Transforming Connections: A Trauma-Informed and Attachment-Based Program to Promote Sensitive Parenting of Trans and Gender Non-conforming Youth

Abstract

Gender non-conforming and trans youth experience high rates of bullying and victimization, placing them at risk for serious mental health challenges. Parent support is one of the most significant protective factors in this population, and yet few programs are specifically developed to promote parenting sensitivity, understanding, and acceptance. Connect, a trauma-informed and attachment-based group program for caregivers of at-risk adolescents, has been shown to reduce parent stress and depressed mood, increase parents' sense of efficacy and satisfaction, and reduce parent-teen conflict. Teens benefit from increased attachment security and improved mental health and well-being. Treatment effects have been documented to continue for up to 2 years post-treatment. This paper describes the adaptation of the Connect program to create a new program, Transforming Connections, for caregivers of transgender and gender non-conforming youth. Participants in the first three groups were 20 parents of 16 gender non-conforming youth (ages 12–18). Common themes in group discussions related to gender included: coming out, connecting with peers, affirming pronouns/names, medical transition, parental reactions (e.g., confusion, isolation, grief, acceptance), and concerns about safety and mental health. All parents completed the full program, attending on average 9 of 10 sessions. Caregivers reported feeling respected, safe, and welcomed in the program and indicated that learning about attachment enhanced their understanding of their teen and their gender journey as well as themselves as a parent. Additionally, all parents reported applying the ideas discussed in the group frequently (60%) or somewhat frequently (40%). The majority indicated that their relationship with their teen had improved somewhat (65%) or a great deal (20%). Findings provide positive preliminary evidence of the fit and value of Transforming Connections for these families.

Dynamics of Primary Social Networks to Support Mothers, Fathers, or Guardians of Transgender Children and Adolescents: A Systematic Review

“…The articles were published in 2009 (4.7%) [20], 2011 (4.7%) [21], 2013 (4.7%) [22], 2014 (4.7%) [23], 2015 (4.7%) [24], 2016 (9.5%) [25,26], 2018 (4.7%) [27], 2019 (9.5%) [28,29], 2020 (19%) [30][31][32][33], and 2021 (33%) [34][35][36][37][38][39][40]. All articles (100%) were published in English, of which 14 (66.6%) [20,21,[23][24][25][26][27][28][30][31][32]35,37,40] were from America, 6 (28.5%) [29,33,34,36,38,39] were from Europe, and one (4.7%) [22] was from Oceania. The information and the synthesis of the main results of the final sample of all articles included in the review are presented in Table 1.…”

“…Recognizing gender identity and social transition of transgender children and adolescents is surrounded by guilt, fears, and uncertainties of mothers, fathers, or guardians, who sometimes experience grief related to the ambiguous loss, psychological loss with the person still physically present [7], and of their idealized children [23,24,26,27,30,33,35]. A study carried out in the United States of America (USA) revealed that most parents recognized their children's gender identity, some ignored it, and others were not involved in decisions related to social transition [20].…”

“…Issues related to gender identity that emerged in the studies included in this review were permeated by parents' concerns with the social transition of their transgender children, especially with communication, use of pronouns, and clothing consistent with gender identity [27,30,35], in addition to issues related to peer and family support [27,37]. In parallel, their need for self-care was also listed as a prerogative to understand their own limits and how to act with their children [27].…”

“…Parents feel challenged by their external environment, family, friends, neighbors, or even co-workers [32]. Studies have shown that the decision to support their transgender children in the social transition resulted in the potential loss of friends [21,24,26,27,29,32,35,40]. In other studies, participants also reported being under stress in their marriage and with close relatives [20,21,24,25,33].…”

“…Disapproval and rejection have been reported with the isolation of the nuclear family [26,32,33]. Other studies have also referred to rejection and broken ties from adult family members and friends [21,29,35,36]. The dynamics in the nuclear family tend to be weakened by the need for mental health actions and welcoming all family members [28].…”