Long-term trajectories of psychosocial functioning among transgender youth and their parents.

项目总结/摘要 在过去几年中，地球仪对缺乏关于 性别确认激素疗法（GAHT;青春期抑制，雌激素， 睾酮），导致广泛的立法和政策 建议限制TGD青年获得这种治疗。同时，研究表明， 心理社会功能的短期改善（例如，心理健康（MH）和生活质量（QoL）） 接受GAHT的TGD青年一直在稳步积累，护理标准继续支持他们的健康。 使用.不幸的是，研究仍然受到随访时间短和样本量小的限制。随着体积 和多样性的青年提出的照顾越来越多，关注的稳定性TGD青年的身份， 他们后悔治疗的可能性也在增加。然而，缺乏对群体内的研究， 在接受GAHT的同时，TGD青年的心理社会轨迹的差异使提供者几乎没有指导 如何进行个性化护理。更广泛地说，由于对性别焦虑的测量不佳， 缺乏纳入少数民族的压力和复原力因素，这一因素在少数民族中特别明显。 当前的社会政治气候。接受GAHT的青少年的父母的作用也被忽视了 尽管父母在TGD青少年的心理健康方面发挥着关键作用。拟议项目利用 这是对美国接受GAHT的TGD青年进行的持续时间最长的研究，旨在解决这些关键差距 在文学作品中。这项研究是在第一个也是最大的多学科性别肯定护理中心进行的。 该计划为美国西南部的TGD青少年提供，自该计划实施以来，已招收了近700个家庭。 成立于2014年。该项目的目的是（1）描述5年和8年的心理社会轨迹， 接受GAHT的TGD青少年（包括性别焦虑、MSR、MH、QoL）及其父母的功能 （包括MSR和QoL），包括这些轨迹如何随时间相互影响，（2）识别和 探索具有相似基线和纵向经历的个体亚组的特征 性别焦虑（青年）和MSR（青年，父母），（3）评估MH之间的时间关系 （青少年），生活质量（青少年和父母），社会政治压力，包括因素，缓和这种影响 独特的压力形式。我们还将探讨那些经历过 改变性别或停止治疗。该项目将由一个以社区为基础的参与性 在整个研究过程中与TGD青年及其父母合作的方法，包括 选择更多的措施，以更好地反映性别焦虑和社会政治压力。鉴于TGD 青年人面临更大的风险，经历各种不良的心理社会后果， 纾解民困，促进健康发展的办法尤为迫切。拟议项目将 就如何做到这一点提供重要的经验指导。

Project Summary/Abstract Over the past several years, concerns have escalated across the globe regarding the lack of knowledge about the long-term effects of gender-affirming hormone therapy (GAHT; puberty suppression, estrogen, testosterone) for transgender and gender diverse (TGD) youth, resulting in widespread legislation and policy recommendations restricting TGD youth’s access to this treatment. Simultaneously, research demonstrating short-term improvements in psychosocial functioning (e.g., mental health (MH) and quality of life (QoL)) among TGD youth receiving GAHT has been steadily accumulating and standards of care continue to support their use. Unfortunately, studies remain limited by short follow-up periods and small sample sizes. As the volume and diversity of youth presenting for care is growing, concerns over the stability of TGD youth’s identities and the likelihood they will regret treatment are also increasing. However, lack of research on within-group differences in TGD youth’s psychosocial trajectories while receiving GAHT leaves providers with little guidance on how to individualize care. More broadly, research is limited by poor measurement of gender dysphoria and lack of inclusion of minority stress and resilience (MSR) factors, which are particularly pronounced in the current sociopolitical climate. The functioning of parents of youth receiving GAHT has also been overlooked despite the critical role parents play in the mental health of TGD youth. The proposed project leverages the longest-running study of TGD youth receiving GAHT in the United States to address each of these critical gaps in the literature. This study is being conducted at the first and largest multidisciplinary gender-affirming care program for TGD youth in the Southwest US and has enrolled nearly 700 families since the program was founded in 2014. The aims of the project are to (1) characterize the 5- and 8-year trajectories of psychosocial functioning among TGD youth receiving GAHT (including gender dysphoria, MSR, MH, QoL) and their parents (including MSR and QoL), including how these trajectories influence each other over time, (2) identify and explore the characteristics of subgroups of individuals who share similar baseline and longitudinal experiences of gender dysphoria (youth) and MSR (youth, parents), and (3) assess the temporal relationships between MH (youth), QoL (youth and parents), and sociopolitical stress, including factors that moderate the impact of this unique form of stress. We will also explore the characteristics and trajectories of youth who experience changes in their gender and/or stop treatment. The project will be guided by a community-based participatory approach that will collaborate with TGD youth and their parents throughout the research process, including in the selection of additional measures to better capture gender dysphoria and sociopolitical stress. Given TGD youth are at heightened risk of experiencing a broad range of adverse psychosocial outcomes, identifying methods to relieve distress and promote healthy development is particularly urgent. The proposed project will provide critical empirical guidance on how to do so.