Stigma by association among relatives of transgender individuals in the Netherlands: a qualitative study

Transgender individuals can be the victim of stigmatisation (Keuzenkamp, 2013; Norton & Herek, 2012). Research shows that people who are associated with stigmatized, for instance partners, parents and children, can also face... [ view full abstract ]

Transgender individuals can be the victim of stigmatisation (Keuzenkamp, 2013; Norton & Herek, 2012). Research shows that people who are associated with stigmatized, for instance partners, parents and children, can also face negative attitudes and stigmatization merely because of this association. This is called stigma by association by association (Reeder & Monroe, 2012). Stigma by association has negative effects on well-being of the associate and, as a coping mechanism, associates can sometimes seek distance and withdraw from the relationship with the stigmatized (Van der Sanden, Bos, Stutterheim, Pryor & Kok, 2013). Since social support from their relatives is especially important to transgender individuals during the transition process (Keuzekamp, 2012; Baumeister & Leary, 1995) stigma by association and the coping mechanisms of the associates can have a negative effect on both the transgender individual and the associates. To our knowledge no specific research on stigma by association of relatives of transgender individuals has been conducted. Furthermore, it is not clear how relatives of transgender individuals cope with stigma by association.

In this study we tried to find answers to the following questions: To what extent and in what form do partners, parents and children in the Netherlands experience stigma by association, what is the influence of stigma by... [ view full abstract ]

In this study we tried to find answers to the following questions: To what extent and in what form do partners, parents and children in the Netherlands experience stigma by association, what is the influence of stigma by association on their well-being and what is their coping behaviour in stigma situations? Since the stigma experiences and coping mechanisms of the partners, parents and children may be influenced by their own attitudes and experiences of the transition itself, we incorporated this in our study as well.

We conducted a qualitative study using in-depth interviews with family members of transgender individuals. A total of 25 people was interviewed, of whom 15 parents, 5 partners and 5 adult children from transgender individuals.... [ view full abstract ]

We conducted a qualitative study using in-depth interviews with family members of transgender individuals. A total of 25 people was interviewed, of whom 15 parents, 5 partners and 5 adult children from transgender individuals. The recruitment took place through transgender associations and secret Facebook groups of transgender individuals and their relatives. Since we wanted the interviewees to retrospect on an extended period of full social transition we incorporated this in the inclusion criteria. The inclusion criteria were being at least 18 years of age and being a partner, parent and child of a transgender individual who made a full social gender transition that took place at least two years before the interview. The interviews were held according to semi-structured protocol and took generally one and a half hour.

The following themes were discussed during the interviews: - Experiences of partners, parents and children of transgender individuals with the transition of their relative, - their experiences with stigma by association, -... [ view full abstract ]

The following themes were discussed during the interviews:
- Experiences of partners, parents and children of transgender individuals with the transition of their relative,
- their experiences with stigma by association,
- the effect of stigma on their well-being,
- their coping behavior in stigma situations.

In response to how they experienced the transition many relatives reported an initial sense of mourning. Many partners had experienced confusion about their own identity. Children and partners of transgender people had... [ view full abstract ]

In response to how they experienced the transition many relatives reported an initial sense of mourning. Many partners had experienced confusion about their own identity. Children and partners of transgender people had difficulty keeping up with the speed at which the transgender individual underwent the transition after their coming out. Many relatives reported to have missed professional help for themselves during this period, all help was directed towards the transgender individual. In spite of the problems many relatives report that their relation with the transgender individual has grown closer than before the transition.
In this study, few relatives had experienced negative reactions and thus stigma by association, many had received positive reactions. However, the negative reactions that were reported were sometimes quite severe. Confronted with stigma by association the interviewed parents of transgender kids were more inclined to confront, while partners and children of transgender individuals rather chose to avoid. Most parents in this study felt the need to share their feelings, while partners and children rather chose not to be affected by negative reactions. We found little impact of stigma by association on the well-being of relatives, although some relatives reported stress symptoms.

In this study, only few of the relatives had experienced stigma by association. This is a positive outcome. However this could be due to a selection bias since all relatives in this study were related to transgender... [ view full abstract ]

In this study, only few of the relatives had experienced stigma by association. This is a positive outcome. However this could be due to a selection bias since all relatives in this study were related to transgender individuals who had also experienced little stigmatisation. The few relatives in this study that did experience stigma by association were related to transgender individuals who were stigmatised as well. For further research is recommended to incorporate a more diverse group of relatives, e.g. relatives from transgender individuals that where more directly stigmatized or relatives that disconnected with the transgender individual, who may have experienced more stigma by association than the group from the current study. One should be careful to generalize the results of this qualitative study.
Although perhaps positively biased, this study reveals a number of negative reactions that relatives of transgender individuals received in the Netherlands. It also reveals their wish for more professional help, both in coping with the transition itself and in coping with stigma by association that can accompany the transition. The outcomes of this study can be used to develop theory- and evidence based support programs targeting relatives of transgender individuals.