Pediatric Gender Diversity Beyond the Binary: An Exploration of Gender-Affirming Care for Nonbinary and Genderqueer Youth Seen Over Time at a Single Institution Gender Center

Purpose

The nonbinary and genderqueer (NBGQ) youth population is growing, yet scant research focuses on this distinct group. We aim to gain a deeper understanding of desired gender-affirming care and interventions pursued by NBGQ youth.

Methods

A retrospective chart review of NBGQ patients seen at the University of California, San Francisco Child and Adolescent Gender Center from January 1, 2009, to December 31, 2020, was performed. Demographic information, desired gender-affirming care, and gender-affirming interventions pursued at initial and most recent visits were collected.

Results

Initial visit charts of 116 NBGQ youth who attended more than one clinic visit were reviewed. In total, 48 unique genders were documented; gender evolved over time for some youth, as did desired gender-affirming care. At the most recent visit, 15 youth (12.9%) had a binary gender, and 101 youth (87.1%) had an NBGQ gender. At the initial visit, 56 youth (48.3%) were interested in gender-affirming hormone therapy, compared with 75 youth (65.6%) at the most recent visit. In addition, 21 (18.1%) and 49 (42.2%) youth were interested in surgery at the initial and most recent visits, respectively. In general, interest in interventions was higher than pursuit of interventions.

Conclusion

There is vast diversity of gender and differences in desired gender-affirming care within the NBGQ youth population. Desires for gender-affirming care within the cohort changed over time, and not all those who expressed a desire for an intervention received it. The reasons are likely multifactorial, highlighting the need for expectation-free and patient-specific affirming care and research on the NBGQ youth population, while also considering barriers to care.

Sex differences and athletic performance. Where do trans individuals fit into sports and athletics based on current research?

There are well known sex differences in parameters of physical fitness/performance due to changes occurring during sexual development. Thus, many sport and athletic events have regulations separating male and female participants. However, the inclusion or exclusion of transgender individuals in athletics has recently received outsized attention despite relatively few cases of transgender athletes. When determining which athletic gender category trans individuals should be permitted to compete in, it is important to understand the level of physical fitness/performance these individuals possess relative to their cisgender counterparts. Unfortunately, there are few studies investigating this topic, and several complications that confound this research. The current review seeks to discuss sex and gender as concepts, review sex differences in fitness/performance and how they develop, and then, consider how current evidence suggests that trans individuals compare to cis individuals. Finally, this review seeks to offer considerations for whether trans individuals should be excluded from sports and athletics, and how future research should proceed to better understand this marginalized population.

Androgenetic alopecia incidence in transgender and gender diverse populations: A retrospective comparative cohort study

BACKGROUND

Androgenetic alopecia (AGA) is a significant challenge for many transgender and gender diverse (TGD) patients, but the rate of AGA among TGD patients receiving gender-affirming hormone therapy (GAHT) compared to cisgender patients has not yet been studied on a large scale.

OBJECTIVE

We examined the incidence of AGA among TGD patients receiving GAHT compared to cisgender patients.

METHODS

Retrospective cohort study using electronic health records from 37,826 patients seen at Fenway Health between August 1, 2014, and August 1, 2020. Crude and adjusted incidence rate ratios (aIRR) for AGA were calculated using Poisson regression.

RESULTS

TGD patients receiving masculinizing GAHT had aIRR 2.50, 95% CI 1.71-3.65 and 1.30, 95% CI 0.91-1.86 compared to cisgender women and cisgender men, respectively. The rate of AGA for TGD patients receiving feminizing GAHT was not significantly different compared to cisgender men but was significantly increased compared to cisgender women (aIRR 1.91, 95% CI 1.25-2.92).

LIMITATIONS

Inability to determine causation and limited generalizability.

CONCLUSION

TGD patients receiving masculinizing GAHT have 2.5 times the rate of AGA compared to cisgender women, whereas TGD patients on feminizing GAHT did not have a significantly increased rate of AGA compared to cisgender men.

The Price to Pay for Being Yourself: Experiences of Microaggressions among Non-Binary and Genderqueer (NBGQ) Youth

This study explores the experiences of NBGQ youth with microaggressions. It investigates the types of microaggressions they face and their subsequent needs and coping mechanisms and the impacts on their lives. Semi-structured interviews with ten NBGQ youth in Belgium were conducted and analyzed using a thematic approach. The results showed that experiences of microaggressions were centered around denial. The most common ways to cope were finding acceptance from (queer) friends and therapists, engaging in a conversation with the aggressor, and rationalizing and empathizing with the aggressor, leading to self-blame and normalization of the experiences. Microaggressions were experienced as exhausting, which influenced the extent to which the NBGQ individuals wanted to explain themselves to others. Furthermore, the study shows an interaction between microaggressions and gender expression, in which gender expression is seen as a motive for microaggressions and microaggressions have an impact on the gender expression of NBGQ youth.

Healthcare Providers' Pregnancy Prevention Counseling of Trans and Non-Binary Assigned Female at Birth (TNB/AFAB) Patients

Transgender and non-binary people assigned female at birth (TNB/AFAB) have unintended pregnancies, but there is a dearth of information about effective pregnancy prevention care for this population. This needs assessment study aimed at discerning pregnancy prevention care best practices involved interviews of 20 healthcare providers solicited for experience providing pregnancy counseling with this group. Findings were organized via the ecological model, revealing four layers of themes. 1) Social structural level themes related to the gender binary system and other forms of oppression (racism, sexism, heterosexism); 2) the systems level theme related to access to and barriers to care; 3) provider level themes included lack of formal education, need to provide trauma-informed care, and provider discomfort or assumptions; and 4) patient-level themes included the fact that patients do not usually raise issues related to contraception and that TNB/AFAB patients have unique contraception needs. Implications of the findings are discussed.

The Intrauterine Device Experience Among Transgender and Gender-Diverse Individuals Assigned Female at Birth

INTRODUCTION

The intrauterine device (IUD) is a long-acting and highly efficacious form of contraception that can also be used for menstrual suppression. Although IUD use is increasing, the type chosen, appeal, and satisfaction among individuals who are transgender and gender diverse and assigned female at birth (TGD-AFAB) is unknown. The purpose of this study is to evaluate IUD usage among TGD-AFAB individuals.

METHODS

TGD-AFAB individuals who had an IUD for a minimum of 6 months at the time of completing the survey or had one in the past completed an anonymous online survey. Descriptive statistics were used to analyze the data.

RESULTS

One hundred and five TGD-AFAB individuals completed the survey. Among participants who were sexually active, 88% reported they were in a relationship in which it was possible to get pregnant. There were 85 individuals who currently had an IUD: 62 (73%) chose a 52-mg levonorgestrel (LNG) IUD, 5 (6%) chose a lower-dose LNG IUD, 17 (20%) chose the copper IUD, and one chose an IUD unavailable in the United States. Menstrual suppression was the primary reason for choosing a 52-mg LNG IUD (58%). Most individuals who opted for a copper IUD did so to avoid hormonal contraception (71%). Participants reported experiencing IUD side effects; however, few desired removal. Among the 36 respondents who had an IUD in the past, the most frequent reasons for removal were expiration of the device (LNG IUDs) and undesired side effects (copper IUD). Approximately half of participants who had an IUD removed had it replaced with another IUD.

DISCUSSION

Pregnancy can occur among TGD-AFAB individuals even if they are on testosterone and amenorrheic. IUDs are well tolerated in this population, with few current users desiring removal for unwanted side effects. Clinicians should counsel TGD-AFAB individuals about the contraceptive and noncontraceptive benefits of IUDs and expected side effects.

Influence of gender and sexual identity on adolescent skin health

BACKGROUND/OBJECTIVE

Studies have identified dermatologic conditions and relevant skin-related behaviors that distinctly or disproportionately impact sexual and gender minority (SGM) adults compared with their cisgender/heterosexual counterparts, but whether these observations apply to SGM adolescents remains unknown. We aimed to describe the nature and frequency of skin conditions in SGM youth relative to their cisgender/heterosexual peers and explore adolescents' attitudes toward their skin health and accessing dermatologic care.

METHODS

SGM and cisgender/heterosexual youth aged 13-21 years seen at Seattle Children's Hospital Adolescent Medicine and Gender clinics from June to December 2019 were invited to participate in this cross-sectional survey study, with subsequent statistical analysis.

RESULTS

One-hundred and eighteen subjects were included in the study. Sexual orientation did not affect how participants personally felt about and cared for their skin, though gender identity did influence this relationship. (P = .012) Both sexual and gender minority youth demonstrated a preference for a dermatologist who identified as SGM and would be more likely to actively seek care from these providers. (P < .001) There was no difference in the reported prevalence of most dermatologic conditions among groups based on sexual orientation or gender identity.

CONCLUSION

Dermatologists should inquire with adolescent and young adult patients how their sexual orientation and gender identities influence how they view their skin, in an effort to guide counseling and demonstrate holistic support for adolescents. Therapeutic alliances with SGM youth may be strengthened by providers who openly identify as SGM.

Narratives of Gender, Sexuality, and Community in Three Generations of Genderqueer Sexual Minorities

Genderqueer identities-those that challenge a strict binary between woman and man-are increasingly visible within mainstream culture and psychological research. However, little is known about generational differences in the lived experience of genderqueer people. Inductive thematic analysis of interviews with 30 genderqueer sexual minorities of 3 distinct generations living the United States revealed 3 major themes: (a) unintelligibility: genderqueer people face challenges in identifying, naming, and expressing their gender due to the constraints of everyday language and material culture; (b) managing stigma through challenging oppression: genderqueer people manage stigma by naming and challenging the gender binary, often in relation to other forms of oppression; and (c) connection beyond mainstream LGBTQ communities: genderqueer people often find connection outside of mainstream LGBTQ spaces, such as through ethnicity-based or sexual subcommunities (e.g., kink/BDSM, polyamorous). Within these themes, key generational patterns included (a) greater challenges among the middle and older generations in naming and expressing a genderqueer identity, especially in relation to their sexual identity; (b) intensified critique of mainstream LGBTQ politics among the younger generation; and (c) greater challenges in finding and maintaining community among the middle and older generations. Across generations, participants emphasized the need to create more inclusive environments by changing language and social structures to deemphasize the gender binary.

Dermatologic care of sexual and gender minority/LGBTQIA youth, Part I: An update for the dermatologist on providing inclusive care

Sexual and gender minority (SGM) persons, including lesbian, gay, bisexual, transgender/gender diverse, questioning/queer, intersex, and asexual (LGBTQIA) individuals, represent a historically underserved population within the field of medicine, though their unique health needs are increasingly recognized. Unfortunately, our understanding of these needs as they relate to dermatology is still nascent, particularly with respect to children and adolescents. This two-part review will discuss the dermatologic care of SGM youth, with Part 1 providing practical advice for dermatologists seeking to provide more culturally mindful and accessible care for SGM children and adolescents. A more comprehensive understanding of the psychosocial and physical needs of SGM youth will allow dermatologists to more actively and compassionately care for this health disparity population.

The terminology of identities between, outside and beyond the gender binary - A systematic review

Background: Recently, a multitude of terms have emerged, especially within North America and Western Europe, which describe identities that are not experienced within the culturally accepted binary structure of gender which prevails within those cultures. As yet, there is no clear single umbrella term to describe such identities and a mixture of words have been used in scholarly work to date. Aims: To explore the origins and track the emergence of newer terms and definitions for identities between, outside and beyond the gender binary, to outline current trends in descriptors within scholarly work and to suggest a term which is wide enough to encompass all identities. Methods: A comprehensive systematic review was made, following the PRISMA guidelines. Several relevant key terms were used to search Web of Science, ScienceDirect, PubMed, and the International Journal of Transgenderism. The descriptions each title gives for identities outside of the binary are extracted for analysis. Results: Several terms have been used over the years to describe identities outside of the binary. "Non-binary" and "genderqueer" are currently mostly used as umbrella terms. However, "gender diverse" is emerging as a more suitable wide-ranging inclusive term for non-male and non-female identities. Discussion: Identity outside of "male" and "female" is an emerging concept which currently has several identifiers and little academic agreement on which is the most pertinent. The two leading descriptors are "non-binary" and "genderqueer." Gender diverse is emerging as a new term which has the aim of including all other terms outside of male and female within it and this article suggests the increase in its use to describe gender identities outside of the binary.

Health of Non-binary and Genderqueer People: A Systematic Review

Background: Non-binary and genderqueer (NBGQ) people are those who do not identify within the gender binary system (male vs. female), not falling exclusively in man/male or woman/female normative categories. A higher proportion of NBGQ people is usually found within young persons. This population is marginalized and, as such, is at risk of stigmatization and of developing negative health outcomes. As literature on the health of NBGQ people is sparse, this study aims at systematically review the limited studies on this field. Methods: The research questions which guided the systematic review were: (1) What are the differences in the health levels between NBGQ and binary transgender (BT) individuals? (2) What are the differences in the health levels between NBGQ and cisgender individuals? (3) Which medical and psychological interventions are most suitable for improving NBGQ health? According to PRISMA guidelines, a systematic search was conducted in PubMed, PsycInfo, Web of Science, and Google Scholar. Results: Eleven studies met the inclusion criteria for the current systematic review. Among them, 9 were focused on the health differences between NBGQ and BT individuals, 4 of the latter and 1 individually were focused on the health differences between NBGQ and cisgender individuals, and 1 was focused on the evaluation of health outcomes related to medical procedures. No studies assessed psychological interventions aimed at improving health in NBGQ individuals. All studies were cross-sectional, did not generally recruit a large sample of NBGQ individuals, and used non-probability sample design. Results related to the difference in health between NBGQ and BT were mixed; indeed, some found a better health status while others a worse one. Results related to the differences in health between NBGQ and cisgender highlighted higher health needs in NBGQ than in BT individuals. The only study analyzing the effects of medical interventions on health found that NBGQ female-assigned at birth individuals improved their quality of life after chest surgery. Conclusions: Although scholars are starting to pay attention to the NBGQ health, research needs to be expanded both in terms of methodology and research contents. Clinical, health-related social policies, and research recommendations in this field are reported.

Health disparities between binary and non binary trans people: A community-driven survey

Background: Genderqueer and nonbinary () people have remained largely invisible in health research. Previous research shows worse outcomes on health indicators for trans people when compared with cisgender controls, but the differences between binary trans and GQNB individuals are inconclusive. Aims: To compare overall health and well-being of GQNB people with controls of trans men and trans women, taking into account the impact of the additive effect of their socio-economic position, as well as their current need for gender affirming medical interventions. Methods: A community-driven survey was conducted in 2016 in five countries (Georgia, Poland, Serbia, Spain, and Sweden). Self-reported health and general well-being were analysed for differences between binary trans and GQNB respondents. The effects of multiple control variables (age, economic situation, educational level, belonging to an ethnic, religious, sexual or ability minority group, sex assigned at birth) as well as the current need for gender affirming medical interventions were controlled for. Results: The sample consisted of 853 respondents aged 16 and older, with 254 trans women (29.8%), 369 trans men (43.2%), and 230 GQNB people (26%). GQNB respondents showed significantly worse self-reported health and worse general well-being in comparison to binary trans respondents. Additional negative impacts of having a lower educational level, having more economic stress, and belonging to a disability minority group were found. Being in need of gender affirming medical interventions contributed significantly to worse self-reported health, whereas being younger contributed to worse general well-being. Discussion: In understanding health disparities between binary trans and GQNB people, it is necessary to take into account the additive effect of multiple socio-economic positions, and the current need for gender affirming medical interventions. The high proportion of GQNB respondents who report worse health outcomes highlights the need for policy makers and health-care providers in creating nonbinary-inclusive environments.

Healthcare Experiences Among Young Adults Who Identify as Genderqueer or Nonbinary

PURPOSE

Research on healthcare among gender-diverse populations has largely focused on people who describe their gender in binary terms, either as trans men or trans women. This qualitative study examined the healthcare experiences of young adults who identify as genderqueer or nonbinary (GQ/NB).

METHODS

Participants (N = 10) were interviewed about experiences seeking and accessing healthcare. All were young adults (ages 23-33) in the San Francisco Bay area who had accessed healthcare at least once in the prior 6 months. A semistructured interview guide elicited conversations about gender identity and experiences of healthcare. Interview transcripts were analyzed using emergent coding analysis to identify themes.

RESULTS

Participants faced unique challenges even at clinics specializing in gender-affirming healthcare. They felt misunderstood by providers who approached them from a binary transgender perspective and consequently often did not receive care sensitive to nonbinary identities. In response to this perceived bias, participants sometimes "borrowed" a binary transgender label to receive care, modified the healthcare they were prescribed, or went without healthcare. The GQ/NB young adults in our study regularly felt disrespected and frustrated as they sought and accessed healthcare. Participants felt that the binary transgender narrative pressured them to conform to binary medical narratives throughout healthcare interactions.

CONCLUSIONS

GQ/NB young adults have unique healthcare needs but often do not feel understood by their providers. There is a need for existing healthcare systems to serve GQ/NB young adults more effectively.

Intersectionality Is Not a Choice: Reflections of a Queer Scholar of Color on Teaching, Writing, and Belonging in LGBTQ Studies and Academia

Drawing on my experience as a queer, genderqueer, Puerto Rican counselor educator, this article considers how LGBTQAI+ studies and academia can expand to better include people with multiple marginalized identities. This article highlights some of the contradictions that educators face when engaging in the liberatory praxis that connects and creates a sense of belonging during these tumultuous times. This reflection suggests a decolonizing approach to intersectionality and highlights the importance of transcending binary discourse to engage in deconstructing the multiple layers of colonization in our internal and external spaces that is necessary for liberatory praxis. Finally, a few recommendations for how LGBTQAI+ studies and academia can support scholars with multiple marginalized identities are identified.

Gender Trouble in Social Psychology: How Can Butler's Work Inform Experimental Social Psychologists' Conceptualization of Gender?

A quarter of a century ago, philosopher Judith Butler (1990) called upon society to create "gender trouble" by disrupting the binary view of sex, gender, and sexuality. She argued that gender, rather than being an essential quality following from biological sex, or an inherent identity, is an act which grows out of, reinforces, and is reinforced by, societal norms and creates the illusion of binary sex. Despite the fact that Butler's philosophical approach to understanding gender has many resonances with a large body of gender research being conducted by social psychologists, little theorizing and research within experimental social psychology has drawn directly on Butler's ideas. In this paper, we will discuss how Butler's ideas can add to experimental social psychologists' understanding of gender. We describe the Butler's ideas from Gender Trouble and discuss the ways in which they fit with current conceptualizations of gender in experimental social psychology. We then propose a series of new research questions that arise from this integration of Butler's work and the social psychological literature. Finally, we suggest a number of concrete ways in which experimental social psychologists can incorporate notions of gender performativity and gender trouble into the ways in which they research gender.

Coming Out as Transgender: Navigating the Social Implications of a Transgender Identity

This study examines transgender coming-out narratives. Most previous studies of coming out as transgender have relied on psychological stage models of identity development, with little empirical verification. This study uses identity theory to reframe transgender coming out as a primarily external, ongoing, and socially situated process. The data were collected from 20 transgender people residing in the Minneapolis-St. Paul, Minnesota metro area through interviews and focus groups. The analyses reveal that coming out as transgender requires navigating others' gender expectations, others' reactions, and the threat of violence. The results indicate that transgender individuals do not simply decide to "come out of the closet" and then stay out. Rather, they make strategic decisions regarding the enactment of gender and gender identity disclosure based on specific social contexts. Coming out as transgender is best conceptualized as an ongoing, socially embedded, skilled management of one's gender identity.

Creating gender: A thematic analysis of genderqueer narratives

Background and Aims: Increasingly, research is emerging on the subjective experience of genderqueer people. This study explored how genderqueer identities are understood and managed in both personal and social domains. Method: Interview data from 25 genderqueer-identified American adolescents and emerging adults, aged 15 to 26 (M = 21.28, SD = 3.20), were pulled from a larger study of 90 transgender and genderqueer participants. The 90-minute semi-structured interviews included questions about gender identity, the developmental pathway of participants, and relationships with others regarding gender. Results: Participants described "genderqueer" as a sufficiently broad category to capture their diverse experiences, and descriptions of genderqueer identities were heterogeneous, directly contradicting binary understandings of gender identity. A thematic analysis of interview transcripts resulted in three themes: intrapsychic experience, descriptions of master narratives about gender identity, and the co-construction of identities. Discussion: Participants described navigating a series of master and alternative narratives, such that all transgender people transgress a cisnormative master narrative, but genderqueer people further transgress normative understandings of a medicalized, binary transgender identity. The experience of co-creating identities was the process by which participants actively navigated constraints of the master narrative experience. Participants described the integral role of language in crafting new narratives to legitimize genderqueer experiences, as well as the subsequent intragroup conflict resulting from conflicting relationships to narratives in the transgender community. This study highlights genderqueer identities as a source of strength and positivity, and the importance of expanding beyond the hegemonic gender binary within research and clinical practice.

What is there to learn about violence and masculinity from a genderqueer man?

Background: In light of the global health burden of violence, which is predominantly perpetrated by men, studies have explored the relationship between masculinities and violence. However, there is a relative lack of work focusing on non-hegemonic men and masculinities in relation to violence. Such work has the potential to advance violence prevention work.

Objective: This article aims to show the shifting relationship between constructions of violent and non-violent masculinity in the talk of a genderqueer man. The article also aims to demonstrate how qualitative approaches are able to reveal the complexity and contradiction in accounts of masculine identities as these are negotiated within the context of the research interview.

Methods: The article is based on a case study of Adam, a middle-class, ‘white’, ‘genderqueer’ man who participated in a larger study which explored the ways in which gender is constructed within 18 South African families. Adam’s interview is analysed using a Foucauldian discourse analysis.

Results: The analysis demonstrates the complex and contradictory process involved in negotiating and resisting a violent version of masculinity. Constructing male violence as rooted in particular psychosocial and cultural assumptions, rather than as an automatic biological response, enables Adam to resist this violence. This deconstruction of violent masculinity is linked to Adam’s ‘genderqueer’ identity or ‘in-betweenness’, which facilitates a critical consciousness in relation to notions of gender. The analysis also demonstrates how notions of masculinity are deliberated and co-constructed within the relational context of the interview.

Conclusions: This article shows that resisting and reformulating masculinity in non-violent ways is a complex process. This suggests that violence prevention efforts need to focus on the creation of spaces for ongoing dialogues about non-violence. As demonstrated by the context of the interview, relational, conversational spaces have the potential to facilitate the co-construction of non-violent masculinities.

An exploration of the lived experiences of non-binary individuals who have presented at a gender identity clinic in the United Kingdom

Background: Despite an increased awareness of non-binary identity in the current social landscape, the experiences and needs of this heterogeneous community are poorly understood and represented in the research literature. Evidence indicates that social exclusion is not uncommon for individuals expressing a non-binary gender identity, with reflections in the literature that this may in turn have an impact on their psychological wellbeing. Aim: As non-binary individuals are increasingly presenting at UK gender identity clinics and requesting medical interventions, the aim of this study was to better understand their experiences and needs. Method: Two focus groups were run consisting of eight service users of a National Health Service (NHS) gender identity clinic in the United Kingdom. The transcripts of these focus groups were analysed using thematic analysis. Results: Five themes were identified: Invisibility, Managing non-binary gender identity in a binary world, Individuality, Gender dysphoria and Seeking interventions. Discussion: Clinical implications are discussed, with the recommendation for an affirmative approach that offers space for the non-binary individual to articulate their desires and come to terms with their identity. This exploration must take into consideration the person's place within a social world that can be transphobic and limited in terms of potential medical interventions. Further research is needed to better understand this marginalised community.

Barriers to Gender-Affirming Care for Transgender and Gender Nonconforming Individuals

Gender-affirming care, including hormone therapy, "top" (e.g., chest reconstruction surgery) and "bottom" (e.g., vaginoplasty, phalloplasty, metoidioplasty, etc.) surgeries, and puberty blockers, is an efficacious treatment of gender dysphoria for transgender and gender nonconforming (TGNC) individuals. However, many TGNC people encounter significant barriers in accessing gender-affirming care, which we detail via results from on online study. Participants included 256 TGNC individuals (78.9% White, ages 16-73, Mage =28.4). Among participants, 61.3% were receiving hormone therapy, 22.7% had undergone top surgery, and 5.5% had undergone bottom surgery. Open-ended responses (n=201) were thematically analyzed and common barriers included finances and insurance issues, a lack of service availability, and fears or worries. Participants reported various systemic issues and incidents of bias within medical and mental health fields, as well as a lack of medical provider awareness and education. Other themes were interpersonal barriers (e.g., fears of rejection); age and need of parental consent for minors; other medical issues; and a lack of information about how to acquire care. These findings can be utilized to educate professionals in medical and mental health fields about barriers their TGNC patients may encounter in receiving affirming care, and suggest a number of ways to improve access to these services.

Non-binary and binary transgender youth: Comparison of mental health, self-harm, suicidality, substance use and victimization experiences

  Background : Little research has compared the mental health and victimization experiences of non-binary youth depending on their sex assigned at birth (SAAB), or compared these two groups with binary transgender youth. Aims : To compare mental health, self-harm and suicidality, substance use and victimization experiences between non-binary and binary transgender young adults, both male assigned at birth (MAAB) and female assigned at birth (FAAB). Methods : Online survey data from 677 participants from the "Youth Chances" community study of 16 to 25 year olds in the United Kingdom was analyzed, comparing across binary participants (transgender females (n = 105) and transgender males (n = 210)) and non-binary participants (MAAB (n = 93) and FAAB (n = 269)). Results : Female SAAB participants (binary and non-binary) were more likely to report a current mental health condition and history of self-harm than male SAAB participants (binary and non-binary). Similarly, female SAAB participants (binary and non-binary) were more likely to report childhood sexual abuse than male SAAB participants (binary and non-binary); the reverse pattern was found for lifetime physical assault relating to being LGBTQ. Non-binary MAAB participants were less likely than the other groups to report past suicide attempts and previous help-seeking for depression/anxiety. Binary participants reported lower life satisfaction than non-binary participants. For all four groups, mental health problems, self-harm, suicidality, alcohol use and victimization experiences were generally higher than that of youth in general population studies. Conclusions : These findings highlight the importance of considering both non-binary versus binary gender identity and SAAB in relation to mental health problems, self-harm, suicidality and substance use in transgender youth. The roles of sexual abuse, other abuse and discrimination in contributing to increased rates of mental illness and self-harm in non-binary and binary transgender individuals, particularly those who were assigned female at birth, relative to those assigned male, require investigation.

Suicide Risk Among Transgender People: A Prevalent Problem in Critical Need of Empirical and Theoretical Research

Transgender individuals are at increased risk for suicide relative to nontransgender people. Despite this, research on transgender people's risk for suicide mirrors their marginalization at the societal level; there is simply not enough research dedicated to understanding increased suicide risk among transgender people. This article presents a brief review of what is known regarding the prevalence and correlates of suicide-related thoughts and behaviors among transgender people and offers perspective regarding what theories of suicide may be pertinent to understanding and addressing increased suicide risk within this population. We also summarize strengths and limitations of the current body of work to provide impetus for additional and improved research on this important problem.

A Comparison of Trans Women, Trans Men, Genderqueer Individuals, and Cisgender Brothers and Sisters on the Bem Sex-Role Inventory: Ratings by Self and Siblings

A U.S. national sample of 295 transgender adults (trans women, trans men, and genderqueer individuals) and their cisgender siblings completed the Bem Sex-Role Inventory about their siblings as well as themselves, which enabled a comparison between self-perceptions and sibling's perceptions of personality characteristics. Self-reported personality characteristics scored as feminine of trans women were not statistically different from those of their cisgender sisters, but they were significantly higher than self-reported femininity scores of trans men, genderqueer individuals, and cisgender brothers. Self-reported personality characteristics scored as masculine of trans men did not differ significantly from those of their cisgender brothers, but they were higher than those of trans women. Trans men and cisgender brothers were viewed by their siblings in a more sex-typed way than they rated themselves, whereas trans women and cisgender sisters were rated by their siblings in a less sex-typed way than they viewed themselves.

Complicated and messy politics of inclusion: Michfest and the Boston Dyke March

To illustrate the challenge of political organizing that grapples with identity politics and inclusion, I focus on two women-centered annual events with very different politics of inclusion: the Michigan Womyn's Music Festival and the Boston Dyke March.

MAIN POINTS

(1) arguments made by marginalized people for inclusion into established oppressed identity groups must be constructed with due care to avoid further marginalizing yet other liminal identities; (2) protesting/boycotting other oppressed groups for the purpose of achieving inclusion is often a problematic strategy; (3) the most effective strategy for honoring all people is to support organizations committed to the ideal of inclusion.