Perceived barriers to transition in male-female transgender adolescents

The factors associated with the persistence and desistence of childhood gender dysphoria have been explored. (Steensma, et al 2013). They identified the intensity of childhood gender dysphoria as a predictor of persistence as... [ view full abstract ]

The factors associated with the persistence and desistence of childhood gender dysphoria have been explored. (Steensma, et al 2013). They identified the intensity of childhood gender dysphoria as a predictor of persistence as well as noting a higher incidence of persistence amongst natal females. However, within the literature there is an acknowledgement that further research is required to explore different developmental pathways for young people presenting to gender identity services.
It is a clinical observation within the GIDS service that there can be a perceived barrier to social transition is some adolescents assigned male at birth and who are transitioning to female. Particularly those in their later teenage years who may have undergone male puberty. Often these young people will present to services with a strong sense of a female gender identity and yet there is resistance to moving forward with the social exploration of gender expression, gender roles or gender fluidity. This can sometimes be interpreted as an ambivalence towards making a change of social gender, however there may be many factors underlying these barriers to transition. To better understand what factors influence the process of social transition in this cohort, the experiences of transgender adolescents were explored.

Aims To explore the perceived Barriers to transition in Male-Female Transgender Adolescents [ view full abstract ]

Aims
To explore the perceived Barriers to transition in Male-Female Transgender Adolescents

An Interpretative Phenomenological Analysis methodology was employed to provide a methodological framework for the collection and analysis of data. Semi-structured, in-depth interviews were carried out with 3 transgender... [ view full abstract ]

An Interpretative Phenomenological Analysis methodology was employed to provide a methodological framework for the collection and analysis of data. Semi-structured, in-depth interviews were carried out with 3 transgender youths for this pilot study. An iterative process of analysis to identify the Subordinate Themes and Subthemes was carried out using the transcribed data. (Smith, Jarman & Osborne 1999)

Emergent Themes from the IPA analysis are presented [ view full abstract ]

Emergent Themes from the IPA analysis are presented

Three convergent themes emerged from the data. The first theme was Relationships. There was an acknowledgement from young people that their transition would impact on other people in their life. Young people valued the support... [ view full abstract ]

Three convergent themes emerged from the data. The first theme was Relationships. There was an acknowledgement from young people that their transition would impact on other people in their life. Young people valued the support they got from parents but the fear of social isolation and transphobia was something they had to overcome and they encountered in their day to day life. The second theme related to Medical Intervention. All participants experienced body dysmorphia and some stated that the physical limitations of a male body was a barrier to their transition. The third theme was Passing. For some young people this encompassed elements of social transition and medical transition, but it emerged as an important goal for all of the participants. However, there were idiographic differences that emerged in the value prescribed to each of the themes. Two of the participants expressed that medical transition was the most important aspect for them and were keen to progress quickly and believed that this would facilitate their aim of passing as a girl. Another young person described how social transition was most important to them and they most valued the social validation they received in new and developing relationships within their family.

The participants were encouraged to explore their feelings around barriers to social transition. The emergent themes of Relationships, Medical and Passing highlighted the complexity of young peoples’ lives. Steensma et al... [ view full abstract ]

The participants were encouraged to explore their feelings around barriers to social transition. The emergent themes of Relationships, Medical and Passing highlighted the complexity of young peoples’ lives. Steensma et al (2013) emphasised the need to think about different pathways for transgender youth. Our exploration of barriers to transition also highlights the idiographic nature of young peoples’ experience. And the need for this to be reflected in the services we provide to them. The different values prescribed to medical and social transition should guide the supportive environment we provide to young people and their families. For example Family Therapy may be indicated when transition impacts upon family relationships that are such a key source of support. Whereas for other young people where medical support is valued and issues of distress and dysmorphia can dominate life, then other sources of support may be required. We provide social and psychological support within our service to help manage such distress. Additional interventions may be required when this becomes unbearable and often we liaise with local CAMHS services to provide this support.