An Integrative Review of Experiences Parenting Transgender and Gender Diverse Children

Abstract

Transgender and gender diverse (TGD) children face increased behavioral health risks including suicidal behaviors and substance abuse. Parental affirmation is associated with behavioral health outcomes similar to non-TGD peers. This integrative review synthesizes and appraises evidence regarding experiences of parenting a TGD child in the United States or Canada from 2008 to 2018. Most parents across these 15 studies described affirming their child’s gender at time of interview. Parents reported initial interpersonal processes (emotions, concerns, beliefs), sought education (frequently online), and described interactions with family members and professionals that were not always affirming. Parents accessed support groups but described their own well-being as a low priority relative to the child’s needs. Parents’ own needs for well-being may affect the process of parenting a TGD child and should be explored. Future research should address the experiences of non-parent family members and participants from more diverse backgrounds. Nursing education must consistently address gender affirming care.

Revisiting gendered parenting of adolescents: understanding its effects on psychosocial development

“…Longitudinal research that employs both parent and adolescent reports would also enhance our understanding of the reciprocal influence between parents and their adolescents. Research with LGBQTI + adolescents indicates that in well-functioning families, there is a shift from parental confusion and negativity at initial disclosure of LGBQTI + identity, to eventual acceptance and support of the young person (Warner et al, 2021 ). Thus, within a warm, connected and supportive parent-adolescent relationship, the adolescent has the potential to shift strongly held values about gender identity (and sexual orientation) in their parents.…”

“…For both gender conforming and non-conforming LGBTQI + adolescents, gendered parenting and gender-typical expectations may be perceived as parental rejection (Mills-Koonce et al, 2018 ), which has been found to have a range of negative emotional and behavioral outcomes for adolescents (Ali et al, 2015 ). For gender non-conforming adolescents, gendered parenting may result in transgender or gender non-conforming adolescents not being ‘allowed’ to present in accordance with their internally felt gender (Warner et al, 2021 ). Support for an adolescent’s desired presentation (including their appearance, pronouns, name) may be an issue both for adolescents who do not identify with the gender they were assigned at birth, and for those who do not feel comfortable with a ‘standard’ gendered appearance (e.g., clothing style, use of makeup etc.…”

“…Gender policing is associated with parental control and relates to the degree of freedom an adolescent has to express their gender identity based on expected social norms about gender (Bebes et al, 2015 ). In cross-sectional research, higher rates of parental gender policing have been found to be associated with poor mental health outcomes in adolescents generally (Bebes et al, 2015 ), and higher rates of substance use, depression, and anxiety among gender non-conforming adolescents and children (Bauermeister et al, 2017 ; Warner et al, 2021 ). Adolescents experience similarly negative mental health and social outcomes when they experience parental rejection after disclosing, or ‘coming out’ about their LGBTQI + identity, including higher rates of depression, attempted suicide, illicit drug use (Ryan et al, 2009 ), and increased risk of homelessness (James et al, 2016 ; Mills-Koonce et al, 2018 ).…”

“…In contrast, parenting that is supportive and accepting of gender non-conforming behavior is associated with positive outcomes for LGBTQI + adolescents (Warner et al, 2021 ). Research with younger children suggests that when parents allow their child to present and behave in gender non-conforming ways, LGBTQI + children aged 3–12 years have the same mental health outcomes as children in this age group who are not gender diverse or LGBTQI+ (Olson et al, 2016 ; Warner et al, 2021 ). Moreover, parental support of transgender adolescents is concurrently associated with greater life satisfaction, and a lower perception of their own transgender identity as burdensome (Simons et al, 2013 ).…”

Living in Pain and Stigma: A Look at Lived Experiences of Mothers with Transsexual Adult Children

“…Parents' first reactions to their child's transsexualism are associated with concerns. They try to get information about this issue [7]. Mothers are always exposed to secondary stigma related to their children due to having transsexual children [8].…”