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Cited by 199LGBTQ Health, Identity, and PolicyChild and Adolescent Psychosocial and Emotional DevelopmentGender, Sexuality, and Education

Mental health of transgender and gender diverse youth

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Wittlin, Natalie M., Kuper, Laura E., Olson, Kristina R.·2023·Annual Review of Clinical Psychology
DOI 10.1146/annurev-clinpsy-072220-020326PMC PMC9936952
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Abstract

Transgender and gender diverse (TGD) children and adolescents are an increasingly visible yet highly stigmatized group. These youth experience more psychological distress than not only their cisgender, heterosexual peers but also their cisgender, sexual minority peers. In this review, we document these mental health disparities and discuss potential explanations for them using a minority stress framework. We also discuss factors that may increase and decrease TGD youth's vulnerability to psychological distress. Further, we review interventions, including gender-affirming medical care, that may improve mental health in TGD youth. We conclude by discussing limitations of current research and suggestions for the future.

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Crossref · 10.1146/annurev-clinpsy-072220-020326

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  • The prevalence of mental ill health and suicidal risk is substantially higher in LGBTIQA+ and gender-diverse young people compared with their non-LGBTIQA+ and non-gender-diverse peers.

    “The prevalence of mental ill health and suicidal risk is substantially higher in LGBTIQA+ and gender-diverse young people compared with their non-LGBTIQA+ and non-gender-diverse peers. 155-157”

    From The Lancet Psychiatry Commission on youth mental health (2024) · cites this paper as [157]

    In “Describing Mental Health Disparities” (page not provided), the review reports elevated depression and anxiety in transgender and gender-diverse (TGD) youth compared with cisgender peers. Its “Suicidality and Non-Suicidal Self-Injury” section also reports higher suicidality and self-harm in TGD youth. The paper does not establish the same comparison for LGBTIQA+ young people as a whole, which is broader than the population it reviews. (LLM, conf=0.88)

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  1. Achille C, Taggart T, Eaton NR, Osipoff J, Tafuri K, 2020. Longitudinal impact of gender-affirming endocrine intervention on the mental health and well-being of transgender youths: preliminary results. Int. J. Pediatr. Endocrinol 2020(8) PMC7191719 32368216
  2. Adams N, Pearce R, Veale J, Radix A, Castro D, 2017. Guidance and ethical considerations for undertaking transgender health research and Institutional Review Boards adjudicating this research. Transgender Health. 2(1): 165– 75 29098202 PMC5665092
  3. Aitken M, Steensma TD, Blanchard R, VanderLaan DP, Wood H, 2015. Evidence for an altered sex ratio in clinic-referred adolescents with gender dysphoria. J. Sex. Med 12: 756– 63 25612159
  4. Akgül GY, Ayaz AB, Yildirim B, Fis NP. 2018. Autistic traits and executive functions in children and adolescents with gender dysphoria. J. Sex Marital Ther 44(7): 619– 26 29419374
  5. Arnoldussen M, van der Miesen AIR, Elzinga WS, Alberse A-ME, Popma A, 2022. Self-perception of transgender adolescents after gender-affirming treatment: a follow-up study into young adulthood. LGBT Health. 9(4): 238– 46 35475663
  6. Atteberry-Ash B, Kattari SK, Harner V, Prince DM, Verdino AP, 2021. Differential experiences of mental health among transgender and gender-diverse youth in Colorado. Behav. Sci 11(4): 48– 61 33918631 PMC8069714
  7. Austin A, Craig SL, D’Souza S, McInroy LB. 2022. Suicidality among transgender youth: elucidating the role of interpersonal risk factors. J. Interpers. Violence 37(5–6): NP2696– 2718 32345113
  8. Avila JT, Golden NH, Aye T. 2019. Eating disorder screening in transgender youth. J. Adolesc. Health 65(6): 815– 17 31500946
  9. Baams L, Wilson BDM, Russell ST. 2021. LGBTQ youth in unstable housing and foster care. Pediatrics. 143(3) PMC6398424 30745432
  10. Barbee H, Deal C, Gonzales G. 2022. Anti-transgender legislation—a public health concern for transgender youth. JAMA Pediatr. 176(2): 125– 26 34747979 PMC10204642
  11. Becker-Hebly I, Fahrenkrug S, Campion F, Richter-Appelt H, Schulte-Markwort M, Barkmann C. 2021. Psychosocial health in adolescents and young adults with gender dysphoria before and after gender-affirming medical interventions: a descriptive study from the Hamburg Gender Identity Service. Eur. Child Adolesc. Psychiatry 30(11): 1755– 67 32990772
  12. Beischel WJ, Gauvin SEM, van Anders SM. 2021. “ A little shiny gender breakthrough”: Community understandings of gender euphoria. Int. J. of Transgender Health, pp. 1– 21 PMC9255216 35799953
  13. Bouman WP, Schwend AS, Motmans J, Smiley A, Safer JD, 2017. Language and trans health. Int. J. Transgend 18(1): 1– 6
  14. Carmichael P, Butler G, Masic U, Cole TJ, De Stavola BL, 2021. Short-term outcomes of pubertal suppression in a selected cohort of 12 to 15 year old young people with persistent gender dysphoria in the UK. PLoS One. 16(2) PMC7853497 33529227
  15. Castro-Peraza ME, García-Acosta JM, Delgado N, Perdomo-Hernández AM, Sosa-Alvarez MI, 2019. Gender identity: the human right of depathologization. Int. J. Environ. Res. Public Health 16(6): 978– 89 30889934 PMC6466167
  16. Chavanduka TMD, Gamarel KE, Todd KP, Stephenson R. 2021. Responses to the gender minority stress and resilience scales among transgender and nonbinary youth. J. LGBT Youth 18(2): 135– 54
  17. Chen D, Abrams M, Clark L, Ehrensaft D, Tishelman AC, 2021. Psychosocial characteristics of transgender youth seeking gender-affirming medical treatment: baseline findings from the Trans Youth Care Study. J. Adolesc. Health 68(6): 1104– 11 32839079 PMC7897328
  18. Chodzen G, Hidalgo MA, Chen D, Garofalo R. 2019. Minority Stress Factors Associated With Depression and Anxiety Among Transgender and Gender-Nonconforming Youth. J. Adolesc. Health 64(4): 467– 71 30241721 PMC6528476
  19. Clark TC, Lucassen MFG, Bullen P, Denny SJ, Fleming TM, 2014. The Health and Well-Being of Transgender High School Students: Results From the New Zealand Adolescent Health Survey (Youth’12). J. Adolesc. Health Care 55(1): 93– 99 24438852
  20. Coates S, Person ES. 1985. Extreme Boyhood Femininity: Isolated Behavior or Pervasive Disorder? J. Am. Acad. Child. Psychiatry 24(6): 702– 09 4067139
  21. Coelho JS, Suen J, Clark BA, Marshall SK, Geller J, Lam PY. 2019. Eating disorder diagnoses and symptom presentation in transgender youth: a scoping review. Curr. Psychiatry Rep 21(11): 107 31617014
  22. Coleman E, Radix AE, Bouman WP, Brown GR, de Vries ALC, 2022. Standards of Care for the Health of Transgender and Gender Diverse People, Version 8. Int. J. of Transgender Health 23(Sup1): S1– 259 PMC9553112 36238954
  23. Costa R, Dunsford M, Skagerberg E, Holt V, Carmichael P, Colizzi M. 2015. Psychological support, puberty suppression, and psychosocial functioning in adolescents with gender dysphoria. J. Sex. Med 12(11): 2206– 14 26556015
  24. Coyne CA, Poquiz JL, Janssen A, Chen D. 2020. Evidence-based psychological practice for transgender and non-binary youth: defining the need, framework for treatment adaptation, and future directions. Evid. Based Pract. Child Adolesc. Ment. Health 5(3): 340– 53
  25. Dangaltcheva A, Booth C, Moretti MM. 2021. Transforming connections: a trauma-informed and attachment-based program to promote sensitive parenting of trans and gender non-conforming youth. Front. Psychol 12 PMC8350507 34381395
  26. Davidson S, Morrison A, Skagerberg E, Russell I, Hames A. 2019. A therapeutic group for young people with diverse gender identifications. Clin. Child Psychol. Psychiatry 24(2): 241– 57 30246547
  27. Day JK, Fish JN, Perez-Brumer A, Hatzenbuehler ML, Russell ST. 2017. Transgender youth substance use disparities: results from a population-based sample. J. Adolesc. Health 61(6): 729– 35 28942238 PMC6802742
  28. DeChants JP, Grant JM, Kattari SK. 2020. Conducting community-based participatory research with transgender/nonbinary individuals and communities. In Social Work and Health Care Practice with Transgender and Nonbinary Individuals and Communities, ed. Kattari SK, Kinney MK, Kattari L, Walls NE, pp. 316– 30. London: Routledge
  29. de Graaf NM, Cohen-Kettenis PT, Carmichael P, de Vries ALC, Dhondt K, 2018. Psychological functioning in adolescents referred to specialist gender identity clinics across Europe: a clinical comparison study between four clinics. Eur. Child Adolesc. Psychiatry 27(7): 909– 19 29256158 PMC6013511
  30. de Graaf NM, Steensma TD, Carmichael P, VanderLaan DP, Aitken M, 2022. Suicidality in clinic-referred transgender adolescents. Eur. Child Adolesc. Psychiatry 31(1): 67– 83 33165650
  31. de Vries ALC, Doreleijers TAH, Steensma TD, Cohen-Kettenis PT. 2011a. Psychiatric comorbidity in gender dysphoric adolescents. J. Child Psychol. Psychiatry 52(11): 1195– 1202 21671938
  32. de Vries ALC, McGuire JK, Steensma TD, Wagenaar ECF, Doreleijers TAH, Cohen-Kettenis PT. 2014. Young adult psychological outcome after puberty suppression and gender reassignment. Pediatrics 134(4): 696– 704 25201798
  33. de Vries ALC, Steensma TD, Doreleijers TAH, Cohen-Kettenis PT. 2011b. Puberty suppression in adolescents with gender identity disorder: a prospective follow-up study. J. Sex. Med 8: 2276– 83 20646177
  34. Durwood L, Eisner L, Fladeboe K, Ji CG, Barney S, 2021. Social support and internalizing psychopathology in transgender youth. J. Youth Adolesc 50(5): 841– 54 33575917 PMC8272454
  35. Ehrensaft D 2017. Gender nonconforming youth: current perspectives. Adolesc. Health, Med. and Ther 8: 57– 67. 28579848 PMC5448699
  36. Eisenberg ME, Gower AL, McMorris BJ, Nicole Rider G, Shea G, Coleman E. 2017. Risk and protective factors in the lives of transgender/gender nonconforming adolescents. J. Adolesc. Health Care 61(4): 521– 26 PMC5626022 28736148
  37. Evans YN, Gridley SJ, Crouch J, Wang A, Moreno MA, 2017. Understanding online resource use by transgender youth and caregivers: a qualitative study. Transgend Health. 2(1): 129– 39 29082333 PMC5628561
  38. Fontanari AMV, Vilanova F, Schneider MA, Chinazzo I, Soll BM, 2020. Gender affirmation Is associated with transgender and gender nonbinary youth mental health improvement. LGBT Health. 7(5): 237– 47 32456545
  39. Fortunato A, Giovanardi G, Innocenzi E, Mirabella M, Caviglia G, 2022. Is It Autism? A critical commentary on the co-occurrence of gender dysphoria and autism spectrum disorder. J. Homosex 69(7): 1204– 21 33852376
  40. Gibson DJ, Glazier JJ, Olson KR. 2021. Evaluation of anxiety and depression in a community sample of transgender youth. JAMA Psychiatry. 4 PMC8027909 33825842
  41. Gower AL, Rider GN, Brown C, McMorris BJ, Coleman E, 2018. Supporting transgender and gender diverse youth: protection against emotional distress and substance use. Am. J. Prev. Med 55(6): 787– 94 30344037 PMC6501838
  42. Green AE, DeChants JP, Price MN, Davis CK. 2022. Association of gender-affirming hormone therapy with depression, thoughts of suicide, and attempted suicide among transgender and nonbinary youth. J. Adolesc. Health 70(4): 643– 49 34920935
  43. Guz S, Kattari SK, Atteberry-Ash B, Klemmer CL, Call J, Kattari L. 2021. Depression and suicide risk at the cross-section of sexual orientation and gender identity for youth. J. Adolesc. Health 68(2): 317– 23 32680801
  44. Hatchel T, Valido A, De Pedro KT, Huang Y, Espelage DL. 2019. Minority stress among transgender adolescents: the role of peer victimization, school belonging, and ethnicity. J. Child Fam. Stud 28(9): 2467– 76
  45. Hatzenbuehler ML. 2017. Advancing research on structural stigma and sexual orientation disparities in mental health among youth. J. Clin. Child Adolesc. Psychol 46(3): 463– 75 27911583 PMC6759852
  46. Hidalgo MA, Petras H, Chen D, Chodzen G. 2019. The Gender Minority Stress and Resilience Measure: Psychometric validity of an adolescent extension. Clin. Pract. Pediatr. Psychol 7(3): 278– 90 33224698 PMC7678225
  47. Hillier A, Torg E. 2019. 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.” Transgender Health. 4(1): 168– 75 31406916 PMC6689185
  48. Hisle-Gorman E, Schvey NA, Adirim TA, Rayne AK, Susi A, 2021. Mental healthcare utilization of transgender youth before and after affirming treatment. J. Sex. Med 18(8): 1444– 54 34247956
  49. Holt V, Skagerberg E, Dunsford M. 2016. Young people with features of gender dysphoria: demographics and associated difficulties. Clin. Child Psychol. Psychiatry 21(1): 108– 18 25431051
  50. Jackman KB, Caceres BA, Kreuze EJ, Bockting WO. 2021. Suicidality among gender minority youth: analysis of 2017 Youth Risk Behavior Survey data. Arch. Suicide Res 25(2): 208– 23 31642392 PMC7176535
  51. Jacobs LA, Rachlin K, Erickson-Schroth L, Janssen A. 2014. Gender dysphoria and co-occurring autism spectrum disorders: review, case examples, and treatment considerations. LGBT Health. 1(4): 277– 82. 26789856
  52. Johns MM, Zamantakis A, Andrzejewski J, Boyce L, Rasberry CN, Jayne PE. 2021. Minority stress, coping, and transgender youth in schools-results from the resilience and transgender youth study. J. Sch. Health 91(11): 883– 93 34533210
  53. Johnson KC, LeBlanc AJ, Sterzing PR, Deardorff J, Antin T, Bockting WO. 2020b. Trans adolescents’ perceptions and experiences of their parents’ supportive and rejecting behaviors. J. Couns. Psychol 67(2): 156– 70 32105126
  54. Jones T, Hillier L. 2013. Comparing trans-spectrum and same-sex-attracted youth in Australia: increased risks, increased activisms. J. LGBT Youth 10(4): 287– 307
  55. Kaltiala R, Heino E, Työläjärvi M, Suomalainen L. 2020. Adolescent development and psychosocial functioning after starting cross-sex hormones for gender dysphoria. Nord. J. Psychiatry 74(3): 213– 19 31762394
  56. Katz-Wise SL, Budge SL, Orovecz JJ, Nguyen B, Nava-Coulter B, Thomson K. 2017. Imagining the future: Perspectives among youth and caregivers in the trans youth family study. J. Couns. Psychol 64(1): 26– 40 28068129 PMC5224913
  57. Keo-Meier C, Ehrensaft D, eds. 2018. Introduction to the gender affirmative model. In The Gender Affirmative Model: An Interdisciplinary Approach to Supporting Transgender and Gender Expansive Children, pp. 3– 19. Washington: American Psychological Association
  58. Khadr S, Masic U, Clarke V, Lynn RM, Holt V, Carmichael P. 2022. Key socio-demographic characteristics of children and adolescents with gender dysphoria: A British Isles surveillance study. Clin. Child Psychol. Psychiatry 0(0): 1– 18 35746847
  59. Kidd KM, Sequeira GM, Paglisotti T, Katz-Wise SL, Kazmerski TM, 2021. “ This could mean death for my child”: parent perspectives on laws banning gender-affirming care for transgender adolescents. J. Adolesc. Health 68(6): 1082– 88 33067153 PMC8041924
  60. Kotov R, Krueger RF, Watson D, Achenbach TM, Althoff RR, 2017. The Hierarchical Taxonomy of Psychopathology (HiTOP): a dimensional alternative to traditional nosologies. J. Abnorm. Psychol 126(4): 454– 77 28333488
  61. Kozee HB, Tylka TL, Bauerband AL. 2012. Measuring transgender individuals’ comfort with gender identity and appearance: development and validation of the Transgender Congruence Scale. Psychol. Women Q 36(2): 179– 96
  62. Kuper LE, Lindley L, Lopez X. 2019a. Exploring the gender development histories of children and adolescents presenting for gender affirming medical care. Clin. Pract. Pediatr. Psychol 7(3): 217– 28
  63. Kuper LE, Mathews S, Lau M. 2019b. Baseline mental health and psychosocial functioning of transgender adolescents seeking gender-affirming hormone therapy. J. Dev. Behav. Pediatr 40(8): 589– 96 31166250
  64. Kuper LE, Stewart S, Preston S, Lau M, Lopez X. 2020. Body dissatisfaction and mental health outcomes of youth on gender-affirming hormone therapy. Pediatrics. 145(4) 32220906
  65. Kuvalanka KA, Weiner JL, Munroe C, Goldberg AE, Gardner M. 2017. Trans and gender-nonconforming children and their caregivers: Gender presentations, peer relations, and well-being at baseline. J. Fam. Psychol 31(7): 889– 99 28795828
  66. Lawlis SM, Butler P, Middleman A. 2020. Evaluating transgender youth and parent interest and preferences regarding support groups. Glob. Pediatr. Health 7: 1– 9 PMC7488600 32964072
  67. Leon K, O’Bryan J, Wolf-Gould C, Turell SC, Gadomski A. 2021. Prevalence and risk factors for nonsuicidal self-injury in transgender and gender-expansive youth at a rural gender wellness clinic. Transgender Health. 6(1): 43– 50 33644321 PMC7906233
  68. Levitan N, Barkmann C, Richter-Appelt H, Schulte-Markwort M, Becker-Hebly I. 2019. Risk factors for psychological functioning in German adolescents with gender dysphoria: poor peer relations and general family functioning. Eur. Child Adolesc. Psychiatry 28(11): 1487– 98 30877477
  69. Linsenmeyer WR, Katz IM, Reed JL, Giedinghagen AM, Lewis CB, Garwood SK. 2021. Disordered eating, food insecurity, and weight status among transgender and gender nonbinary youth and young adults: a cross-sectional study using a nutrition screening protocol. LGBT Health. 8(5): 359– 66 34097472
  70. López de Lara D, Rodríguez OP, Flores IC, Masa JLP, Campos-Muñoz L, 2020. Psychosocial assessment in transgender adolescents. Anales de Pediatría (English Edition). 93(1): 41– 48 32144041
  71. Lucassen MF, Stasiak K, Fleming T, Frampton C, Perry Y, 2021. Computerized cognitive behavioural therapy for gender minority adolescents: analysis of the real-world implementation of SPARX in New Zealand. Aust. N. Z. J. Psychiatry 55(9): 874– 82 33287554 PMC8404718
  72. Mahfouda S, Panos C, Whitehouse AJO, Thomas CS, Maybery M, 2019. Mental health correlates of autism spectrum disorder in gender diverse young people: evidence from a specialised child and adolescent gender clinic in Australia. J. Clin. Med. Res 8 PMC6832530 31547002
  73. Malpas J, Pellicane MJ, Glaeser E. 2022. Family-based interventions with transgender and gender expansive youth: systematic review and best practice recommendations. Transgender Health. 7(1): 7– 29 36644030 PMC9829155
  74. Matsuno E, Israel T. 2021. The Parent Support Program: development and acceptability of an online intervention aimed at increasing supportive behaviors among parents of trans youth. J. GLBT Fam. Stud. 17(5): 413– 31
  75. Mehringer JE, Harrison JB, Quain KM, Shea JA, Hawkins LA, Dowshen NL. 2021. Experience of chest dysphoria and masculinizing chest surgery in transmasculine youth. Pediatrics. 147(3) 33536330
  76. Nahata L, Quinn GP, Caltabellotta NM, Tishelman AC. 2017. Mental health concerns and insurance denials among transgender adolescents. LGBT Health. 4(3): 188– 93 28402749
  77. Newhook JT, Benson K, Bridger T, Crowther C, Sinnott R. 2018. The TransKidsNL study: Healthcare and support needs of transgender children, youth, and families on the Island of Newfoundland. Can. J. Commun. Ment. Health 37(2): 13– 28
  78. Paceley MS, Dikitsas ZA, Greenwood E, McInroy LB, Fish JN, 2021. The perceived health implications of policies and rhetoric targeting transgender and gender diverse youth: a community-based qualitative study. Transgender Health. PMC9991426 36895313
  79. Paceley MS, Okrey-Anderson S, Heumann M. 2017. Transgender youth in small towns: perceptions of community size, climate, and support. J. Youth Stud 20(7): 822– 40
  80. Pang KC, de Graaf NM, Chew D, Hoq M, Keith DR, 2020. Association of media coverage of transgender and gender diverse issues with rates of referral of transgender children and adolescents to specialist gender clinics in the UK and Australia. JAMA Pediatr. 3(7) PMC7388018 32721030
  81. Pariseau EM, Chevalier L, Long KA, Clapham R, Edwards-Leeper L, Tishelman AC. 2019. The relationship between family acceptance-rejection and transgender youth psychosocial functioning. Clin. Pract. Pediatr. Psychol 7(3): 267– 77
  82. Peng K, Zhu X, Gillespie A, Wang Y, Gao Y, 2019. Self-reported rates of abuse, neglect, and bullying experienced by transgender and gender-nonbinary adolescents in China. JAMA Public Health. 2(9) PMC6735403 31490542
  83. Peterson CM, Matthews A, Copps-Smith E, Conard LA. 2017. Suicidality, self-harm, and body dissatisfaction in transgender adolescents and emerging adults with gender dysphoria. Suicide Life Threat. Behav 47(4): 475– 82 27539381
  84. Pham A, Morgan AR, Kerman H, Albertson K, Crouch JM, 2020. How are transgender and gender nonconforming youth affected by the news? A qualitative study. J. Adolesc. Health 66(4): 478– 83 31964610
  85. Potter A, Dube S, Allgaier N, Loso H, Ivanova M, 2021. Early adolescent gender diversity and mental health in the Adolescent Brain Cognitive Development study. J. Child Psychol. Psychiatry 62(2): 171– 79 32463952 PMC7704539
  86. Price-Feeney M, Green AE, Dorison SH. 2020. Understanding the mental health of transgender and nonbinary youth. J. Adolesc. Health 66(6): 684– 90 31992489
  87. Price-Feeney M, Green AE, Dorison SH. 2021. Impact of bathroom discrimination on mental health among transgender and nonbinary youth. J. Adolesc. Health 68(6): 1142– 47 33288457
  88. Pulice-Farrow L, Cusack CE, Galupo MP. 2020. “ Certain parts of my body don’t belong to me”: trans individuals’ descriptions of body-specific gender dysphoria. Sex. Res. Social Policy 17(4): 654– 67
  89. Pullen Sansfaçon A, Temple-Newhook J, Suerich-Gulick F, Feder S, Lawson ML, 2019. The experiences of gender diverse and trans children and youth considering and initiating medical interventions in Canadian gender-affirming speciality clinics. Int. J. Transgend 20(4): 371– 87 32999623 PMC6913674
  90. Reed GM, Drescher J, Krueger RB, Atalla E, Cochran SD, 2016. Disorders related to sexuality and gender identity in the ICD-11: revising the ICD-10 classification based on current scientific evidence, best clinical practices, and human rights considerations. World Psychiatry. 15(3): 205– 21 27717275 PMC5032510
  91. Reisner SL, Vetters R, Leclerc M, Zaslow S, Wolfrum S, 2015. Mental health of transgender youth in care at an adolescent urban community health center: a matched retrospective cohort study. J. Adolesc. Health 56(3): 274– 79 25577670 PMC4339405
  92. Rider GN, McMorris BJ, Gower AL, Coleman E, Eisenberg ME. 2018. Health and care utilization of transgender and gender nonconforming youth: a population-based study. Pediatrics. 141(3) PMC5847087 29437861
  93. Rimes KA, Goodship N, Ussher G, Baker D, West E. 2019. Non-binary and binary transgender youth: comparison of mental health, self-harm, suicidality, substance use and victimization experiences. Int. J. Transgend 20(2–3): 230– 40 32999609 PMC6831005
  94. Röder M, Barkmann C, Richter-Appelt H, Schulte-Markwort M, Ravens-Sieberer U, Becker I. 2018. Health-related quality of life in transgender adolescents: associations with body image and emotional and behavioral problems. Int. J. Transgend 19(1): 78– 91
  95. Rogol AD, Roemmich JN, Clark PA. 2002. Growth at puberty. J. Adolesc. Health 31: 192– 200 12470915
  96. Ross-Reed DE, Reno J, Peñaloza L, Green D, FitzGerald C. 2019. Family, school, and peer support are associated with rates of violence victimization and self-harm among gender minority and cisgender youth. J. Adolesc. Health 65(6): 776– 83 31564618
  97. Russell ST, Pollitt AM, Li G, Grossman AH. 2018. Chosen name use is linked to reduced depressive symptoms, suicidal ideation, and suicidal behavior among transgender youth. J. Adolesc. Health 63(4): 503– 5 29609917 PMC6165713
  98. Sievert ED, Schweizer K, Barkmann C, Fahrenkrug S, Becker-Hebly I. 2021. Not social transition status, but peer relations and family functioning predict psychological functioning in a German clinical sample of children with gender dysphoria. Clin. Child Psychol. Psychiatry 26(1): 79– 95 33081539
  99. Skagerberg E, Davidson S, Carmichael P. 2013a. Internalizing and externalizing behaviors in a group of young people with gender dysphoria. Int. J. Transgend 14(3): 105– 12
  100. Skagerberg E, Parkinson R, Carmichael P. 2013b. Self-harming thoughts and behaviors in a group of children and adolescents with gender dysphoria. Int. J. Transgend 14(2): 86– 92
  101. Sood R, Chen D, Muldoon AL, Chen L, Kwasny MJ, 2021. Association of chest dysphoria with anxiety and depression in transmasculine and nonbinary adolescents seeking gender-affirming care. J. Adolesc. Health Care 68(6): 1135– 41 PMC8903018 33849759
  102. Sorbara JC, Chiniara LN, Thompson S, Palmert MR. 2020. Mental health and timing of gender-affirming care. Pediatrics. 146(4) 32958610
  103. Strang JF, Janssen A, Tishelman A, Leibowitz SF, Kenworthy L, 2018. Revisiting the link: evidence of the rates of autism in studies of gender diverse individuals. J. Am. Acad. Child Adolesc. Psychiatry 57(11): 885– 6 30392631
  104. Strauss P, Morgan H, Wright Toussaint D, Lin A, Winter S, Perry Y. 2019. Trans and gender diverse young people’s attitudes towards game-based digital mental health interventions: A qualitative investigation. Internet Interv. 18 PMC6926275 31890628
  105. Suess Schwend A, Winter S, Chiam Z, Smiley A, Cabral Grinspan M. 2018. Depathologising gender diversity in childhood in the process of ICD revision and reform. Glob. Public Health 13(11): 1585– 98 29363412
  106. Surace T, Fusar-Poli L, Vozza L, Cavone V, Arcidiacono C, 2021. Lifetime prevalence of suicidal ideation and suicidal behaviors in gender non-conforming youths: a meta-analysis. Eur. Child Adolesc. Psychiatry 30(8): 1147– 61 32170434
  107. Taliaferro LA, McMorris BJ, Eisenberg ME. 2018. Connections that moderate risk of non-suicidal self-injury among transgender and gender non-conforming youth. Psychiatry Res. 268: 65– 67 30005190 PMC6129209
  108. Taliaferro LA, McMorris BJ, Rider GN, Eisenberg ME. 2019. Risk and protective factors for self-harm in a population-based sample of transgender youth. Arch. Suicide Res 23(2): 203– 21 29461934 PMC6102088
  109. Thoma BC, Rezeppa TL, Choukas-Bradley S, Salk RH, Marshal MP. 2021. Disparities in childhood abuse between transgender and cisgender adolescents. Pediatrics. 148(2) PMC8344346 34226247
  110. Toomey RB. 2021. Advancing research on minority stress and resilience in trans children and adolescents in the 21st century. Child Dev. Perspect 15(2): 96– 102
  111. Toomey RB, Syvertsen AK, Shramko M. 2018. Transgender adolescent suicide behavior. Pediatrics. 142(4) PMC6317573 30206149
  112. Turban JL, van Schalkwyk GI. 2018. “ Gender dysphoria” and autism spectrum disorder: Is the link real? J. Am. Acad. Child Adolesc. Psychiatry 57(1): 8– 9 29301673
  113. Van Cauwenberg G, Dhondt K, Motmans J. 2021. Ten years of experience in counseling gender diverse youth in Flanders, Belgium. A clinical overview. Int. J. Impot. Res 33(7): 671– 78 33953378
  114. Vance SR, Boyer CB, Glidden DV, Sevelius J. 2021. Mental health and psychosocial risk and protective factors among Black and Latinx transgender youth compared with peers. JAMA Pediatr. 4(3) PMC7998078 33769506
  115. Wallien MSC, Swaab H, Cohen-Kettenis PT. 2007. Psychiatric comorbidity among children with gender identity disorder. J. Am. Acad. Child Adolesc. Psychiatry 46(10): 1307– 14 17885572
  116. Wang Y, Yu H, Yang Y, Drescher J, Li R, 2020. Mental health status of cisgender and gender-diverse secondary school students in China. JAMA Psychiatry 3(10) PMC7592029 33107922
  117. Weinhardt LS, Xie H, Wesp LM, Murray JR, Apchemengich I, 2019. The Role of family, friend, and significant other support in well-being among transgender and non-binary youth. J. GLBT Fam. Stud 15(4): 311– 25
  118. Wernick LJ, Kulick A, Inglehart MH. 2014. Influences of peers, teachers, and climate on students’ willingness to intervene when witnessing anti-transgender harassment. J. Adolesc 37: 927– 35 25032899
  119. Witcomb GL, Claes L, Bouman WP, Nixon E, Motmans J, Arcelus J. 2019. Experiences and psychological wellbeing outcomes associated with bullying in treatment-seeking transgender and gender-diverse youth. LGBT Health. 6(5): 216– 26 31184969
  120. Yadegarfard M, Meinhold-Bergmann ME, Ho R. 2014. Family Rejection, Social Isolation, and Loneliness as Predictors of Negative Health Outcomes (Depression, Suicidal Ideation, and Sexual Risk Behavior) Among Thai Male-to-Female Transgender Adolescents. J. LGBT Youth 11(4): 347– 63
  121. Zucker KJ. 2005. Gender Identity Disorder in Children and Adolescents. Annu. Rev. Clin. Psychol 1: 467– 9 17716096

Cited by

Sorted by citations

Authors
Wittlin, N. M., Kuper, L. E., & Olson, K. R.
Affiliations
  • Princeton University (US)
  • The University of Texas Southwestern Medical Center (US)
ORCID
Venue
Annual Review of Clinical Psychology
Publisher
Annual Reviews
Published
2023-05-09
Volume
19
Issue
1
Pages
207-232
ISSN
  • 1548-5943 (ISSN-L)
  • 1548-5951
DOI
10.1146/annurev-clinpsy-072220-020326
PMC
PMC9936952
OpenAlex
W4313611754
Cited by
199
References
12
Citations by year
2026: 66 · 2025: 71 · 2024: 51 · 2023: 10 · 2022: 1
FWCI
9.66
Type
journal article
Language
en
Open access
Licence
Locations
  • Annual Review of Clinical Psychology (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • PubMed Central (acceptedVersion)
Funders
  • National Science Foundation
  • John D. and Catherine T. MacArthur Foundation
  • National Institutes of Health
  • National Institute on Minority Health and Health Disparities (F32MD017147)
  • Eunice Kennedy Shriver National Institute of Child Health and Human Development (R01HD092347)
Topics
  • Social Sciences › Psychology › Social Psychology › LGBTQ Health, Identity, and Policy
  • Social Sciences › Psychology › Clinical Psychology › Child and Adolescent Psychosocial and Emotional Development
  • Social Sciences › Gender Studies › Gender, Sexuality, and Education
Keywords
transgender youth, gender-diverse youth, mental health disparities, psychological distress, minority stress, stigma, gender-affirming care, mental health interventions, adolescents, children
MeSH terms
Sexual and Gender Minorities, Psychological Distress, Adolescent, Child, Female, Humans, Male, Mental Health, Transgender Persons

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