Understanding Online Resource Use by Transgender Youth and Caregivers: A Qualitative Study

Abstract

This study assessed what online resources transgender youth and their caregivers use to acquire information about transgender health. Through a variety of settings, including subspecialty clinics, support groups, and online solicitation, we recruited caregivers of transgender youth aged 22 years or younger and self-identified transgender youth aged 14-22 years. We used a mixed methods approach of conducting in-person focus groups, interviews in person or through phone, and an online survey that allowed for increased flexibility for participants and to triangulate key themes from multiple data sources. Scripts were semistructured, and prompts were focused on resources accessed by transgender youth and their caregivers. We had a total of 65 participants, including 50 caregivers and 15 youth. Five main themes emerged from participants on why they sought out information on the Internet and what they found in their online searches. These themes include (1) exploring gender identity, (2) filling knowledge gaps, (3) seeking support networks, (4) finding transgender-friendly providers, and (5) encountering misinformation. Our findings demonstrate the need for reliable trustworthy content online, the importance of the virtual community to support both youth and caregivers, and the challenge of navigating misinformation that is often faced by transgender youth as they navigate online resources. We propose partnering with professional organizations, such as the American Academy of Pediatrics or World Professional Association of Transgender Health, to promote evidence-based guidelines, position statements, and online information on healthcare for transgender youth.

Recommendations from Transgender Healthcare Consumers in Rural Areas

“…Researchers have conducted studies of online resource use, 15 of the process by which transgender patients choose a surgeon, 9 and of ways that fear of mistreatment reduces the likelihood that transgender people will access healthcare in the first place. 7 Less is known about how this knowledge is transmitted within peer-to-peer social support networks rural communities where transgender individuals tend to experience disproportionate exposure to discrimination and more psychological distress.…”

“…Given the available information about the challenges that rural transgender individuals face when they attempt to access healthcare 8 and the historic lack of visible, competent, and well-advertised providers, 9–12 it is no wonder that transgender people have relied on social networks and on the internet as sources of vital information. 15–17 In fact, social networking within communities of transgender individuals is linked to resilience and to positive healthcare experiences. 16 , 17 Aside from the general benefits of social support, 18 interpersonal connections allow for the transmission of vital information and resources.…”

“…Considering the benefits of social support, scholars and practitioners suggest that social components (e.g., group therapy, online connections) be included in transgender affirmative treatment. 15 , 20–22 Affirmative treatment addresses the transgender person holistically and with an awareness of the lived experiences of transgender people. 7 , 22 Thus, guidelines for transgender treatment providers in rural areas include recommendations to include social support components.…”

Embodying Transgender: An Analysis of Trans Women in Online Forums

“…Trans people use online support groups to form friendships and connections with other transgender individuals [39,40]. Because transgender people are a minority and only make up a small percentage of the population, many people may have had limited contact with transgender communities, due to stigma, isolation or anxiety, and because transgender people are a minority and only make up a small percentage of the population [36,39].…”

Parent Participation in a Support Group for Families with Transgender and Gender-Nonconforming Children: “Being in the Company of Others Who Do Not Question the Reality of Our Experience”

“…20 Their results highlight the specific concerns parents voiced during the group about their child's gender confusion, playmates, bullying and sexuality and their own grieving, embarrassment, and shame, and uncertainty about disclosing their child's gender identity. One more recent study points to the importance of the Internet for obtaining information and social support for parents of trans/GNC children, 21 but no published studies other than Menvielle and Tuerk have considered the value of in-person support groups for parents of trans/GNC children.…”