Content area
Abstract
This study examined concordance of family members’ perspectives of family functioning and mental health across two years in families with transgender and/or nonbinary youth (TNBY). Participants were 89 family members (30 TNBY, age 13–17 years; 44 cisgender caregivers; 15 cisgender siblings, age 14–24 years) from 30 families from the U.S. New England region. Family members completed an online survey every 6–8 months for 5 waves between December 2015 and Feb 2019. Surveys assessed family functioning (quality of communication, satisfaction with family) and the following mental health-related outcomes: depression and anxiety symptoms, non-suicidal self-injury, suicidality, self-esteem, and resilience. Analyses tested concordance of family functioning and mental health across family members. Reports of family functioning changed over time, and family members were not consistently concordant in their reports of family functioning. Caregivers perceived a higher quality family communication than TNBY at all waves and higher than siblings at some waves. Perceptions of family satisfaction did not show a clear pattern between family member types across waves. The greatest concordance of perceived family functioning was between caregivers and siblings and between TNBY and siblings. Across all waves, TNBY reported more severe depression and anxiety symptoms than their caregivers and siblings, and more non-suicidal self-injury than their siblings. Compared to siblings, TNBY reported higher self-esteem, but less resilience. This study highlights opportunities for intervention in clinical work with TNBY and their families. Providers working with families with TNBY should use family systems approaches to support the mental health of all family members.
Highlights
Transgender and nonbinary youth (TNBY) reported worse mental health over time, compared to their caregivers and siblings.
Perceived family functioning was most concordant between caregivers and siblings and TNBY and siblings.
TNBY mental health changed over time and better mental health was associated with perceptions of better family functioning.
Fluctuations in family functioning and mental health provide intervention opportunities for TNBY and their families.
Details
; Sarda, Vishnudas 2 ; Line, Emmett C. 3 ; Marchwinski, Breana 2 ; Budge, Stephanie L. 4 ; Godwin, Eli G. 2 ; Moore, L. B. M. 2 ; Ehrensaft, Diane 5 ; Rosal, Milagros C. 6 ; Thomson, Katharine A. 7 1 Boston Children’s Hospital, Division of Adolescent/Young Adult Medicine, Boston, USA (GRID:grid.2515.3) (ISNI:0000 0004 0378 8438); Harvard Medical School, Department of Pediatrics, Boston, USA (GRID:grid.38142.3c) (ISNI:000000041936754X); Harvard T. H. Chan School of Public Health, Department of Social and Behavioral Sciences, Boston, USA (GRID:grid.38142.3c) (ISNI:000000041936754X)
2 Boston Children’s Hospital, Division of Adolescent/Young Adult Medicine, Boston, USA (GRID:grid.2515.3) (ISNI:0000 0004 0378 8438)
3 Boston Children’s Hospital, Division of Adolescent/Young Adult Medicine, Boston, USA (GRID:grid.2515.3) (ISNI:0000 0004 0378 8438); Columbia University, Teachers College, New York, USA (GRID:grid.21729.3f) (ISNI:0000 0004 1936 8729)
4 University of Wisconsin – Madison, Department of Counseling Psychology, Madison, USA (GRID:grid.14003.36) (ISNI:0000 0001 2167 3675)
5 University of California San Francisco School of Medicine, Department of Pediatrics, San Francisco, USA (GRID:grid.266102.1) (ISNI:0000 0001 2297 6811)
6 University of Massachusetts Chan Medical School, Department of Population and Quantitative Sciences, Worcester, USA (GRID:grid.168645.8) (ISNI:0000 0001 0742 0364)
7 BC Children’s Hospital, Department of Psychology, Vancouver, Canada (GRID:grid.414137.4) (ISNI:0000 0001 0684 7788); University of British Columbia, Department of Psychiatry, Vancouver, Canada (GRID:grid.17091.3e) (ISNI:0000 0001 2288 9830)