Doctoral Dissertation Research: Medicalization During Adolescence: Perspectives of Parents, Doctors and Youth

自2010年以来，寻求医疗和心理服务的儿童迅速增加，原因是他们在出生时(男性或女性)遇到的压力与他们在日常生活中体验性别的方式(男性、女性、两者都不)之间的不一致，也称为性别焦虑症。人们对这些青少年的心理健康问题非常关注，特别是对包括自杀在内的不良心理健康事件的风险。然而，研究表明，当不合规的青少年得到很好的支持时，他们的抑郁程度与其他青少年相似。对于寻求医疗干预的这类青少年，这些支持系统可能包括父母作为倡导者和/或专门为他们提供服务的医疗保健专业人员。在这些情况下，采取干预措施的决定由青少年、他们的父母以及医生共同决定。这项深入访谈研究的结果将有助于让医疗保健专业人员了解如何改善这些青少年的医疗服务。这项研究还将为家庭和其他利益攸关方提供关于如何增进青少年健康和福祉的信息。这个项目为青少年提供了一个描述他们生活经历的平台，这可以使医疗领域和需要他们的专业知识的家庭受益。研究性别不一致的青少年为研究人员提供了分析有助于创造他们身份的过程的机会。这个项目将解释接受医疗干预的不合规的青少年如何处理他们身份的复杂性。数据收集包括对三组人进行60次深入的、半结构化的面对面访谈：20名不合规青少年、20名此类青少年的父母和20名与此类青少年合作的医生。这项研究的参与者将通过个人接触和滚雪球抽样相结合的方式确定。与医生面谈的问题包括探索批准或拒绝向青少年提供医疗服务的原因，这些服务如何有助于促进父母和青少年之间的讨论，以及如何改善这些青少年的医疗保健。对父母的采访集中在他们孩子的行为和与医生的互动上。向青少年提出的问题将调查他们决定寻求医疗干预信息背后的原因以及他们在这一过程中的经验。访谈数据将接受开放式编码，以利用NVivo管理笔录和数据分析得出数据中存在的主题。这个项目解决了我们对不合规青少年的行为和信仰的认识上的差距，并将提供对支持他们的医疗技术的洞察。调查结果还将为与性别和社会身份相关的社会学理论提供信息，特别是对青少年过渡到成年的社会学理论。这一奖项反映了NSF的法定使命，并通过使用基金会的智力优势和更广泛的影响审查标准进行评估，被认为值得支持。

Since 2010, there has been a rapid increase in children who seek medical and psychological services related to the stress they experience regarding the nonconformity between their assigned sex at birth (male or female) and how they experience their gender in daily life (male, female, both, or neither), also known as gender dysphoria. There has been significant concern about the mental health of these youth, especially concerning the risk of adverse mental health events, including suicide. However, research shows that when nonconforming adolescents are well-supported, they have similar levels of depression to other adolescents. For such adolescents who seek medical intervention, these support systems may include parents as advocates and/or healthcare professionals who specialize in serving them. In these cases, decisions about steps towards intervention are made between the adolescents, their parents, as well as the physicians. Findings from this in-depth interview study will help inform healthcare professionals about ways in which medical services can improve for these adolescents. This research will also provide information for families and other stakeholders about how to advance the health and wellbeing of adolescents. This project provides a platform for adolescents to describe their lived experiences, which can benefit the medical field and families that need their expertise.Studying gender non-conforming adolescents provides researchers with the opportunity to analyze the processes that contribute to the creation of their identities. This project will explain how non-conforming adolescents who receive medical interventions address the complexity of their identities. Data collection involves 60 in-depth, semi-structured face-to-face interviews with three groups: 20 non-conforming adolescents, 20 parents of such adolescents, and 20 physicians who work with such adolescents. Participants in this study will be identified through a combination of personal contacts and snowball sampling. Interview questions with physicians include exploring reasons for approving or denying medical services to adolescents, how they help facilitate discussions between parents and adolescents, and ways in which healthcare for these adolescents can be improved. Interviews with the parents focus on their child’s behaviors and interactions with doctors. Questions with the adolescents will probe for reasons behind their decisions to seek information about medical intervention and their experiences with this process. Interview data will be subjected to open coding to derive themes present in the data using NVIVO to manage transcripts and data analysis. This project addresses the gap in our knowledge on the behaviors and beliefs of non-conforming adolescents and will provide insight into medical technologies to support them. Findings will also inform sociological theories related to gender and social identities, particularly for adolescents as they transition to adulthood.This award reflects NSF's statutory mission and has been deemed worthy of support through evaluation using the Foundation's intellectual merit and broader impacts review criteria.