Adolescence can be a challenging time for anyone and because so much of adolescence is about forming one’s identity within the context of society and societal norms, it becomes more challenging when one is in the minority – for any reason.
It can be especially challenging for adolescents who are transgender, gender diverse, or gender nonconforming, despite recent advances in societal awareness and acceptance of this minority group. As a pediatrician, I have become more comfortable with approaching the topic of gender identity with our adolescent patients (e.g., asking for their pronouns and preferred name at every visit) and discussing topics that are important to them. However, as I do not know many persons who are transgender, gender diverse, or gender nonconforming outside of the clinical realm, there is much that I still need to learn.
I was thus excited to read a study (10.1542/peds.2020-007906) by Dr. Adrian Araya and colleagues at Michigan Medicine (which is early released by Pediatrics this week), in which they conducted qualitative interviews with 30 adolescents who were transgender, gender diverse, and gender nonconforming (15-20 years of age) to learn about how these youth experience romantic relationships.
Important themes that emerged from these interviews include:
- Most had experienced romantic relationships – these occurred before, during, and after medical/social transitioning. These relationships could be with partners who were cisgender, transgender, or gender nonconforming.
- They find romantic partners through school, work, mutual friends, organizations, and through social networking and dating apps, but describe the dating pool as limited.
- They often are confronted with transphobia within the LGBT community, and this makes disclosure of gender identity challenging.
- Some describe emotional or sexual abuse within relationships.
- Gender affirming hormone treatment is viewed as having a positive effect on romantic health; they gain increased self-confidence and comfort with their own body.
It is important to note that these adolescents were recruited from a pediatric and adolescent gender services clinic that requires parental support for enrollment. The romantic experiences of these adolescents may be very different from the experiences of those who do not have parental support or who are not receiving gender health services.
Most of us likely have patients who are transgender, gender diverse, or gender nonconforming, and this is an important read for all of us, so that we are more well-versed in the challenges that these individuals experience during the critical period of exploring interpersonal relationships.