The Family Environment, Social Support, and Health in Transgender Youth

跨性别青少年的家庭环境、社会支持和健康

• 批准号: 9013489
• 负责人: Sabra L. Katz-Wise
• 金额: $ 11.91万
• 依托单位: BOSTON CHILDREN'S HOSPITAL
• 依托单位国家: 美国
• 财政年份: 2015
• 资助国家: 美国
• 起止时间: 2015-02-12 至 2017-01-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9013489
• 关键词: Address; Affect; Age; Alcohol or Other Drugs use; Anxiety; Attitude; Award; Behavior; Birth; Caring; Clinic; Cognitive; Data; Depression and Suicide; Development; Discrimination; Environment; Family; Family member; Fostering; Future; Gender; Gender Identity; Goals; Group Homes; Health; Health behavior change; Homelessness; Housing; Individual; Institute of Medicine (U.S.); Intervention; Intervention Studies; Interview; Knowledge; Lead; Lesbian Gay Bisexual Transgender; Life; Link; Mental Depression; Mentors; Methods; Minority; Modeling; Multimedia; New England; Outcome; Parents; Participant; Personal Satisfaction; Persuasive Communication; Phase; Play; Population; Prejudice; Process; Provider; Qualitative Methods; Recruitment Activity; Research; Risk; Self Efficacy; Self-Injurious Behavior; Shelter facility; Siblings; Social Network; Social support; Source; Stigmatization; Stress; Surveys; System; Systems Theory; Target Populations; Testing; Time; Training; Transportation; United States National Institutes of Health; Visual; Work; Youth; absorption; base; biological adaptation to stress; community based participatory research; community center; cultural values; digital; experience; family support; gender minority; improved; innovation; psychologic; sex; sex risk; sexual minority; skills; social; social stigma; stressor; support network; theories; therapy development; transgender

 DESCRIPTION (provided by applicant): Transgender youth, who identify with a gender that is different from their sex assigned at birth, are at increased risk for negative health outcomes due in part to stigmatization and family rejection. Research with non- transgender sexual minorities suggests that family support is crucial to youths' health and well-being and that family rejection may lead to negative outcomes, such as youth homelessness. Yet little is known about transgender youth specifically and how their experiences are linked to their current or past family environment (family of origin, chosen family, foster family, group care). In families with transgender youth, development of a transgender identity and the process of transitioning from assigned sex to identified gender may represent a source of stress for both the youth and the larger family system. Responding to the Institute of Medicine's and NIH LGBT Research Coordinating Committee's call for research on transgender-specific health needs, the specific aims of this research are to: 1) longitudinally investigate how the family environment affects health outcomes among transgender youth, 2) examine whether and what types of social support from within and outside of the family can improve family functioning and be protective for transgender youths' health, and 3) develop a narrative-based intervention to improve family functioning and social support-seeking behaviors in families with transgender youth. The Minority Stress Model and Family Systems Theory are integrated to provide a framework for Studies 1 and 2. Study 1 will investigate how the family environment is longitudinally associated with health outcomes (substance use, sexual risk, self-harm, suicidality, depression, anxiety) among transgender youth. With the goal of informing future interventions, Study 1 will also examine whether and what types of social support from within and outside of the family can improve family functioning and be protective for transgender youth's health. I will use community-based participatory research (CBPR) principles with mixed methods (qualitative interviews and quantitative surveys) to examine multiple aspects of the family environment, perceived stress, health outcomes, and social support using data collected at five waves across 24 months from 40 transgender youth ages 13 to 17 years and their parents/guardians and siblings (Total N = 80-160). Participants will be recruited from multiple sources to capture a diverse range of experiences and variability in family functioning. Previous research has indicated that social support may reduce negative stress-related outcomes in families with transgender youth. Interventions emphasizing social support are needed to ameliorate the effects of stressors and improve the family environment in this marginalized population. Study 2 will develop and pilot an innovative narrative-based intervention based on Social Cognitive and Transportation Theories to improve the family environment for transgender youth, including decreasing enacted stigma (overt anti-transgender attitudes and behaviors) within the family, and improving family functioning and social support-seeking skills. Narrative-based interventions use storytelling to promote health behavior change through mechanisms of transportation (absorption into the story and identification with characters), persuasion, and self-efficacy. The intervention developed in Study 2 will use digital storytelling, a specific narrative-based intervention method, to produce multimedia visual narratives from transgender youth about their family environment. Narrative-based interventions have been used successfully to change health behaviors and reduce stigma in marginalized populations, making this an innovative and promising approach to improve the family environment in families with transgender youth. The planned research will, for the first time, longitudinally investigate effects of the family environment on health outcomes among transgender youth using multiple family member perspectives and develop and pilot test a narrative-based intervention to improve the family environment for transgender youth. Ultimately this work will improve the health and well-being of transgender youth and families and inform future work with other marginalized populations.

 描述（由申请人提供）：跨性别青年的性别认同与出生时指定的性别不同，他们面临负面健康结果的风险增加，部分原因是污名化和家庭排斥。针对非跨性别性少数群体的研究表明，家庭支持对于青少年的健康和福祉至关重要，家庭的拒绝可能会导致负面结果，例如青少年无家可归。然而，人们对跨性别青年的具体情况以及他们的经历与当前或过去的家庭环境（原生家庭、选择的家庭、寄养家庭、团体照顾）有何联系却知之甚少。在有跨性别青少年的家庭中，跨性别身份的发展以及从指定性别向确定性别的转变过程可能会给青少年和更大的家庭系统带来压力。为了响应医学研究所和 NIH LGBT 研究协调委员会对跨性别特定健康需求进行研究的号召，本研究的具体目标是：1）纵向调查家庭环境如何影响跨性别青少年的健康结果，2）研究家庭内外的社会支持是否以及何种类型可以改善家庭功能并保护跨性别青少年的健康，3）制定基于叙述的干预措施以改善家庭 有跨性别青年的家庭的功能和寻求社会支持的行为。少数民族压力模型和家庭系统理论相结合，为研究 1 和 2 提供了一个框架。研究 1 将调查家庭环境如何与跨性别青少年的健康结果（药物使用、性风险、自残、自杀、抑郁、焦虑）纵向相关。为了为未来的干预措施提供信息，研究 1 还将研究家庭内外的社会支持是否以及何种类型可以改善家庭功能并保护跨性别青少年的健康。我将使用基于社区的参与性研究 (CBPR) 原则和混合方法（定性访谈和定量调查）来检查家庭环境、感知压力、健康结果和社会支持的多个方面，使用 24 个月内分五波从 40 名 13 至 17 岁跨性别青少年及其父母/监护人和兄弟姐妹（总 N = 80-160）收集的数据。将从多个来源招募参与者，以获取家庭功能的各种经验和变化。先前的研究表明，社会支持可以减少跨性别青少年家庭中与压力相关的负面结果。需要采取强调社会支持的干预措施，以减轻压力源的影响并改善边缘化人群的家庭环境。研究2将开发和试点一种基于社会认知和运输理论的创新性叙事干预措施，以改善跨性别青少年的家庭环境，包括减少家庭内的耻辱（公开的反跨性别态度和行为），并改善家庭功能和寻求社会支持的技能。基于叙事的干预措施利用讲故事，通过传输机制（吸收故事和认同人物）、说服和自我效能来促进健康行为改变。研究 2 中开发的干预措施将使用数字讲故事（一种特定的基于叙事的干预方法）来制作跨性别青少年关于其家庭环境的多媒体视觉叙事。基于叙事的干预措施已成功用于改变边缘化人群的健康行为并减少耻辱，这使其成为改善跨性别青少年家庭环境的创新且有前景的方法。计划中的研究将首次利用多个家庭成员的视角纵向调查家庭环境对跨性别青少年健康结果的影响，并开发和试点测试基于叙事的干预措施，以改善跨性别青少年的家庭环境。最终，这项工作将改善跨性别青年和家庭的健康和福祉，并为未来与其他边缘化人群的工作提供信息。

项目成果

Using Family and Ecological Systems Approaches to Conceptualize Family- and Community-Based Experiences of Transgender and/or Nonbinary Youth From the Trans Teen and Family Narratives Project.

• DOI: 10.1037/sgd0000442
• 发表时间: 2022-03
• 期刊: PSYCHOLOGY OF SEXUAL ORIENTATION AND GENDER DIVERSITY
• 影响因子: 3.8
• 作者: Katz-Wise, Sabra L.;Godwin, Eli G.;Parsa, Neeki;Brown, Courtney A.;Sansfacon, Annie Pullen;Goldman, Roberta;MacNish, Melissa;Rosal, Milagros C.;Austin, S. Bryn
• 通讯作者: Austin, S. Bryn

The 2016 United States presidential election's impact on families with transgender adolescents in New England.

• DOI: 10.1037/fam0000873
• 发表时间: 2022-03
• 期刊: Journal of family psychology : JFP : journal of the Division of Family Psychology of the American Psychological Association (Division 43)
• 作者: Pletta DR;Kant JD;Ehrensaft D;MacNish M;Cahill S;Katz-Wise SL
• 通讯作者: Katz-Wise SL

Experiences of cisgender youth with a transgender and/or nonbinary sibling.

顺性别青年与跨性别和/或非二元兄弟姐妹的经历。

• DOI: 10.1111/famp.12957
• 发表时间: 2024
• 期刊: Family process
• 影响因子: 3.9
• 作者: Godwin,EliG;Moore,LbM;Sansfaçon,AnniePullen;Nishman,MelissaMacNish;Rosal,MilagrosC;Katz-Wise,SabraL
• 通讯作者: Katz-Wise,SabraL

Longitudinal Associations of Sexual Fluidity and Health in Transgender Men and Cisgender Women and Men.

• DOI: 10.1037/sgd0000246
• 发表时间: 2017
• 期刊: Psychology of sexual orientation and gender diversity
• 影响因子: 3.8
• 作者: Katz-Wise SL;Williams DN;Keo-Meier CL;Budge SL;Pardo S;Sharp C
• 通讯作者: Sharp C

Family Functioning as a Protective Factor for Sexual Risk Behaviors Among Gender Minority Adolescents.

• DOI: 10.1007/s10508-021-02079-5
• 发表时间: 2021-10
• 期刊: Archives of sexual behavior
• 影响因子: 3.8
• 作者: Garcia Saiz E;Sarda V;Pletta DR;Reisner SL;Katz-Wise SL
• 通讯作者: Katz-Wise SL