Transgender youth

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The transgender symbol
The transgender symbol

Transgender youth are children and adolescents who are transgender and/or transsexual. Because transgender youth are usually dependent on their parents for care, shelter, financial support, and other needs, and because most doctors are reluctant to provide medical treatments to them, transgender youth face different challenges compared to adults. Transgender issues manifest at different times in life in different individuals. In most cases of gender dysphoria, the condition is often apparent in early childhood, when such a child may express behavior incongruent with and dissatisfaction related to their assigned gender. However, many of these children experience rejection as a result of their differences and quickly attempt to repress them. Therefore, people who see these children regularly may be unaware that they are unhappy as members of their assigned gender.

Coming out[edit]

In many parts of the world, being transgender[1] is not widely accepted by the public and as for transgender youth, they not only face discrimination but also can encounter family exclusion.[2] Transgender youth may feel that they need to remain in "the closet" until they feel that it is safe and appropriate to come out and reveal their gender identity to their parents, family members, and friends. To "come out", according to Merriam Webster,[3] means to openly declare something about oneself previously kept hidden or to openly declare one's homosexuality. For the LGBT community, to "come out" means to acknowledge ones sexual identity or gender identity and make it known to the public of their identity. At the beginning, they may first be aware of the discordance of their gender identities and biological representation. This process can occur as early as six years old, with a mean age of 10.4. It takes on average three years then they would start getting labels from others saying that they are transgender individuals. Around a year later, they would recognise themselves as transgender individuals and start telling others about it. They would also start representing themselves according to their gender identities.[4]

Family acceptance[edit]

Family acceptance holds a significant impact on the lives of transgender youth.[2] It may be impossible to predict a parent's reaction to the news of their child's decision to change his or her gender identity and the process can be fraught for many transgender youths. In some cases, parents will react negatively to such news and reject the child's decision by disowning the child or taking actions such as kicking the youth out of the home. Current research suggests that transgender youth who have been entered into the juvenile justice system are more likely to have experienced family rejection, abuse, and or abandonment compared to those youth who are not transgender as a result of "coming out" at a young age. Because transgender youth depend on their parents for support and acceptance, family exclusion can result in them becoming emotionally vulnerable and regretting their decision to come out.[5] On the other hand, some parents are very supportive and provide their children with aid to guide them through transitioning.[6] Additionally, reactions of parents to transgender children can change over time. For example, parents who initially reacted with negativity and hostility may eventually come around to support their transgender children.

Health risks[edit]

Family acceptance among transgender youth predicts an increase in greater self-esteem, social support, and general health status; it also protects against depression, substance abuse, and suicidal ideation and behaviors.[7] As recent as 2015, research has shown that in carefully selected patients, people who transition young suffer few ill effects,[8] and maintain a higher level of functioning than before transitioning. Additionally, results of treatment such as counseling are considered better when it is offered at an earlier age.

Family behaviors can increase or decrease health risks of transgender youth.[9] Behaviors such as physically or verbally abusing the youth, pressuring the youth to become more masculine or feminine, excluding the youth from family events, etc. will lead to higher health risks such as depression and suicide. On the positive end, behaviors such as supporting the youths gender identity by talking about it and working to support their choice even though the parent might be uncomfortable makes a significant impact on boosting the youths confidence, which works to combat health risks associated with rejection.[8]

Vulnerability[edit]

Transgender youth are extremely vulnerable to a multitude of problems, including substance use disorders, suicide, childhood abuse, sexual abuse/assault, and psychiatric disorders.[10]

Gender dysphoria[edit]

Gender dysphoria is a strong, persistent discomfort and distress with one's gender, anatomy, birth sex, and even societal attitudes toward their gender variance.[11] Transgender youth who experience gender dysphoria tend to be very conscious of their body; appearance, weight, and other people's opinions of their body may become very important. Body esteem of several transgender youth was measured in an interview in three categories (personal satisfaction of appearance, personal satisfaction of weight, and perceived satisfaction of others of one's body appearance). It was found that those transgender youth who experienced less personal satisfaction with their weight and who perceived others’ satisfaction with their body as worse were more likely to practice life-threatening behaviors than those who were more satisfied with their weight and thought that others view their body more positively.[12]

Physical, sexual, and verbal abuse[edit]

Transgender youth are at an increased risk for physical, verbal and sexual abuse. There is evidence that indicates around 75% of transgender youth were verbally abused by their parents or caregivers, and around 35% had faced physical abuse by the hand of their caregiver.[12] As one transgender youth said, "Throughout my whole life, I was abused physically and mentally by relatives in my family. Have marks on my body. I have things that I remember happened to me.[10]" Youth who have parental support of their atypical gender presentation are much more likely to be better off in several ways: mentally, financially, academically, etc. Transgender youth who face physical abuse may be forced to leave their homes, or choose to leave, which can be a particularly traumatic experience. The lack of housing was found to often lead to financial difficulties for such youth. Lack of support at home and constant harassment at school may lead to academic difficulties for the youth as well, who face a much higher drop out level compared to their cisgender counterparts[10]

Homelessness and survival sex[edit]

According to the National Healthcare for the Homeless Council, 1 in 5 LGBT youth have unstable housing or lack housing altogether,[13] as a result of that 1 in 5, it is estimated that between 20-40% of homeless youth are a part of the LGBT population.[8] Some of the reasoning as to why LGBT youth are not able to have stable housing is family rejection/conflict, varying forms of violence, and difficulty within various institutions such as school or the foster care system.[13] Even when LGBT youth find themselves in homeless shelters, they are not having their needs met even within homeless shelters leaving them at disproportionate rates on the streets compared to their heterosexual and cisgender peers, who fit within the gendered housing they are given and do not require additional services in their shelter placement.[14]

One practice that has resulted from transgender youth's inability to attain shelter that cares for their needs is to turn to survival sex for their money and shelter needs. Survival sex is the act of engaging in sexual activity with another individual or the act of selling sex in order to meet one's basic survival needs.[15] A recent multi city study found that about one in four homeless and runaway youth has engaged in survival sex.[16] Transactions typically result in the youth receiving monetary value, but also can be utilized to gain a bed for the night, a meal, or clothing. While there is an awareness of the possible dangers associated with survival sex, it is often reported that a sense of pride in being able to support oneself accompanies the activity or the positivity of being able to eat and have somewhere to rest that night. Dangers do lurk when it comes to this transaction, primarily being the stigma that results from the transaction and the possibility of contracting an STI/STD (sexually transmitted infection/disease).[15]

Lack of access to healthcare[edit]

Transgender youth potentially face many hardships in obtaining medical treatment for gender dysphoria. This lack of access may be due to doctors refusing to treat youth or youth fearing negative reactions from health care providers. Psychiatrists and endocrinologists are generally reluctant to provide hormone therapy to youths under 16, and obtaining sex reassignment surgery prior to the age of 18 is almost impossible in most countries. Many youth who have used hormones to develop desired secondary male or female sex characteristics have obtained these hormones illicitly. This can be potentially dangerous, and can result in a multitude of health problems for the youth, including improper pubertal growth and HIV due to contaminated needles. Sexually transmitted infections are a large health problem for transgender teens as well, as sexual partners often do not perceive these youth as health risks, especially since male-to-female youth cannot become pregnant. This trend of unprotected sex among the transgender population puts them at increased risk and has led to higher numbers of STIs among the group[10] However, the latest revision of the Standards of Care for the Health of Transsexual, Transgender, and Gender Nonconforming People has addressed the needs of transgender children.

Existing healthcare options[edit]

When an individual is transitioning from female to male (FTM) or male to female (MTF), there are several avenues[17] that are available to them pendant upon their financial capabilities, insurance's agreement to cover costs, and personal desire to utilize these options. While these options do exist, many of them are labeled off limits to minors (individuals under the age of 18). One of the options that does exist for minors is the use of puberty blockers, which in 2013 were officially stated as not damaging to bone health at the Endocrine Society's 95 Annual Meeting in San Francisco.[18] In puberty, the mass of bones is built significantly, so this finding holds great importance in allowing transgender youth to keep from undergoing the psychological damage that may accompany their bodies going through a puberty that is not consistent with their gender identity. Puberty blockers are believed to put the succession of puberty on pause and can reverse any changes that had been made. Typically puberty blockers, which are reversible are first administered between the ages of 12–14 years of age, this is the age block because 16 years of age is believed to be too late.[18] For youth in Dutch nations, transgender youth are allowed to begin cross sex hormones at age 16, following their course of puberty blockers, allowing for successful transitions.[18] Medical interventions in the form of hormone therapy and sex reassignment surgery (SRS) are justified in the case of harm reduction for prepubescent children with severe gender dysphoria, since both can prevent severe psychological suffering.[19]

Norman Spack, an endocrinologist who primarily has worked with intersex patients, has been a forerunner in helping youth navigate the transition process and educate others. His work is guided by his desire to see the suicide rates amongst untreated transgender individuals go down and to keep youth from undergoing psychological trauma that can accompany puberty when they do not identify. Spack is inspired by the research done in Dutch nations in their use of puberty blockers and affirms this choice, this affirmation stems from the fact that early administration of cross sex hormones causes stunts in growth, issues of infertility, and other health issues. When this procedure of puberty blockers and cross sex hormones are followed, transitional surgery is then granted upon turning 18 years old.[20] Spack boasts a number of successful and well-known patients around the world, working with youth who cannot follow this prescription due to the height they may end up, one of these successes being a young woman named Jackie from England.[20]

For those who are above age 18 and do not require the consent of an adult, there is a myriad of options[17] available if they wish to transition. For those wishing to transition from male to female, options consist of facial feminisation surgery, vaginoplasty, breast augmentation surgery, and cross-sex hormones. For those wishing to transition from female to male, options consist of penile construction surgery, breast reduction surgery, and cross- sex hormones.[21] In order for any individual to receive these medical treatments, they must have a written diagnosis of gender dysphoria and have undergone up to a year's worth of therapy if they are a United States citizen.[22] If they are a citizen of Malta, there is a quick and relatively simple paperwork process to change their gender marker, in contrast, the United States has a difficult and extensive process that requires medical proof of need and returning to your home state to obtain various legal documents. In the United States to change an individual's existing gender marker and name, visits must be made to change the driver's license, social security card, banking documents, passport, the list trails on and extensive documentation must be presented in order to change each individual item.[23]

Bullying[edit]

School settings can be some of the toughest for transgender youth. Several problems may be faced at schools, including verbal and physical harassment and assault, sexual harassment, social exclusion and isolation, and other interpersonal problems with peers. Transgender students were much more likely than their peers to report harassment, assault, and feeling unsafe in school settings.[24] These experiences vary between individuals and schools attended. Larger schools tend to have safer climates for transgender students, as do schools with more low income and religious and ethnic minorities.[25]

Results of a 2009 study of 6th through 12th grade transgender students showed that most experienced a hostile school climate with regular harassment from peers. Eighty two percent of these youth reported that they felt unsafe at school because of their gender identity, and almost 90% reported experiencing homophobic harassment from peers frequently. A majority of these students also reported physical harassment at school, with nearly half reporting that they had been punched, kicked, or injured with a weapon. Sexual harassment among these students was also reported with alarming frequency (76%).[26] Restrooms and locker rooms pose an especially high threat to transgender students. They frequently reported fear an anxiety about using these facilities at school because of experiences of harassment by both peers and adults when using them. Negative comments about gender presentation may be frequently overheard in these places, and surveyed students have reported being "pushed around," "getting the crap beat out of them," and "getting their asses kicked" by peers.[26]

Unfortunately, school administrations often do not take reports of victimisation of transgender students seriously. Only a third of transgender students who reported victimization to school staff members feel that their situation was taken care of adequately and effectively. The other two thirds often run into situations where the school staff members blame the victimized students. One student, when reporting bullying, said that they were told "that I need to stop flaunting my sexuality".[26] School administrations often single out transgender students and discipline them for doing things such as wearing appropriate clothes for their gender identity, using restrooms consistent with their gender identity, and insisting on using their preferred name and personal pronouns. These things serve no educational purpose and only isolate transgender students further.[26]

High drop out rates and low grade point averages seem to plague the transgender population. The severity and frequency of bullying and harassment are directly correlated to these things. In one study of transgender youth, three quarters of the participants dropped out of school, almost all citing the main reason the constant acts of violence against them due to their gender identity. Anti-transgender bullying in schools has also been found to directly correlate with other negative outcomes, such as homelessness, unemployment, incarceration, and drug use.[26]

Suicide[edit]

Though several studies that estimate life-threatening behavior for gay, lesbian, and bisexual youth have been done, few have been done regarding transgender youth, and thus comparable estimates do not exist. The few studies that have been done, however, have all concluded that transgender youth are at increased risk even over their gay, lesbian, and bisexual counterparts. A 2007 study of transgender youth found that, of the youth interviewed, about half had seriously contemplated ending their own lives. Of those who had thought about suicide, about half had actually made an attempt. Overall, 18% of all interviewed transgender teenagers reported an attempted suicide that was linked to their transgender identity.[12] A similar study was conducted with gay, lesbian, and bisexual youth, with results showing 15% had made a suicide attempt that was due at least partly to their sexual orientation.[27] Both of these numbers are higher than the 8.5% of high school population overall who had reported life-threatening behavior.[15] In a recent study, it is found that these statistics are even higher for those who are homeless or have been rejected from receiving medical care due to their gender identity, this brings the numbers up to 69% with a general statistic stating that around 40% of transgender youth have attempted suicide.[28] In the 2011 National Transgender Discrimination Survey, which surveyed 6,450 transgender individuals, 41% of respondents reported attempting suicide compared to 1.6% of the general population. Suicide rates were reported even higher for those who were unemployed, experienced harassment and physical or sexual abuse, or low household income.[29]

Youth are generally predisposed to life-threatening behaviors due to a number of conditions, such as self-hatred, victimisation via bullying, substance abuse, etc. Transgender youth may also face victimization from peers and family members’ negative reactions to their atypical gender presentation, increasing their risk of life-threatening behaviors. Of the transgender youth who were interviewed and reported an attempt at taking their own life in the aforementioned study, almost all had been verbally abused by their parents, and a significant number had been physically abused as well. In comparing those transgender youth who had and had not attempted suicide, there were significant differences in family relations, peer relations, and school performance [12] Awareness of the suicide rates of LGBT youth spiked post-2010, as a result of significant publicity being given to the recent suicides of Leelah Alcorn, Skylar Lee, and Ash Haffner only being a few.[30]

Ensuring the child's security[edit]

A national survey conducted by GLSEN found that 75% of transgender youth feel unsafe at school, and those who are able to persevere have significantly lower GPAs and are more likely to miss school out of concern for their safety. These students also reported to be less likely to plan on continuing their education as a result to their unsafe environment.[1]

In recent years, some transgender children have received counseling and, in some cases, medical treatment for their condition, as well as the ability to change their gender identity. In some countries, schools are working to accommodate gender identity and expression by eliminating traditional gendered activities.[31]

A safe school climate is essential for transgender, gender dysphoric, and gender non-conforming children, who likely experience stress and anxiety due to their desire to transition or display themselves as a different gender. While many schools have become more accepting and allow children to express their desired gender identity, current research shows that there is an increased amount of harassment, bullying, indifference by school staff, and antigay victimization towards transgender and gender non-conforming youth.[32] Schools must enforce LGBTQ-related policies and implement necessary staff trainings to minimize these social hazards for transgender and gender non-conforming children.

Families with a young child that identifies as a different gender and chooses to alter their gender role through dress or behaviors may respect their child's decision, and sometimes, may decide to relocate the child to another area in order to afford the young person the best opportunity to live in their desired gender role among a novel set of peers and community. This helps protect transgender children from peer rejection, bullying, and harassment.

Families with a transgender child living within an intolerant community may face challenging issues. Gwen Araujo of Newark, California was a young person who was living as female, when she had been assigned to the male gender at birth. When her trans status was revealed at a party she attended, she became the victim of violent crimes that resulted in her death. Thankfully the Araujo case is an extreme one, however parents should be aware of the social implications of their transgender child living in an unsafe environment.[33]

Acceptance of transgender youth[edit]

On a global scale, transgender individuals face varying levels of acceptance or denial based on their location's attitude towards the LGBT community. Factors that influence acceptance or denial of their identity tend to surround political interests, religious affiliations, and whether their identity is still labeled as a mental health disorder.[34] Acceptance levels tend to predominantly be higher in countries located in the Global North.[34] Despite higher levels, acceptance rates still vary from country to country, Malta and the United States of America are two examples of countries where legislation and the social acceptance levels have curated a safer environment for transgender individuals.

Malta[edit]

In early April 2015, Malta adopted what some have declared as a groundbreaking bill in Parliament titled the 'Gender Identity, Gender Expression and Sex Characteristics Act' (GIGESC Bill). The bill allows youth to have their parents apply to have their gender marker changed for them or to have a gender marker held from their birth certificate held until their gender identity has been discovered. The bill also keeps from having surgeries performed on intersex infants until their gender identity has been discovered; the parents are no longer required to make an immediate decision and medical personnel cannot override this decision.[23] For individuals who are no longer a minor, they only need to request a notary for self declaration and cannot be asked for medical records when changing their gender marker or performing any other legal changes in conjunction to their gender identity.[27] In order to continue Malta's progress in LGBT protections and rights, the government has set up a council called the LGBTIQ Consultative Council, this action shows their commitment and dedication to actually enforcing the Bill.[23] While there are other European countries who have created allowances and encouraged acceptance of transgender individuals, most require compulsory sterilization and have lengthy legal proceedings.[35]

United States of America[edit]

Many transgender youth constantly face struggles in attempting to transition and to be accepted in the U.S.. According to the Human Rights Campaign, in 32 states an individual can be fired for being transgender and in 33 states an individual can be refused housing.[36][37] In 2013, the state of California signed a bill in to legislation titled the School Success and Opportunity Act giving transgender students the full rights and opportunities that their cisgender peers are granted.[38] For individuals who are minors, if their parents consent, they are able to begin receiving puberty blockers at a young age and later receive cross sex hormones and then transitional surgeries upon turning 18 years of age.[20] For those who are not minors, they are able to participate in any body altering transitional experience that they desire if they are able to financially afford it and after going through a year of therapy to affirm this decision, but will have to jump over several hurdles for it to also be legally marked.[21]

Transgender youth leaders/activists[edit]

D.W. Trantham[edit]

At 13 years old, D.W. began the transition from male to female quietly for a year before coming out to her peers at her school, South Junior High School, in Boise, Idaho.[39] Upon coming out and deciding to use a women's bathroom in her school, the parents of one child very publicly pulled their child out of school out of anger that their child would have to share a bathroom with D.W.[40] In January 2015, D.W. testified before the Idaho state courthouse on needing protections as a transgender youth and the need for transgender rights. While the Add the Words bill did not end up passing, the testimonies of D.W. and her father were felt throughout the crowd, whether positively or negatively.[41]

Jazz Jennings[edit]

At age 15, Jazz Jennings is a prominent figure in the transgender youth community after beginning to publicly transition at age 6 following a Barbara Walters interview. Since then she has spoken on a national level for transgender youth.[42] She has also gone on to star in a Clean&Clear commercial, write a book, and have a TLC show made about her viewpoint and daily life as a transgender youth.[43][44] In 2010, Jazz was named a youth ambassador by the Human Rights Campaign for all of the work she has done for the transgender community and for her prominence during Prop 8 in California.[45] At age 11, Jazz began using puberty blockers and will have to wait to begin taking cross-sex hormones and have gender affirmation surgeries completed until she is old enough.[45]

Media representations[edit]

The film Ma Vie en Rose (My Life in Pink) (1997) by Alain Berliner depicts a similar scenario. Ludovic is a young child who is assigned male but who lives as a girl and tries to make others agree with her identification. Ludovic's "gender play" incurs conflict within the family and prejudice from the neighbors; in the end, the family had to relocate to a new community.[citation needed]

The film Tomboy (2011) by Céline Sciamma follows the story of 10-year-old child named Laure who, after moving with her family to a new neighborhood, dresses as a boy and introduces himself to his new friends as Mikäel.

The 2015 Documentary film Louis Theroux: Transgender Kids follows documentarian Louis Theroux's exploration of the burgeoning transgender youth therapy community in San Francisco, California. He interviews several transgender youth as they engage in medical, social, and psychological therapies to conform to their desired gender identities.[46]

The film The Danish Girl (2015) by Tom Hooper, based on the novel of the same name by David Ebershoff, follows the life of one of the first known recipients of male-to-female sex reassignment surgery Lili Elbe.

See also[edit]

References[edit]

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External links[edit]