For Transgender Kids, Support Is Key to Emotional Well-Being

Study did not find higher depression levels when parents backed children's choice

Friday, February 26, 2016

FRIDAY, Feb. 26, 2016 (HealthDay News) -- Transgender children who feel supported seem to have no greater risk of depression and anxiety than other kids do, a new study suggests.

Experts said the findings are welcome news -- especially in light of past studies finding high rates of depression, anxiety and suicidal thoughts among transgender children and adults.

These latest results suggest that when transgender kids feel supported in their "social transition," their mental well-being is on par with their peers, the researchers said.

Social transitioning is considered an option for children who consistently identify as transgender. It means that the children take on a name, clothing, hairstyle and other characteristics typical of the gender they identify with, rather than the gender they were born with.

No one is suggesting that social transition is the answer for all -- or even most -- children who are gender nonconforming, said Kristina Olson, the lead researcher on the study.

"Gender nonconforming" means a child prefers the games, toys, clothes and other behaviors often associated with the opposite sex -- but he or she doesn't necessarily identify as a member of that gender.

"Most clinicians who support social transitions believe they are only helpful for a very small subset of gender nonconforming children -- the subset who are truly identifying as the 'other' gender regularly and for an extended period," said Olson, an assistant professor of psychology at the University of Washington, in Seattle.

And it's not clear that social transitioning, by itself, had mental health benefits for children in this study, according to Olson.

That's partly because kids who are able to make the transition likely have families, friends or even whole communities generally supportive of them, she explained.

"Without further study it's difficult to know exactly what feature of these children's lives is causing their good overall mental health," Olson said.

But at the very least, she said, the findings challenge the notion that transgender children are destined for poorer mental health.

The study findings were published online Feb. 25 in the journal Pediatrics.

Dr. Ilana Sherer is a pediatrician at the Palo Alto Medical Foundation, in Dublin, Calif., who often works with transgender children. She agreed that the findings offer a much needed positive view.

"For parents who have nonconforming children, I hope this study shows that their child can still have a happy and productive childhood," said Sherer, who wrote an editorial published with the study.

"The news tends to cover the tragic side of being transgender -- suicides and violence," Sherer said. "But in my professional life, I see so many great kids who are living their lives with supportive families and really thriving."

For the study, Olson's team had parents complete standard surveys about their kids' depression and anxiety levels. The group included 73 children between the ages of 3 and 12 who had socially transitioned, their siblings, and a comparison group of 73 children who weren't transgender.

On average, all three groups of children showed a similar level of depression symptoms.

Transgender children did have slightly higher than average anxiety scores. But, Olson said, their scores were still within range of what's expected for most children -- and well below the cutoff for a full-blown anxiety disorder.

Plus, she said, the socially transitioned children had substantially lower anxiety and depression scores when compared with gender nonconforming kids in two previous studies.

There are still plenty of questions to be answered, Olson said. Her team plans to study these same transgender children, and others, as they grow older, to see how their mental health evolves.

But that's only the beginning, according to Olson.

"Much more research is needed to figure out exactly when and for whom social transitions are helpful," she said. "The current findings really just suggest that there is a subset of children for whom social transitions are associated with good mental health outcomes. It's the only study to even test that question."

Sherer made the same point. "This is just the tip of the iceberg," she said. "I'd like studies to look at the many factors that touch kids' lives -- school, home, medical team, activities, community, religion, as well as specific medical interventions."

SOURCES: Kristina Olson, Ph.D., assistant professor, psychology, University of Washington, Seattle; Ilana Sherer, M.D., pediatrician, Palo Alto Medical Foundation, Dublin, Calif.; March 2016, Pediatrics

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