Development of Transgender Identity
IN A RECENT STUDY ON IDENTITY DEVELOPMENT AMONG male-identified transgender youth, Pollock and Eyre (2012) found that the initial stage of adolescent trans identity emerged as the young people experienced an evolving sense of their own male gender. The young trans men described their growing understanding of themselves as being shaped by the onset of puberty and their emerging sexuality as well as interactions with peers and discovering the stories of other transgender individuals.
This was followed by a moment when they recognized their own transgender identity (the second stage of trans identity development). In the third stage, the young men moved from this more internal process out into the external world. The developmental tasks revolved around a period of social adjustment when they were integrating their male identity and exploring new ways of interacting with the world around them.
During trainings, I am often asked, “Why there are so many more transgender children and adolescents today than before?” Part of my response is that I don’t necessarily know that there are more transgender youth than there were in the past; perhaps transgender people simply feel safe enough today to come out at younger ages than they did in the past.
Most transgender adults today report having at least some sense of being different as a child, and many suspected, or knew, this difference was about their gender somehow not fitting their birth-assigned sex. With the increasing visibility of transgender children, adolescents, and adults in the media and so many of their stories being recorded on social media, trans youth are more likely to be able to name what feels different about them. In fact, for Pollock and Eyre’s (2012) participants, learning about the existence of other FTM transgender people was a critical link in recognizing their transgender identity. When they learned about the existence of other transgender people, they recognized themselves. This recognition can occur at much younger ages today, whereas in the past, trans people were largely invisible.
Another change that contributes to transgender adolescents coming out is the fact that historical representations of transgender people reflected deviance and criminality. As discussed earlier in the context of psychiatry, transgender identity was abnormal and deficient. Even more, it was a mental illness, and this is how transgender people were portrayed in the media. “Successful” transgender adults who lived engaged and fulfilling lives were largely “stealth.” Media portrayals were the only ones most youth and adults generally saw. The few visible trans people tended to be those outed by the psychiatric or criminal justice system as people who lived unhappy and tragic lives. Today, trans youth have access to many more narratives of the possibilities of transgender life. They are able to see transgender people with families and careers, enjoying their lives.
The Emergence of Trans Identity in Adolescence
As discussed earlier, young children with diverse gender expression may or may not identify as transgender when they grow up. In contrast, youth who come out as trans during adolescence typically continue to identify with their affirmed gender into adulthood. In one study of 70 young adolescents given puberty blockers to alleviate their dysphoria, all youth continued to identify with their affirmed gender and began masculinizing or feminizing hormone therapy at a later date (de Vries, Steensma, Doreleijers, & Cohen-Kettenis, 2010).
The onset of puberty leads to the development of greater gender consistency among young people. There is an increasing understanding that who you are now in terms of gender is who you will be as an adult. This is one reason trans identity often emerges more clearly in adolescence as opposed to gender variance or gender diversity. Young children who were more gender-diverse may begin to identify as transgender when they enter adolescence.
As discussed earlier, gender is not always a central identity for young trans children. Some youth report not thinking about gender much until adolescence. Other gender-diverse children imagine they will become the gender they identify with when they grow up rather than their current birth-assigned sex.
When I asked Tommy, a 14-year-old trans boy, to tell me about his experience of gender when he was younger, he said, “You know how on your birthday, you have a cake with candles? And you’re supposed to make a wish before you blow out the candles and if you blow them all out, the wish will come true? Well, every year my wish was to wake up in a boy’s body, but it never happened.” Even at 14 years, the tone in his voice as he described this suggested he was still astonished that his wish never came true.
For Tommy and other prepubertal trans youth, as secondary sex characteristics begin to develop for their peers and themselves, the reality of becoming an adult man or woman, as defined by their birth sex, becomes suddenly undeniable.
It is difficult, if not impossible, for most cisgender therapists to comprehend the degree and intensity of these feelings for transgender adolescents. When young transgender boys look in the mirror and see breasts developing, their gender dysphoria shoots through the roof. It becomes almost impossible to get dressed to go to school in the morning because none of their shirts fit right. No matter what they do, those breasts are visible to others. This is why transgender teenage boys bind their chests—with binders made for this purpose if they can afford them; if not, they use Ace bandages or duct tape. The horror of beginning to menstruate is almost unimaginable.
The stakes are no less high for teenage transgender women. Watching their peers develop facial hair, hearing their own voice start to crack, waking up to a wet dream—each of these experiences creates a sense of overwhelming anxiety and panic. The changes occurring in their bodies are completely out of their control. There is nothing they can do to stop a spontaneous erection from occurring.
The panic that accompanies this crisis contributes to elevated risk among transgender adolescents. Facing an adult life in the world as someone you do not recognize places these teenagers at high risk of drug and alcohol use, self-harming behavior, eating disorders, and other behaviors in an effort to manage their anxiety and block out what is happening to their bodies and their lives (Almeida et al., 2009; Diamond et al., 2011; Grossman & D’Augelli, 2007; Mustanski et al., 2014).
Alongside this internal dysphoria and distress are the pressures trans youth encounter to present themselves in gender-normative and expected ways—for teenage girls to look and act like girls and teenage boys to look and act like boys in ways that align with their birth-assigned sex. As discussed earlier, while there is a certain latitude for young girls to be tomboys, as they reach adolescence they are expected to feminize their appearance and behavior and start becoming young women. In a heteronormative culture, this means teenage girls are supposed to become interested in makeup, jewelry, and getting their nails done. They’re supposed to begin noticing boys and caring about what they think. Navigating these enforced social norms unquestionably creates tremendous discomfort for male-identified transgender yout.
Female-identified transgender teens move into adolescence where expectations about masculinity suddenly intensify. In our world, teenage boys are unequivocally men. Real men are supposed to be strong and independent, capable of taking care of themselves and the women around them. Real men walk and talk and dress like men. Real men no longer need others for emotional support. While there has never been much room for their femininity, the consequences of this escalate in adolescence. Masculinity is enforced verbally and physically. Any trace of femininity leads to punishment by other men.
In this increasingly gendered environment, transgender teens are forced to develop a false self in order to survive. Moving through the world in this false self means that they are not visible or seen by others. No one, not even those closest to them, really knows them. This, in and of itself, creates a tremendous sense of isolation for transgender youth. They are present, but not fully present. They may have friends, but the friends’ acceptance cannot fully be trusted because they know the friends do not really know them. The same is true for their family. This false self must be maintained at all costs.
During this period when the teen is closeted about their affirmed gender, sometimes this false self is manifested by becoming unusually and even intensely gender-conforming. The adolescent may assume a hypermasculinity or hyperfemininity that can serve a number of functions. This extreme gender conformity may represent an attempt to align with their birth-assigned sex in an effort to fit in with peers. It may represent one final attempt to become the gender they understand others expect them to be. In this context, the teen may say to themselves, “Let me try one more time to be a girl/boy. Maybe I just haven’t tried hard enough before. If I can’t make it work, at least I’ll know I tried hard enough.” In other cases, the gender conformity can serve to deflect harassment and bullying that the teen has experienced as a result of their diverse gender expression. This period of hyperconformity often confuses family members and professionals when the teen later comes out as transgender.
Coming out alleviates some of the internal stressors a trans adolescent experiences. They no longer need to rigidly maintain a false self. If there is some familial and peer support, they are able to begin expressing their affirmed gender through hairstyle, dress, and mannerisms. They can begin going by a name and pronouns that match their affirmed gender—at least with peers, even if parents are not quite there yet.
However, many transgender teenagers do not experience the support of their families, or even peers. Parental rejection takes a tremendous toll on transgender teens. All of us want the people who brought us into this world to love and accept us. Rejection never feels good. Parental denial—when parents refuse to acknowledge or simply ignore their child’s trans identity—can be just as painful. The consequences for transgender adolescents in these situations are clear. They are much more likely to abuse drugs and alcohol, drop out of school, engage in risky sexual behaviors, or attempt suicide by the time they are young adults (Diamond et al., 2011; Grossman & D’Augelli, 2007; Ignatavicius, 2013; Ryan, Huebner, Diaz, & Sanchez, 2009).
In addition, transgender adolescents are at high risk for harassment and bullying from other teenagers (Grossman, D’Augelli, Howell, & Hubbard, 2006; Grossman, D’Augelli, & Salter, 2006; Sausa, 2005). Even when there is no overt harassment, trans youth often encounter unsupportive school settings where teachers refuse to use their affirmed name and pronouns or they are forced to use the restroom that matches their birth-assigned sex. While these microaggressions do not rise to the level of overt bullying, they nonetheless contribute to the inherent stressors trans and gender-diverse youth face.
Microaggressions can be defined as “everyday verbal, nonverbal, and environmental slights, snubs, or insults whether intentional or unintentional, that communicate hostile, derogatory, or negative messages to target persons based solely upon their marginalized group membership” (Sue, 2010a, p. 3). These messages invalidate the experiential reality of trans and gender-diverse youth, demeaning them and communicating that they are lesser human beings. Further, these messages often stigmatize the young person in the context of their peers. Numerous studies indicate that while microaggressions may seem less harmful than more overt aggression, they can have a powerful impact on the psychological well-being of marginalized persons and groups (Sue, 2010a, 2010b; Nadal, 2013).
In a recent study of transgender persons, many participants reported experiencing anger, frustration, sadness, belittlement, and disappointment in the face of microaggressions. Participants expressed how these experiences negatively impacted their interpersonal relationships. Many described these incidents with words like “taxing” or “exhausting,” indicating the emotional toll these microaggressions had on their psychological well-being (Nadal, Skolnik, & Wong, 2012).
The fact that these incidents are often “small acts” does not diminish their cumulative effect and demeaning impact and power.
Types of microaggressions that transgender and gender-diverse students typically encounter include denial of their sense of self (their affirmed gender) by continuing to use the birth-assigned name (or legal name) when the trans student has requested the school use their affirmed name, or refusing to use the pronouns that match the student’s affirmed gender. Other microaggressions within educational settings include negative language or comments about transgender people, endorsement and/or enforcement of gender-normative culture and behaviors, viewing transgender people as abnormal or deviant, denying the reality of transphobia, physical threat or harassment, and bullying.
The way transgender students are frequently denied bodily privacy reflects another aspect of routine microaggression. Cisgender adults and peers often feel they have permission to ask intrusive personal questions about the trans youth’s body, such as, “Do you have a penis or vagina? Are you on hormones? Have you had ‘the surgeries’ yet?” These personal questions about someone’s physical body are not asked of non-transgender youth or adults.
More systemic microaggressions can be rooted in policies that insist that transgender students use the restroom of their birth-assigned sex rather than that of their affirmed gender—sometimes long after the student has transitioned and no longer even “looks like” their birth-assigned sex. When sustained over time, these experiences of microaggression and overt bullying can put trans teens at high risk of isolation from peers, depression, and other mental health concerns (Almeida et al., 2009; Nemoto et al., 2011; Nuttbrock et al., 2010).
Risk Factors
Risky behaviors typically emerge as a strategy for managing the stress associated with gender dysphoria, lack of family acceptance and support, rejection by peers or social isolation, or bullying. Engaging in alcohol and other drug use can alleviate the anxiety or depression generated in the face of these internal and external stressors. Getting high can take the edge off the heightened pressures transgender adolescents feel to fit in with peers. Drinking can lessen the social anxiety caused by trying to ensure people believe your false self is authentic. Getting high and drinking help transgender teens manage their gender dysphoria in moving through the world. They can make it possible to feel comfortable enough to be intimate with one’s boyfriend or girlfriend.
Self-harming behaviors are another tool that can help trans teens manage anxiety and depression. The real pain they experience from cutting diminishes the pain felt earlier at school when another student called them a “he-she.” Isolating in their room and scratching their arms until they bleed validates the pain they felt in the kitchen when their mother told him, “I don’t care what you think. You’re my daughter. You were born a girl and you will always be a girl—no matter what you try to do to change that.”
Many clinicians are unaware of the development of eating disorders as a strategy for body modification among transgender youth (Goldberg & Ashbee, 2006). Grossman and D’Augelli (2007) define gender dysphoria as a “strong and persistent (long term) discomfort and distress with one’s birth sex, gender, and anatomical body.” They go on to note that, given this, “body esteem—especially how one feels about one’s appearance and weight, and perception of how others think of one’s body—assumes importance” (p. 528).
If an adolescent trans boy overeats or binges and becomes fat, his breasts may be less obvious. Overweight, and dressed in baggy jeans and bulky sweatshirts, he may finally be recognized as a guy. Alternately, he may starve himself to become too thin to be seen as a girl anymore. If he loses enough weight, there’s the added bonus of menstruation ceasing. For young trans women, that thin, no-hips shape is a dead giveaway for a man. Added body weight can make them appear more femininely shaped. This lessens the daily harassment on the street. It is more likely that they will be read as a woman by the man on the other side of the street and arrive home safely.
Transgender students report the lowest feelings of safety at school (Greytak, Kosciw, & Diaz, 2009). Because they are at increased risk for being the target of verbal or physical bullying at school, transgender youth are more likely to be absent from school, experience diminished academic performance, or drop out before high school graduation (Greytak et al., 2009).
Transgender youth are more likely to engage in compulsive and/or risky sexual behaviors, often as a way to have their affirmed gender identity validated (Garofalo, Deleon, Osmer, Doll, & Harper, 2006). “If you are attracted to me, I must be a beautiful young woman. You must see me as a woman. You see me as a desirable woman.” While this validation might feel good for any heterosexual young woman, for young trans women it is a validation of their identity as women. Someone in the outside world believes them. Someone recognizes and acknowledge their true self. The need for this kind of validation increases when trans youth experience rejection from family and peers.
When parents or other caregivers deny a transgender adolescent’s affirmed gender identity or refuse to allow the young person to socially or medically transition, some youth run away from home or find themselves thrown out of their homes. Most studies indicate that approximately 20% to 40% of homeless youth identify as LGBT, with transgender youth being disproportionately represented among this population (Durso & Gates, 2012; Shelton, 2015). An estimated two thirds are youth of color (U.S. Department of Health and Human Services, 2014). The most frequently cited factor that led to being homeless was family rejection because of sexual orientation or gender identity.
In the face of rejection, and many times ridicule and abuse, some trans youth can no longer tolerate the manifestations of this rejection and self-initiate leaving home. They may want to disconnect before the final rejection of being thrown out occurs. Some teens feel the need to seek relief by escaping for a time. Other trans youth leave rejecting and abusive homes because they want something better for themselves or to find a community where they can safely be themselves.
Nearly three quarters of trans youth experience verbal abuse from their families. More than one quarter report that they have been slapped, beaten, or hit very hard. Thirteen to twenty percent report being punched, kicked, or pushed very hard (Grossman & D’Augelli, 2007). Young trans women (typically perceived early on as gender-variant boys) were at highest risk for physical abuse within their homes (Koken, Bimbi, & Parsons, 2009). Studies indicate a significant correlation between more verbal and physical abuse and suicide attempts (Grossman & D’Augelli, 2007; Ryan et al., 2010).
Nearly one-third of homeless LGBT youth have experienced some kind of physical, emotional, or sexual abuse while still living at home (Durso & Gates, 2012). Given these statistics, it is not surprising that homeless transgender youth experience lower levels of physical and mental health compared to other homeless youth (Durso & Gates, 2012; U.S. Department of Health and Human Services, 2014).
Another factor contributing to increased homelessness among transgender youth is the discrimination they frequently encounter in the areas of obtaining and maintaining employment and finding stable housing. Most transgender youth who are homeless encounter significant difficulty accessing trans-competent and affirmative health care. Being unemployed and unable to obtain employment due to discrimination, coupled with homelessness, severely limits access to education among transgender youth—a factor that only perpetuates their homelessness. For homeless youth, generally unemployed, the costs associated with obtaining required paperwork frequently delays or precludes their being able to legally change their name and identity documents. This in turn increases opportunities for further marginalization and discrimination (Shelton, 2015).
Given the extent of these internal and external stressors, it is not surprising that trans youth are at increased risk for suicidal ideation and attempts (Almeida et al., 2009; Diamond et al., 2011; Kelleher, 2009). Suicide risks are higher among trans youth who have been victimized, bullied, and harassed or have experienced parental or familial rejection (Grant et al, 2010; Diamond et al., 2011; Nuttbrock et al., 2010). In one study, 45% of transgender youth reported thoughts about suicide and 26% had attempted suicide (Grossman & D’Augelli, 2007). In the face of these compounding risk factors, clinical interventions must focus on strengthening coping skills and resilience with transgender youth.
Resilience
Despite these stressors and very real risk factors, most transgender adolescents are incredibly resilient. The Merriam-Webster Online Dictionary defines resilience in two ways: the ability to become strong, healthy, or successful again after something bad happens; or the ability of something to return to its original shape after it has been pulled, stretched, pressed, or bent (Resilience, n.d.).
Take a moment to reflect on the courage it takes to announce to the world that you are not who everyone perceives you to be, that your true gender identity does not match the sex you were assigned at birth or the gender others have known you to be. Imagine the risk involved when a transgender child or adolescent defines themselves in opposition to what has always been assumed to be true about their identity, in opposition to what they have always been told is true about who they are. Consider the internal sense and strength of self required to affirm and maintain your understanding of yourself in the face of others’ persistent denial of your truth.
I see this resilience every day in my clinical practice—the way a high school freshman navigates coming out in the middle of her school year; the way a young trans man negotiates his first year in college where he is stealth; the way a 17-year-old trans woman shows up every day for work at a large clothing store prior to obtaining her legal name change even though the job roster continues to list her birth name and regularly outs her as trans; the 13-year-old trans boy who adamantly insists his father find him a new therapist because his previous one knew little about gender identity and dismissed his questions and concerns; the unemployed 21-year-old trans woman so determined to see a transgender therapist that she kept calling her managed care Medicaid insurance company until they finally agreed to sign a single-case agreement with me so she could afford to see me for therapy.
In contrast to earlier experiences of internalized shame, resilience among transgender youth is enhanced as they acquire a sense of pride in their identity. For trans youth of color, this includes developing pride in each aspect of their identity—both race and gender (Singh & McKleroy, 2011). In a study of emerging young adults, Woodford, Paceley, Kulick, and Hong (2015) noted that as Queer identity is strengthened and becomes more salient, anxiety symptoms decrease.
Peer relationships are important for all adolescents. Social support, including having supportive and accepting friends and access to trans-friendly groups and activities, is a strong facilitator of resilience among transgender adolescents (Budge, Adelson, & Howard, 2013; Liu & Mustanski, 2012; Mustanski, Newcomb, & Garofalo, 2011; Singh & McKleroy, 2011).
When transgender youth come out, surrounded by love and acceptance, stressors and concomitant risk factors generally diminish. There is still the challenge of negotiating who you are in the world—of your body not looking like it should, of others knowing you are transgender—but when those closest to you support you, these stressors become more manageable. This is reflected in the fact that trans adolescents growing up in accepting families experience fewer risk factors and greater mental and emotional well-being as they move into young adulthood (Bouris et al., 2010; Needham & Austin, 2010; Ryan et al., 2010; Simons et al., 2013; Singh & McKleroy, 2011).
Gender-Diverse and Nonbinary Youth
Gender-diverse and nonbinary youth face certain challenges that can differ from those encountered by trans youth who gender transition. Virtually every time we fill out an application, we are asked to check male or female. There are no other choices. When you lined up along the hallways to use the bathroom in first grade, it was boys on one wall and girls against the other. There were no other choices. Trans youth who identify as nonbinary are forced over and over to make a choice when neither choice adequately represents their identities. This means confronting the message on a daily basis that you don’t fit in—anywhere.
Not only do you not fit in; you do not even really exist. Not on your driver’s license. Not on your college or job application. There is simply no way for nonbinary youth to check a box that reflects who they are.
Given that gender is ubiquitous in our society, people gender us constantly. While it has begun to change, much of the time when we interact with customer service personnel, we are “Sir’d” or “Ma’am’d.” The outcome of this for nonbinary youth is that they are continually being misgendered. This contributes not only to a feeling of not fitting in but also a profound sense of being invisible in the world. If there is no language, no pronouns, that adequately reflect who I am, then I am invisible. There is no way to address me; “Mr.,” “Mrs.,” “Ms.” do not describe who I am. There are no pronouns that work adequately when you discuss my progress in a teacher’s meeting—“he,” “she,” but not me.
Given that their identity is neither male nor female, some nonbinary youth use more recent gender-neutral pronouns, such as “zie” for he or she and “hir” for him or her. Some nonbinary youth use plural pronouns, like “they,” “them,” and “theirs.” Other youth prefer not to use pronouns at all and simply use their name.
Nonbinary youth often find themselves not taken seriously by adults. They are frequently told they are “just confused” about gender, or that there simply are only two genders and sooner or later they will have to accept this. They are told you can play around like this while you’re in high school, but once you get into the real world, you’ll have to choose one gender or the other. They are told, “People in the work world are not going to play along with your little gender pronoun games.” Adults, even medical and mental health providers, may ask, “Why do you have to make things so complicated [for me]? Why can’t you just choose a box?” Or, they are sometimes admonished for “just being difficult.”
The gender-fluid or nonbinary adolescents and young adults with whom I work struggle not so much with themselves and their own identities. Instead, they struggle with how to live in a world constructed and still operating around a binary gender system—a system that does not acknowledge their existence and insists on putting them in a binary box despite the lack of fit. While they have claimed a place underneath the large trans umbrella, most of these young people do not want to gender transition in the traditional sense of moving from their birth-assigned sex to living in the opposite/their affirmed gender. Instead, they simply want a world where gender matters less or doesn’t matter at all. They want a world where there are multiple genders, or no gender. Despite this, we have often had conversations where they grappled with whether or not to gender transition simply because it would be easier to live in the world as a young man or young woman rather than as someone who is gender-fluid or nonbinary.
As mentioned previously, in June 2016, a judge in the Circuit Court in Multnomah County, Oregon, ruled that nonbinary is a legal gender and that individuals may use nonbinary as a legal sex classification rather than choosing male or female (Mele, 2016). This may be the first step in our lifetime toward the world these nonbinary youth envision.
Trans Youth of Color
While all transgender youth encounter moments of discrimination or marginalization as they move through the world, trans youth of color routinely experience multiple facets of stigma and marginalization. For example, a white transgender young adult or a white nonbinary teenager may not be hired for a job because of discrimination against transgender people. Yet, a Black or Latino transgender adolescent may encounter discrimination in terms of their trans identity, their racial identity, or both. A 17-year-old African American trans woman may experience negative stereotyping or stigma on three levels—her racial identity, her transgender identity, or her gender as a woman. In situations like this, it may be difficult or even impossible for a transgender young person to determine which aspect of their stigmatized identities resulted in the discrimination or marginalization.
The salience of different aspects of a transgender youth’s identity can vary based on the immediate context. For example, an African American transgender male college freshman who transitioned during high school may no longer experience routine discrimination due to his transgender identity. Being seen consistently as a man at this point typically renders his transgender history or identity invisible.
Yet his racial identity is never invisible, leaving him open to ongoing experiences of racial microaggressions, stigma, and discrimination. Being consistently read as a young man in the world, he can choose to be stealth with peers, but he cannot choose to be stealth as a black man. Forced to continually navigate both racism and transphobia in the context of the dominant culture, transgender youth of color often face day-to-day realities that vary significantly from the lived experiences of white transgender children and adolescents.
Transgender youth of color often also experience racism within LGBTQ communities. Historically, and often even today, the visible LGBT community has been predominately white. White LGBT individuals experience white privilege in a white dominant culture the same way white cisgender individuals experience privilege around racial identity. White LGBT individuals are socialized in an environment that is rife with negative images and stereotypes about people of color. Given this, systemic racism and personal racial prejudice can be just as prevalent within LGBT communities as they are in the larger culture.
The impact of this can be particularly difficult for trans youth of color. Attending a transgender adolescent support group may mean feeling incredibly accepted and included in some ways. However, if the group is predominantly white, the young person may feel out of place and disconnected in terms of racial identity. Their peers may relate to the shared struggles as trans youth, but not to the added dynamics of intersecting racism.
White group facilitators or program directors frequently do not address intersectionality within the context of transgender youth. Consequently, these challenges go unaddressed for trans youth of color, increasing their sense of isolation. Unaddressed internalized racism among white-identified mental health professionals means that encounters with stigma or marginalization may be just as frequently perpetrated by adult youth workers and mental health providers, even if unconsciously or unintentionally.
Simultaneously, the nature of systemic racism means that marginalization and discrimination are typically embedded within program planning, structures, and governance. Consequently, many trans youth of color experience the same degree of racism within LGBT and trans settings as they do in the larger world.
Homophobia and Transphobia Within Racial/Ethnic Communities
For people of color, their family and larger racial ethnic community often serve as significant sources of support for navigating the realities of racism in the world. As children grow up, their families socialize them and prepare them with the tools needed for staying safe in the world and not internalizing the negative attitudes and beliefs of the dominant culture.
This is generally not the case for transgender youth of color, in terms of their trans identity. While they may experience support around their racial identity, they may encounter prejudice and discrimination around their transgender identity. In accepting families of color, there are ways parents connect the dots between encounters with trans oppression and their lived experience of racial oppression. These connections form a strength they are able to offer their trans children and adolescents. While the information and vignettes in this book and others can be helpful, most parents do not share the same lived realities of navigating trans-prejudice or discrimination.
Communities of color are not more transphobic than white communities. There are individuals and families within all racial/ethnic communities that do not understand the differences between biological sex, gender expression, gender identity, and sexual orientation. Many times, family rejection may be rooted in this lack of education and accurate information can facilitate greater understanding and acceptance.
Lack of family acceptance of transgender youth of color may also be rooted in fear. While white parents also worry about their children’s life possibilities and safety, there is an added dimension when the young person experiences discrimination and stigma in terms of both racial and gender identity.
Another dynamic trans youth of color encounter is the phenomenon of being perceived as representing their entire racial group. When a person of color does something that is perceived as wrong, their choices and behavior are frequently seen as typical of their entire racial/ethnic community. For example, when an African American teenager is arrested for drug possession or vandalizing property, their actions are often viewed by the white dominant culture as proof that all black teenagers are drug addicts or delinquents. Yet when a white adolescent is arrested for burglary or a white young adult enters a church and murders nine adults during Bible study, the cloak of white privilege means that the individual white young person’s actions are never viewed as representative of white people as a whole.
The systemic reality of these dynamics places a higher burden on youth of color to not act in ways that could reflect badly on their racial community. Both trans youth and their families struggle with how these higher expectations impact them. This pressure can add to the challenges of coming out for transgender youth of color and sometimes delays their coming out. As a whole, youth of color are significantly less likely to have disclosed being LGBTQ to their parents. In one study, while about 80% of white youth were out to parents, only 71% of Latinos, 61% of African Americans, and 51% of Asians and Pacific Islanders (APIs) had shared their identities with their parents (Grov & Bimbi, 2006). What appears to be rejection by families of color may be an embedded struggle around the ways a trans youth’s gender identity might negatively reflect on the larger racial minority community or compound the family’s experiences of discrimination and oppression in the world.
Within immigrant families, rejection of transgender children and youth can intersect with the challenges of acculturation processes. Adults tend to be more strongly tied to the culture of origin, while adolescents are typically more acculturated to white American norms and customs. In this context, parents may object to their children’s growing Americanism and view being transgender as a white American phenomenon. Education about gender identity and trans youth may not be enough in these situations. Mental health providers and families must also explore the intersections between the needs of the transgender young person and how a seeming lack of acceptance and support may be precipitated by perceived benefits and negative consequences of acculturation.
While much of white, Anglo culture places a high premium on individualization and self-actualization, other cultural groups prioritize familial and communal values. In the latter context, the needs of the family or group may override the needs of one individual member of that group. Valuing the larger unit over the needs of an individual is particularly reflective of many Asian and Latino families and communities. The conflict between the dominant white U.S. culture and ethnic community values can cause trans youth of color to feel torn between these two systems.
When trans youth come out within communities that place a greater premium on the family over the individual, the young person may be perceived as rejecting their ethnic heritage. The compounding nature of societal prejudices toward ethnic minority groups and transgender people may contribute to trans youth delaying their disclosure and/or cause family members to remain silent about a child’s disclosure and refrain as long as possible from sharing this information with anyone outside the immediate family. Within Latino cultures, the key role of machismo alongside traditional Roman Catholic beliefs can play a particular role in female-identified trans youth denying their affirmed gender and/or delaying disclosure to family members (U.S. Conference of Mayors, 1996).
The way negative beliefs and attitudes toward trans people can reflect on families may precipitate questions about what parents did to cause this in their children. As a result, within Asian American and Pacific Islander communities, trans youth may feel they have shamed their family by diverging from normative cultural expectations about biological sex and gender identity as well as norms of marrying and having children (Wade, 1991).
Higher Risk for Discrimination, Harassment, and Violence
Each of the above dynamics plays a role in whether a transgender young person of color comes out, how “out” they choose to be, and/or the repercussions of being out as transgender. White trans youth generally experience only one marginalized identity; this means greater privilege to be openly transgender with fewer risks of harassment, police surveillance, and transphobic violence. Intersecting and compounding experiences of oppression place trans youth of color at much higher risk for external stressors and isolate them from numerous avenues for obtaining affirmation and support (Garofalo et al., 2006). Transgender women of color consistently face the highest rates of violence and abuse (NCAVP, 2015).
GLSEN’s biennial National School Climate Surveys consistently indicate that transgender youth are harassed and assaulted at higher levels than their non-transgender peers. Almost all transgender students were verbally harassed (e.g., called names or threatened) during the 2013 school year because of their sexual orientation (89%) and their gender expression (87%) (Kosciw, Greytak, Palmer, & Boesen, 2014). Over half had been physically harassed (e.g., pushed or shoved), and many trans students had been physically assaulted (e.g., punched, kicked, or injured with a weapon) in school that year because of their sexual orientation (28%) and their gender expression (26%). While transgender youth of color are harassed for their gender identity and expression as often as the general transgender population, the additional reality of hearing racist language from school staff (54%) and fellow students (23%) puts additional stress on transgender students of color (Dunn & Moodie-Mills, 2012; Singh, 2013).
The risks of sexual exploitation among trans youth of color were also elevated. In one study, more than half of ethnic minority transgender youth had experienced forced sex, while almost 60% had traded sex for money or resources. These youth were consequently also at high risk of becoming HIV positive (Garofalo et al., 2006).
In light of the challenges inherent to intersecting identities alongside concomitant increased risks, the resilience of trans youth of color is indisputable. Citing Munoz (1999, p. 37), Saketopoulou (2011) states,
I always marvel at the ways in which nonwhite children survive in a white supremacist U.S. culture that preys on them. I am equally in awe of the ways in which queer children navigate a homophobic public sphere that would rather they did not exist. The [psychic] survival of children who are both queer and racially identified [as nonwhite] is nothing short of staggering.
Effective Work With Trans Youth of Color
An important consideration when exploring LGBTQ or trans youth groups or programs for trans youth of color is the racial/ethnic demographics within these programs. Will a Latino trans man be the only trans man of color in the group? If so, how might this impact him? How might it affect his ability to relate to peers and obtain the support he needs and deserves? Will the racial/ethnic demographics of the group facilitate an experience of greater connection, or will they reinforce his sense of being different?
There is no single right or wrong answer. It is entirely possible that a Latino trans boy will feel a part of a group of white trans male peers. On the other hand, he may not. What is essential is that these dynamics be addressed directly with the young person so they can make an informed choice about participation and are prepared to navigate the racial/ethnic context of the group. Similar dynamics can be true when a young trans woman participates in an LGBT youth group where the other young women are all cisgender peers.
After a young person joins a group, it is important to periodically check in about their experiences within the setting, including questions about any microaggressions directed toward the young person. It is also helpful to be attentive to ways a trans youth of color may feel torn between aspects of their identity or the multiple communities of which they are a part. Within this context, an Asian American trans young woman may feel she needs to prove to peers and/or adults that she is trans enough or Asian enough or feel she must prove her allegiance to both communities.
When working with trans youth from a different cultural background or community than that of the mental health professional, the clinician must watch and listen closely for the varied ways culture shapes the values, beliefs, customs, and traditions of both the transgender young person and their family. These aspects of the young person’s cultural context must be integrated into the therapeutic process and/or program activities.
Given the intersections of race and gender identity in the lives of trans youth of color, effective interventions must incorporate knowledge of and sensitivity to both aspects of their identities. Mental health professionals must bring a nuanced understanding of the ongoing impact of systemic racism as well as transphobia within the larger culture. When working with transgender youth of color and their families, the focus can never just be about transgender identity alone. These young people and their families do not have the luxury of a single oppression in their daily lives.
Effective clinical work must incorporate the multiple aspects of the trans young person’s identity and intersecting oppressions. The clinician needs to initiate conversations that explore the varying ways trans youth of color experience stigma and oppression, not only within the broader world but also within the Queer community. Youth of color may justifiably be anxious about these conversations—particularly in the presence of white mental health professionals. These conversations can only be effective when white mental health providers actively assume responsibility for unpacking their own internalized racism and work to recognize, acknowledge, and take responsibility for the racial privilege they hold within the larger society. Moving out from here, the work must focus on cultivating increased coping skills so that trans youth of color can sustain a positive sense of self and effectively navigate the world around them.
A recent study exploring resilience strategies among trans youth of color illuminated several ways these young people navigate the intersections of discrimination and prejudice toward both racial and gender identities (Singh, 2013). The first strategy highlighted how the young people were able to draw on their intersecting racial and gender identities to define themselves rather than allowing themselves to be defined by others. The second strategy revolved around their awareness of “adultism,” defined as “the system where adults hold power and privilege in youths’ lives” (p. 697). It was within this context that the young people experienced the greatest degree of racism and trans-prejudice. This dynamic led to the development of the third strategy for resilience—the young people’s determination to learn to advocate for themselves within educational settings. This often included becoming student leaders.
Connections within LGBTQ communities and finding a place to belong within these communities formed another key aspect of their resilience. The final strategy involved the use of social media as a vehicle for developing greater understanding of the intersections of their identities. Interactions on social media also enabled the youth to broaden their support network beyond their immediate geographical location. The last two strategies are relational in nature, suggesting that a key aspect of their resilience involves making connections with others like them and finding a community in which they feel they belong. Maintaining a strong sense of their intersecting identities and becoming advocates for themselves and their communities strengthened their resilience.