Trans Adolescents' Perceptions and Experiences of Their Parents' Supportive and Rejecting Behaviors

• Published in: Journal of counseling psychology 2020-03, Vol.67 (2), p.156-170
• Main Authors: Johnson, Kelly C, LeBlanc, Allen J, Sterzing, Paul R, Deardorff, Julianna, Antin, Tamar, Bockting, Walter O
• Format: Article
• Language: English
• Subjects: Adolescent Attitudes; Adolescent Literature; Adolescents; Children; Cisgender; Classification; Clinical outcomes; Elicitation; Empathy; Experiences (Events); Family support; Female; Gender identity; Gender-affirming care; Health behavior; Health services; Health status; Human; Interviews; Male; Mental Health; Mental health services; Multiculturalism & pluralism; Parental Investment; Parents; Parents & parenting; Peers; Photography; Pronouns; Protective Factors; Psychosocial factors; Psychosocial problems; Sexual orientation; Social Acceptance; Social rejection; Social Support; Suicidal ideation; Suicide; Teenagers; Transgender persons; Well being
• ISSN: 0022-0167; 1939-2168
• DOI: 10.1037/cou0000419

Transgender (trans) adolescents consistently report higher rates of adverse mental health outcomes compared to their cisgender peers. Parental support is a recognized adolescent protective factor; however, little is known about the specific parental behaviors that trans adolescents perceive as most or least supportive. To address this gap, we analyzed data from qualitative interviews conducted with an ethnically diverse, urban-based sample of trans adolescents (N = 24; 16-20 years old) to describe (a) the spectrum of specific parental behaviors across 3 categories-rejecting, supportive, and mixed (i.e., simultaneous supportive and rejecting behaviors)-and (b) the perceived psychosocial consequences across these 3 categories of parental behaviors. Qualitative data were gathered through lifeline interviews (i.e., visual representations from birth to present) and photo elicitation (i.e., photographs representing parental support and/or rejection). Supportive behaviors included instances where parents made independent efforts to learn about trans issues or help their child obtain gender-affirming health care. Rejecting behaviors included instances when parents refused to use their child's name or pronouns or failed to show empathy when their child struggled with gender-identity-related challenges. Mixed behaviors included examples when parents expressed support of their child's gender identity, but not of their sexual orientation (or vice versa). Overall, participants reported that rejecting and mixed parental behaviors contributed to a range of psychosocial problems (e.g., depression and suicidal ideation), while supportive behaviors increased positive wellbeing. These findings expand upon descriptions of parental support and rejection within the trans adolescent literature and can help practitioners target specific behaviors for interventions. Public Significance Statement This study qualitatively describes the specific parental behaviors that trans adolescents perceive as rejecting, supportive, or mixed (i.e., simultaneous supportive and rejecting behaviors). Overall, participants perceived that rejecting and mixed parental behaviors contributed to a range of psychosocial problems (e.g., depression and suicidal ideation), while supportive behaviors increased positive wellbeing. Interventions should target these specific parental behaviors to improve trans adolescent mental health and well-being.