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Malpas J, Pellicane MJ, Glaeser E. Family-Based Interventions with Transgender and Gender Expansive Youth: Systematic Review and Best Practice Recommendations. Transgend Health 2022; 7:7-29. [PMID: 36644030 PMCID: PMC9829155 DOI: 10.1089/trgh.2020.0165] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023] Open
Abstract
Research on transgender and gender expansive (TGE) youth has highlighted the disproportionate and challenging mental health and developmental outcomes faced by these young people. Research also largely suggests that family acceptance of TGE youth's gender identity and expression is crucial to preventing poor psychosocial outcomes in this community. Recently, family-based treatment has become common practice with TGE youth whose families are available for care, but it is unclear whether research provides outcome data for family interventions with TGE youth. This study follows Preferred Systematic Reviews and Meta-Analyses (PRISMA) guidelines to systematically review articles that provide outcome data or clinical recommendations for family-based interventions with TGE youth and their families. No quantitative outcome data for family therapy with TGE youth were found, but numerous articles spanning decades (n=32) provided clinical practice recommendations for family-based interventions with this population. Very few articles provided outcome data for family therapy with sexual minority youth (n=2). Over time, clinical strategies have moved from pathologizing to affirming of TGE youths' gender journey. Common clinical strategies of affirming interventions include (1) providing psychoeducation, (2) allowing space for families to express reactions to their child's gender, (3) emphasizing the protective power of family acceptance, (4) utilizing multiple modalities of support, (5) giving families opportunities for allyship and advocacy, (6) connecting families to TGE community resources, and (7) centering intersectional approaches and concerns. Future research should examine the efficacy of family-based interventions that incorporate these clinical strategies and collect quantitative data to systematically determine their effect on psychosocial outcomes.
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Affiliation(s)
- Jean Malpas
- The Gender & Family Project, Ackerman Institute for the Family, New York, New York, USA.,Private Practice, New York, New York, USA.,Address correspondence to: Jean Malpas, LMFT, LMHC, 1133 Broadway, Suite 1511, New York, NY 10010, USA,
| | - Michael J. Pellicane
- The Gender & Family Project, Ackerman Institute for the Family, New York, New York, USA.,Department of Psychological Sciences, Kent State University, Kent, Ohio, USA
| | - Elizabeth Glaeser
- The Gender & Family Project, Ackerman Institute for the Family, New York, New York, USA.,Department of Counseling Psychology, Teachers College Columbia University, New York, New York, USA
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Moreno-Bencardino C, Zuluaga L, Perez J, Cespedes C, Forero C, Fernandez N. Gender Dysphoria in the Pediatric Population: Initial Experience of a Transdisciplinary Group. Rev Urol 2021. [DOI: 10.1055/s-0041-1730327] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
Abstract
Introduction Although there is an increasing experience in the management of transgender individuals, this has not been thoroughly explored in children. The need to establish a comprehensive and transdisciplinary management is of critical importance. In order to solve this issue, we want to report the results of a cohort of individuals with gender dysphoria (GD) seen by our transdisciplinary group from a social and clinical and health access perspective.
Methods A 10-year retrospective case series of all patients that had been seen by our transdisciplinary team was reviewed. The main demographic characteristics were described, as well as impact variables in terms of diagnosis and treatment of these individuals. A social description of each individual was described. Frequency, distribution, and central tendency measures were evaluated for data presentation. IBM SPSS Statistics for Windows, version 24.0 (IBM Corp, Armonk, NY) software was used.
Results Four cases of GD were included. Three had male to female dysphoria and one female to male. The median reported age of GD awareness was 6 years old (between 4 and 8 years old), and the median time between GD awareness and the 1st medical evaluation was 7 years for all individuals. The median age at gender role expression was 12 years old (between 10 and 14 years old). All patients had already assumed their experienced gender role before the 1st evaluation by our group. The median age at the 1st evaluation by our group was 13 years old (between 10 and 16 years old); three of the patients were evaluated after initiation of puberty. In the present study, individuals with GD demonstrated having health care access barriers for their transition process. Referral times are high, and individuals with GD are cared after pubertal development, which is related to suboptimal outcomes. The spectrum of GD is broad, and management must be individualized according to expectations.
Conclusion Individuals with GD face multiple access barriers that limit their possibility of being seen by a transdisciplinary team. This reflects in longer waiting times that negatively impact medical management. Gender dysphoria is a wide spectrum, and individuals should be evaluated individually by a transdisciplinary team.
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Affiliation(s)
- Camila Moreno-Bencardino
- Division of Urology, Hospital Universitario San Ignacio, Pontificia Universidad Javeriana, Bogotá, D.C, Colombia
| | - Laura Zuluaga
- Urology Department, Fundación Santa Fe de Bogotá, Universidad de los Andes, Bogotá, D.C, Colombia
| | - Jaime Perez
- Division of Urology, Hospital Universitario San Ignacio, Pontificia Universidad Javeriana, Bogotá, D.C, Colombia
- Urology Department, Fundación Santa Fe de Bogotá, Universidad de los Andes, Bogotá, D.C, Colombia
| | - Camila Cespedes
- Pediatric Endocrinology Division, Hospital Universitario San Ignacio, Pontificia Universidad Javeriana. Bogotá, D.C, Colombia
| | - Catalina Forero
- Pediatric Endocrinology Division, Hospital Universitario San Ignacio, Pontificia Universidad Javeriana. Bogotá, D.C, Colombia
| | - Nicolas Fernandez
- Division of Urology, Seattle Children's Hospital, University of Washington, Seattle, WA, United States
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Davidson S, Morrison A, Skagerberg E, Russell I, Hames A. A therapeutic group for young people with diverse gender identifications. Clin Child Psychol Psychiatry 2019; 24:241-257. [PMID: 30246547 DOI: 10.1177/1359104518800165] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Young people are presenting to specialist gender services in higher numbers than before and many with significant psychosocial difficulties. Negative experiences of stigma, difficult peer relationships and discrimination exacerbate distress and psychological difficulties, negatively impacting wellbeing and resilience. Social support is advocated as a means of supporting young people with diverse gender identifications, such as through peer support groups. This article describes the establishment of a young persons' group in 2011 within the United Kingdom's Gender Identity Development Service (GIDS), for those attending the service as a means of enabling their coping with difficult experiences and facilitating their wellbeing and resilience through effective social support. The group was evaluated using qualitative and quantitative measures and has subsequently run each year. Now in its sixth year, the authors reflect on their learning and experiences.
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Affiliation(s)
- Sarah Davidson
- 1 Gender Identity Development Service, The Tavistock and Portman NHS Foundation Trust, UK
| | - Annabelle Morrison
- 1 Gender Identity Development Service, The Tavistock and Portman NHS Foundation Trust, UK
| | | | - Ian Russell
- 1 Gender Identity Development Service, The Tavistock and Portman NHS Foundation Trust, UK
| | - Anna Hames
- 1 Gender Identity Development Service, The Tavistock and Portman NHS Foundation Trust, UK
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