptions of parental support and rejection, including their psychosocial consequences, among an ethnically diverse sample of trans and non-binary adolescents.
Methods : Twenty-four trans and non-binary adolescents (ages 16-20) from New York City and the San Francisco Bay Area participated in the study. Qualitative data was gathered in two phases. In Phase one, we conducted “lifeline interviews,” inviting participants to visually depict their life histories along a timeline, displaying significant events in chronological order. At the end of the interview, we asked participants to take photos that corresponded to prompts about psychosocial resources (e.g. “Take photos that represent important sources of support”). In Phase two, participants returned with their photos, which were used to guide the second interview. All interviews were audio recorded, transcribed verbatim, coded, and analyzed using inductive thematic analysis.
Results : Participants described three categories of parental behaviors and attitudes: supportive, rejecting, and mixed (i.e. simultaneous supportive and rejecting behaviors and attitudes). For example, supportive behaviors included instances where parents made independent efforts to become more informed about trans issues or when they helped their child to obtain gender affirming health care. Rejecting behaviors included instances when parents refused to use their child’s name or pronouns or demonstrated a lack of empathy when their child struggled with gender identity-related challenges. Mixed behaviors included cases where parents expressed support of their child’s gender identity, but not of their sexual orientation (or vice versa). Overall, participants reported that rejecting and mixed parental behaviors and attitudes contributed to a range of psychosocial problems (e.g., depression and suicidal ideation), while supportive behaviors and attitudes increased positive well-being.
Conclusions : The results of this study add to the extant literature by offering a more nuanced understanding of how trans and non-binary adolescents experience and perceive parental support and rejection. Participants described a range of supportive, rejecting, and mixed parental behaviors and attitudes that can help practitioners design more effective interventions and services for trans and non-binary adolescents and their families. The parental support themes identified in this study could also be used to create better quantitative measures of parental support for use in future longitudinal studies with trans and non-binary adolescents.