An unprecedented increase of legislative action targeting transgender and gender-diverse (TGD) youth has been observed across the United States, including Texas. The aim of this study was to assess the effects of the current sociopolitical climate on the well-being of families of TGD youth, as well as their intent to relocate.
Methods:
This is a cross-sectional survey of parent(s) and guardian(s) of TGD youth of age 17 or younger being seen in a clinic for gender-affirming care in Texas.
Results:
Out of 124 participants, 107 (88%) described the sociopolitical climate in Texas regarding TGD youth as “very hostile.” Just before the ban on gender-affirming care for youth was implemented, 18 (14%) families had relocated out of Texas. Of those remaining, 75 (75%) reported that they were at least somewhat likely to move in the near future, and 2 (2%) were in the process of relocating. Concern for their child’s mental health, physical health, access to gender-affirming care, as well as safety; risk of being accused of child abuse; and the parent’s own mental health were the main reasons for the intent to relocate.
Conclusions:
Current sociopolitical efforts directed at TGD youth in Texas are leading to distress and migration of families. Future studies need to assess how restrictive government policies directed at TGD youth impact their mental health and quality of life as well as that of their family members.
AbbottG. Texas Governor Directive to the Department of Family and Protective Services to Investigate Parents of Transgender Children. Office of the Texas Governor: Austin, TX; 2022. Available from: https://gov.texas.gov/uploads/files/press/O-MastersJaime202202221358.pdf [Last accessed: October24, 2023].
3.
SwansonV. Texas House Bill 25: Relating to Requiring Public School Students to Compete in Interscholastic Athletic Competitions Based on Biological Sex. Texas Legislature: Austin, TX; 2021. Available from: https://legiscan.com/TX/bill/HB25/2021/X3 [Last accessed: October24, 2023].
CampbellD. Relating to Prohibitions on the Provision to Certain Children of Procedures and Treatments for Gender Transitioning, Gender Reassignment, or Gender Dysphoria and on the Use of Public Money or Public Assistance to Provide Those Procedures and Treatments. Texas Legislature: Austin, TX; 2023. Available from: https://legiscan.com/TX/bill/SB14/2023 [Last accessed: October24, 2023].
7.
de VriesALC, McGuireJK, SteensmaTD, et al.Young adult psychological outcome after puberty suppression and gender reassignment. Pediatrics, 2014; 134(4):696–704; doi: 10.1542/peds.2013-2958
8.
CostaR, DunsfordM, SkagerbergE, et al.Psychological support, puberty suppression, and psychosocial functioning in adolescents with gender dysphoria. J Sex Med, 2015; 12(11):2206–2214; doi: 10.1111/jsm.13034
9.
KaltialaR, HeinoE, TyöläjärviM, et al.Adolescent development and psychosocial functioning after starting cross-sex hormones for gender dysphoria. Nord J Psychiatry, 2020; 74(3):213–219; doi: 10.1080/08039488.2019.1691260
10.
TurbanJL, KingD, CarswellJM, et al.Pubertal suppression for transgender youth and risk of suicidal ideation. Pediatrics, 2020; 145(2):e20191725; doi: 10.1542/peds.2019-1725
11.
KuperLE, StewartS, PrestonS, et al.Body dissatisfaction and mental health outcomes of youth on gender-affirming hormone therapy. Pediatrics, 2020; 145(4):e20193006; doi: 10.1542/peds.2019-3006
12.
van der MiesenAIR, SteensmaTD, de VriesALC, et al.Psychological functioning in transgender adolescents before and after gender-affirmative care compared with cisgender general population peers. J Adolesc Health, 2020; 66(6):699–704; doi: 10.1016/j.jadohealth.2019.12.018
13.
GreenAE, DeChantsJP, PriceMN, et al.Association of gender-affirming hormone therapy with depression, thoughts of suicide, and attempted suicide among transgender and nonbinary youth. J Adolesc Health, 2022; 70(4):643–649; doi: 10.1016/j.jadohealth.2021.10.036
14.
TordoffDM, WantaJW, CollinA, et al.Mental health outcomes in transgender and nonbinary youths receiving gender-affirming care. JAMA Netw Open, 2022; 5(2):e220978; doi: 10.1001/jamanetworkopen.2022.0978
15.
ArnoldussenM, van der MiesenAIR, ElzingaWS, et al.Self-perception of transgender adolescents after gender-affirming treatment: A follow-up study into young adulthood. LGBT Health, 2022; 9(4):238–246; doi: 10.1089/lgbt.2020.0494
16.
ChenD, BeronaJ, ChanY-M, et al.Psychosocial functioning in transgender youth after 2 years of hormones. N Engl J Med, 2023; 388(3):240–250; doi: 10.1056/NEJMoa2206297
17.
OlsavskyAL, GrannisC, BrickerJ, et al.Associations among gender-affirming hormonal interventions, social support, and transgender adolescents’ mental health. J Adolesc Health, 2023; 72(6):860–868; doi: 10.1016/j.jadohealth.2023.01.031
18.
AllenLR, WatsonLB, EganAM, et al.Well-being and suicidality among transgender youth after gender-affirming hormones. Clin Pract Pediatr Psychol, 2019; 7(3):302–311; doi: 10.1037/cpp0000288
19.
De VriesALC, SteensmaTD, DoreleijersTAH, et al.Puberty suppression in adolescents with gender identity disorder: A prospective follow-up study. J Sex Med, 2011; 8(8):2276–2283; doi: 10.1111/j.1743-6109.2010.01943.x
AbreuRL, SostreJP, GonzalezKA, et al.Impact of gender-affirming care bans on transgender and gender diverse youth: Parental figures’ perspective. J Fam Psychol, 2022; 36(5):643–652; doi: 10.1037/fam0000987
22.
AbreuRL, SostreJP, GonzalezKA, et al.“I am afraid for those kids who might find death preferable”: Parental figures’ reactions and coping strategies to bans on gender affirming care for transgender and gender diverse youth. Psychol Sex Orientat Gend Divers, 2022; 9(4):500–510; doi: 10.1037/sgd0000495
23.
KiddKM, SequeiraGM, PaglisottiT, et al.“This could mean death for my child”: Parent perspectives on laws banning gender-affirming care for transgender adolescents. J Adolesc Health, 2021; 68(6):1082–1088; doi: 10.1016/j.jadohealth.2020.09.010
24.
HarrisPA, TaylorR, ThielkeR, et al.Research electronic data capture (REDCap)–a metadata-driven methodology and workflow process for providing translational research informatics support. J Biomed Inform, 2009; 42(2):377–381; doi: 10.1016/j.jbi.2008.08.010
25.
StraussA, CorbinJ. Basics of Qualitative Research: Techniques and Procedures for Developing Grounded Theory. 2nd ed. Sage Publications: Thousand Oaks, CA; 1998.
26.
LeeWY, HobbsJN, HobaicaS, et al.State-level anti-transgender laws increase past-year suicide attempts among transgender and nonbinary young people in the USA. Nat Hum Behav, 2024; 8(11):2096–2106; doi: 10.1038/s41562-024-01979-5
27.
McNamaraM, LeporeC, AlstottA, et al.Scientific misinformation and gender affirming care: Tools for providers on the front lines. J Adolesc Health, 2022; 71(3):251–253; doi: 10.1016/j.jadohealth.2022.06.008
28.
KuperLE, CooperMB, MooneyMA. Supporting and advocating for transgender and gender diverse youth and their families within the sociopolitical context of widespread discriminatory legislation and policies. Clin Pract Pediatr Psychol, 2022; 10(3):336–345; doi: 10.1037/cpp0000456
Please find the following supplemental material available below.
For Open Access articles published under a Creative Commons License, all supplemental material carries the same license as the article it is associated with.
For non-Open Access articles published, all supplemental material carries a non-exclusive license, and permission requests for re-use of supplemental material or any part of supplemental material shall be sent directly to the copyright owner as specified in the copyright notice associated with the article.
