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

项目摘要/摘要 在过去的几年里，全球各地对缺乏对 性别肯定激素治疗的长期效果(GAHT；青春期抑制，雌激素， 为变性人和性别多元化(TGD)青年提供的(睾丸激素)，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，精神健康和生活质量) 接受GAHT治疗的TGD青年一直在稳步积累，护理标准继续支持他们的 使用。不幸的是，研究仍然受到随访期短和样本量小的限制。随着体积的增加 提供护理的青年的多样性正在增长，人们对TGD青年身份的稳定性和 他们后悔接受治疗的可能性也在增加。然而，缺乏对集团内部的研究 接受GAHT治疗时TGD青少年心理社会轨迹的差异使提供者几乎没有得到指导 关于如何使护理个体化。更广泛地说，研究受到性别焦虑症和性别焦虑症测量不力的限制。 缺少纳入少数群体压力和韧性(MSR)因素，这在 当前的社会政治气候。接受GAHT治疗的青少年的父母的功能也被忽视了 尽管父母对TGD青少年的心理健康起着至关重要的作用。拟议的项目利用 在美国对接受GAHT治疗的TGD青年进行的最长时间的研究，以解决这些关键差距 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 面向美国西南部TGD青年的计划，自该计划实施以来，已有近700个家庭参加了该计划 成立于2014年。该项目的目标是(1)描述5年和8年的心理社会发展轨迹 接受GAHT治疗的TGD青少年(包括性别焦虑症、MSR、MH、QOL)及其父母的功能 (包括MSR和QOL)，包括这些轨迹随着时间的推移如何相互影响，(2)识别和 探索拥有相似基线和纵向经历的个体亚组的特征 性别焦虑症(青年)和MSR(青年、父母)，以及(3)评估MH之间的时间关系 (青年)、生活质量(青年和父母)和社会政治压力，包括缓和这一影响的因素 独特的重音形式。我们还将探索经历过的青年的特征和轨迹 改变他们的性别和/或停止治疗。该项目将由以社区为基础的参与式 将在整个研究过程中与TGD青少年及其父母合作的方法，包括 选择更多措施以更好地捕捉性别焦虑症和社会政治压力。给定TGD 年轻人经历一系列不利的心理社会后果的风险更高， 解困解困、促进健康发展的方法显得尤为迫切。拟议的项目将 就如何做到这一点提供关键的经验指导。

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.