Exploring parental understanding of gender diversity in high schools – literature-based study.
Abstract
For a long time now, high school trans learners have been subject to discrimination because their gender identity does not align with the gender assigned to them at birth. This study explored how parents' understanding of gender can promote gender diversity in high schools. Parents' reactions to their children ‘coming out’ as transgender were used as a proxy to determine what parents' understanding of gender is and whether they can promote gender diversity in high schools. This literature-based study draws from the literature review chapter of a doctoral thesis. The literature search for this study was carried out using various databases, such as EBSCOhost, ScienceDirect, and SABINET. Additional literature searches were completed using the University of the Free State’s online and physical libraries. The findings of this study show a trend of parents taking an affirming stance towards transgenderism and inclining to challenge the established binary systems of gender. However, more studies are needed in the South African school context to explore parents' understanding of gender more deeply.
How to Cite
References
- Abreu, P. D. D., Andrade, R. L. D. P., Maza, I. L. D. S., Faria, M. G. B. F. D., Nogueira, J. D. A., & Monroe, A. A. (2022). Dynamics of primary social networks to support mothers, fathers, or guardians of transgender children and adolescents: A systematic review. International Journal of Environmental Research and Public Health, 19(13), 7941. https://doi.org/10.3390/ijerph19137941
- Bastian, B., & Haslam, N. (2006). Psychological essentialism and stereotype endorsement. Journal of experimental social psychology, 42(2), 228-235. https://doi.org/10.1016/j.jesp.2005.03.003
- Beckett, L., Bode, M., & Crewe, K. (1995). Sex and gender: What parents want. Australian Association for Research in Education Conference, Hobart, Australian Council of State School Associations.
- Belmont, N., Cronin, T. J., & Pepping, C. A. (2024). Affirmation-support, parental conflict, and mental health outcomes of transgender and gender diverse youth. International Journal of Transgender Health, 25(1), 50-62. https://doi.org/10.1080/26895269.2023.2252418
- Blosnich, J. R., Nasuti, L. J., Mays, V. M., & Cochran, S. D. (2016). Suicidality and sexual orientation: Characteristics of symptom severity, disclosure, and timing across the life course. American Journal of Orthopsychiatry, 86(1), 69-78. https://doi.org/10.1037/ort0000112
- Boe, J. L., Ellis, E. M., Sharstrom, K. A., & Gale, J. E. (2020). Disrupting cisnormativity, transnormativity, and transmisogyny in healthcare: Advancing trans inclusive practices for medical family therapists. Journal of Feminist Family Therapy, 32(3-4), 157-175. https://doi.org/10.1080/08952833.2020.1848051
- Bölte, S., Neufeld, J., Marschik, P. B., Williams, Z. J., Gallagher, L., & Lai, M.C. (2023). Sex and gender in neurodevelopmental conditions. Nature Reviews Neurology, 19(3), 136-159. https://doi.org/10.1038/s41582-023-00774-6
- Bottoman, L. (2021). The experiences of transgender learners in compulsory heteronormative school environments in the Republic of South Africa. Journal of Educational Studies, 2021(si1), 157-176. https://hdl.handle.net/10520/ejc-jeds_v2021_nsi1_a9
- Campbell, L., Viswanadhan, K., Lois, B., & Dundas, M. (2023). Emerging evidence: A systematic literature review of disordered eating among transgender and nonbinary youth. Journal of Adolescent Health, 74(1), 18-27. https://doi.org/10.1016/j.jadohealth.2023.07.027
- Campuzano, G. (2008). Building identity while managing disadvantage: Peruvian transgender issues. Institute of Development Studies. Retrieved from https://hdl.handle.net/20.500.12413/4169
- Canitz, S. N., & Haberstroh, S. (2022). Navigating loss and grief and constructing new meaning: Therapeutic considerations for caregivers of transgender youth. Journal of Child and Adolescent Counseling, 8(3), 168-180. https://doi.org/10.1080/23727810.2022.2133511
- Chan, R. C., & Huang, Y. T. (2022). A typology of intergenerational relationships between Taiwanese gay and bisexual men and their parents: Negotiating outness and co-residence in Chinese families. Sexuality Research and Social Policy, 19, 295–307. https://doi.org/10.1007/s13178-021-00542-5
- Cheah, W. H., & Singaravelu, H. (2017). The coming-out process of gay and lesbian individuals from Islamic Malaysia: Communication strategies and motivations. Journal of Intercultural Communication Research, 46(5), 401-423. https://doi.org/10.1080/17475759.2017.1362460
- Clark, B. A., Marshall, S. K., & Saewyc, E. M. (2020). Hormone therapy decision-making processes: Transgender youth and parents. Journal of Adolescence, 79, 136-147. https://doi.org/10.1016/j.adolescence.2019.12.016
- Clark, K. A., Argiros, A. P., Dougherty, L. R., & Pachankis, J. E. (2024). Stigma and anxiety and depressive symptoms in parents of sexual and gender minority youth. Journal of Family Psychology, 38(2), 201–211. https://doi.org/10.1037/fam0001183
- Coleman, E., Bockting, W., Botzer, M., Cohen-Kettenis, P., DeCuypere, G., Feldman, J., Fraser, L., Green, J., Knudson, G., & Meyer, W. J. (2012). Standards of care for the health of transsexual, transgender, and gender-nonconforming people, version 7. International Journal of Transgenderism, 13(4), 165-232. https://doi.org/10.1080/15532739.2011.700873
- Coulter-Thompson, E. I., Matthews, D. D., Applegate, J., Broder-Fingert, S., & Dubé, K. (2023). Health care bias and discrimination experienced by lesbian, gay, bisexual, transgender, and queer parents of children with developmental disabilities: A qualitative inquiry in the United States. Journal of Pediatric Health Care, 37(1), 5-16. https://doi.org/10.1016/j.pedhc.2022.09.004
- Dangaltcheva, A. (2018). Supporting parents of transgender youth: An attachment-based approach. Journal of the American Academy of Child & Adolescent Psychiatry, 57(10), S323.
- de Bres, J. (2022). Research on parents of gender-diverse children: From pathologization to affirmation. LGBTQ+ Family: An Interdisciplinary Journal, 18(2), 135-150. https://doi.org/10.1080/27703371.2022.2058669
- De La Cruz, J. J. (2023). Communicating outness: Studying self-disclosures of LGBTQ+ identities in coming out conversations, (Unpublished PhD thesis). Pennsylvania: The Pennsylvania State University, United States.
- De Pedro, K. T., Shim-Pelayo, H., & Bishop, C. (2019). Exploring physical, nonphysical, and discrimination-based victimization among transgender youth in California public schools. International Journal of Bullying Prevention, 1, 218-226. https://doi.org/10.1007/s42380-019-00016-8
- Esposito, G., Scandurra, C., Freda, M. F., Pepicelli, G., Valerio, P., & Vitelli, R. (2022). Qualities of mentalization and perception of parental mirroring in a group of Italian transgender people: An empirical study. Psychoanalytic Psychology, 39(1), 59. https://doi.org/10.1037/pap0000388
- Francis, D. A. (2023). Did you just say I was lit?” Transgender and non-binary youth doing gender; resisting cisnormativity in South African schools. Journal of Gender Studies, 1-12. https://doi.org/10.1080/09589236.2023.2172386
- Francis, D. A., Brown, A., McAllister, J., Mosime, S. T., Thani, G. T., Reygan, F., Dlamini, B., Nogela, L., & Muller, M. (2019). A five-country study of gender and sexuality diversity and schooling in Southern Africa. Africa Education Review, 16(1), 19-39. https://doi.org/10.1080/18146627.2017.1359637
- Frigerio, A., Montali, L., Anzani, A., & Prunas, A. (2021). “We’ll accept anything, as long as she is okay”: Italian parents’ narratives of their transgender children’s coming-out. Journal of GLBT Family Studies, 17(5), 432-449. https://doi.org/10.1080/1550428X.2021.1932005
- Gnepp, J., & Gould, M. E. (1985). The development of personalized inferences: Understanding other people's emotional reactions in light of their prior experiences. Child Development, 1455-1464. https://doi.org/10.2307/1130465
- Goldberg, A. E., & Allen, K. R. (2022). “I’m not just the nonbiological parent”: Encountering, strategizing, and resisting asymmetry and invalidation in genetic/gestational parent status among LGBTQ parents. Journal of Family Nursing, 28(4), 381-395. https://doi.org/10.1177/10748407221123062
- Grossman, A. H., D'Augelli, A. R., Howell, T. J., & Hubbard, S. (2005). Parents' reactions to transgender youth gender nonconforming expression and identity. Journal of Gay & Lesbian Social Services, 18(1), 3-16. https://doi.org/10.1300/J041v18n01_02
- Grossman, A. H., D'Augelli, A. R., Salter, N. P., & Hubbard, S. M. (2006). Comparing gender expression, gender nonconformity, and parents' responses of female-to-male and male-to-female transgender youth: Implications for counseling. Journal of LGBT Issues in Counseling, 1(1), 41-59. https://doi.org/10.1300/J462v01n01_04
- Grossman, A. H., Park, J. Y., Frank, J. A., & Russell, S. T. (2021). Parental responses to transgender and gender nonconforming youth: Associations with parent support, parental abuse, and youths’ psychological adjustment. Journal of Homosexuality, 68(8), 1260-1277. https://doi.org/10.1080/00918369.2019.1696103
- Haitembu, R. K. (2023). Gender and sexual diversity: Inclusion in the Namibian education context. Cogent Education, 10(2), 2253702. https://doi.org/10.1080/2331186X.2023.2253702
- Hale, A. E., Chertow, S. Y., Weng, Y., Tabuenca, A., & Aye, T. (2021). Perceptions of support among transgender and gender-expansive adolescents and their parents. Journal of Adolescent Health, 68(6), 1075-1081. https://doi.org/10.1016/j.jadohealth.2020.11.021
- Hidalgo, M. A., & Chen, D. (2019). Experiences of gender minority stress in cisgender parents of transgender/gender-expansive prepubertal children: A qualitative study. Journal of Family Issues, 40(7), 865-886. https://doi.org/10.1177/0192513X19829502
- Hill, N. E., & Craft, S. A. (2003). Parent-school involvement and school performance: Mediated pathways among socioeconomically comparable African American and Euro-American families. Journal of Educational Psychology, 95(1), 74.-83. https://doi.org/10.1037/0022-0663.95.1.74
- Hodax, J. K., Wagner, J., Sackett-Taylor, A. C., Rafferty, J., & Forcier, M. (2020). Medical options for care of gender diverse and transgender youth. Journal of Pediatric and Adolescent Gynecology, 33(1), 3-9. https://doi.org/10.1016/j.jpag.2019.05.010
- Horton, C. (2023a). Gender minority stress in education: Protecting trans children’s mental health in UK schools. International Journal of Transgender Health, 24(2), 195-211. https://doi.org/10.1080/26895269.2022.2081645
- Horton, C. (2023b). “I never wanted her to feel shame”: parent reflections on supporting a transgender child. Journal of LGBT Youth, 20(2), 231-247. https://doi.org/10.1080/26895269.2022.2081645
- Huebner, D. M., Thoma, B. C., & Neilands, T. B. (2015). School victimization and substance use among lesbian, gay, bisexual, and transgender adolescents. Prevention Science, 16, 734-743. http://doi.org/10.1007/s11121-014-0507-x
- Johnson, D., Sikorski, J., Savage, T. A., & Woitaszewski, S. A. (2014). Parents of youth who identify as transgender: An exploratory study. School Psychology Forum, 8(1), 56-74.
- Johnson, K. C., LeBlanc, A. J., Sterzing, P. R., Deardorff, J., Antin, T., & Bockting, W. O. (2020). Trans adolescents’ perceptions and experiences of their parents’ supportive and rejecting behaviours. Journal of Counseling Psychology, 67(2), 156-170. http://dx.doi.org/10.1037/cou0000419
- Jones, C. L. (1997). Communicating through writing about processes in science. Journal of Biological Education, 31(1), 55-64. https://doi.org/10.1080/00219266.1997.9655533
- Kelley, J., Pullen Sansfaçon, A., Gelly, M. A., Chiniara, L., & Chadi, N. (2022). School factors strongly impact transgender and non-binary youths’ well-being. Children, 9(10), 1520- https://doi.org/10.3390/children9101520
- Kennedy, N. (2022). Deferral: the sociology of young trans people’s epiphanies and coming out. Journal of LGBT Youth, 19(1), 53-75. https://doi.org/10.1080/19361653.2020.1816244
- Khanyetsi, B. (2023). Christian missions and healthcare in Basutoland (Unpublished Masters thesis). Maseru: National University of Lesotho, Lesotho.
- Kidd, K. M., Didden, E., Harman, H., Sequeira, G. M., Faeder, M., Inwards-Breland, D. J., Voss, R. V., & Katz-Wise, S. L. (2023). Parents of gender diverse youth: Support sought, received, and still needed. Journal of Adolescent Health. 74(2024), 1078-1087. https://doi.org/10.1016/j.jadohealth.2023.08.001
- Koch, A., Rabins, M., Messina, J., & Brennan-Cook, J. (2023). Exploring the challenges of sexual orientation disclosure among lesbian, gay, bisexual, transgender, queer individuals. The Journal for Nurse Practitioners, 19(10), 104765. https://doi.org/10.1016/j.nurpra.2023.104765
- Köllen, T., & Rumens, N. (2022). Challenging cisnormativity, gender binarism and sex binarism in management research: foregrounding the workplace experiences of trans* and intersex people. Gender in Management: An International Journal, 37(6), 701-715. https://doi.org/10.1108/GM-01-2022-0022
- Lacombe-Duncan, A., & Logie, C. H. (2021). The ethical dilemmas of working safely with community researchers: Lessons from community-based research with lesbian, gay, bisexual, transgender and queer communities. In Peer research in health and social development (pp. 176-190). London: Routledge.
- Lelutiu-Weinberger, C., English, D., & Sandanapitchai, P. (2020). The roles of gender affirmation and discrimination in the resilience of transgender individuals in the US. Behavioral Medicine, 46(3-4), 175-188. https://doi.org/10.1080/08964289.2020.1725414
- Lesutis, G. (2023). Queering as (un) knowing: Ambiguities of sociality and infrastructure. Progress in Human Geography, 47(3), 392-408. https://doi.org/10.1177/03091325231173564
- Lewin, T. (2024). Queering Gender Backlash. IDS Bulletin, 55(1), 141-150. https://doi.org/10.19088/1968-2024.112
- Lo, I. P.-Y., Liu, E. H., & Yu, S. W.-K. (2022). Family and work lives of lesbians in China: Implications for the adult worker model. International Journal of Environmental Research and Public Health, 19(11), 6390. https://doi.org/10.3390/ijerph19116390
- Logie, C. (2021). Working with excluded populations in HIV: Hard to reach or out of sight? (Vol. 8). Springer Cham. https://doi.org/10.1007/978-3-030-77048-8
- Mangwegape, D. S. M. (2022). Mental health challenges among the Lesbian, Gay, Bisexual, Transgender and Intersex community in Gaborone, Botswana (Unpublished Masters thesis). Mahikeng: North-West University, South-Africa.
- Mangwegape, D. S., Manyedi, E., & Molato, B. J. (2023). Mental health challenges experienced by LGBTI+ community in Gaborone: A phenomenological study. Health SA Gesondheid, 28(0), a2347. https://doi.org/10.4102/hsag.v28i0.2347
- Mann, T., Jones, T., Van Bergen, P., & Burns, E. (2023). Thriving not surviving: LGBTQ+ students’, staff, and parents’ experiences of schools as sites of euphoria. Sexuality Research and Social Policy, 21, 44–61. https://doi.org/10.1007/s13178-023-00839-7
- Manning, J. (2015). Positive and negative communicative behaviors in coming-out conversations. Journal of Homosexuality, 62(1), 67-97. https://doi.org/10.1080/00918369.2014.957127
- Martino, W., Kassen, J., & Omercajic, K. (2022). Supporting transgender students in schools: Beyond an individualist approach to trans inclusion in the education system. Educational Review, 74(4), 753-772. https://doi.org/10.1080/00131911.2020.1829559
- Marx, R. A., Hatchel, T., Mehring, C. B., & Espelage, D. L. (2021). Predictors of sexual victimisation and suicidal ideation among transgender and gender-nonconforming adolescents. Psychology & Sexuality, 12(1-2), 79-95. https://doi.org/10.1080/19419899.2019.1690034
- Marx, R. A., Peña, F. J., McCurdy, A. L., & Maier, A. (2023). “They won't push me away”: Transgender and gender?expansive youth of color's perceptions of parental gender?identity?specific support. Family Relations, 73(2), 993-1013 https://doi.org/10.1111/fare.12923
- Matsumunyane, K., & Hlalele, D. (2020). Sexual diversity and social vulnerability: Voices from learners in Lesotho. Gender and Behaviour, 18(2), 15237-15246.
- Matsuno, E., McConnell, E., Dolan, C., & Israel, T. (2022). I am fortunate to have a transgender child: An investigation into the barriers and facilitators to support among parents of trans and nonbinary youth. LGBTQ+ Family: An Interdisciplinary Journal, 18(1), 1-19. https://doi.org/10.1080/1550428X.2021.1991541
- McBride, R.S., & Neary, A. (2021). Trans and gender diverse youth resisting cisnormativity in school. Gender and Education, 33(8), 1090-1107. https://doi.org/10.1080/09540253.2021.1884201
- McCarty, M. K., & Burt, A. H. (2024). Understanding perceptions of gender non-binary people: Consensual and unique stereotypes and prejudice. Sex Roles, 90, 392–416. https://doi.org/10.1007/s11199-024-01449-2
- Mokots, R. I. (2022). Decoloniality of school governance in Lesotho: A religio-historical approach. Pharos Journal of Theology, 103(1). https://doi.org/10.46222/pharosjot.1035
- Morenammele, J., & Schoeman, W. (2020). Exploring Christian leadership in parachurch organisations in Lesotho. Acta Theologica, 30, 86-112. http://dx.doi.org/10.18820/23099089/actat.Sup30.4
- Morgenroth, T., van der Toorn, J., Pliskin, R., & McMahon, C. E. (2024). Gender nonconformity leads to identity denial for cisgender and transgender individuals. Social Psychological and Personality Science, 15(1), 46-59. https://doi.org/10.1177/1948550622114
- Moss?Racusin, C. A., Van der Toorn, J., Beneke, G., & Olson, K. R. (2024). Mothers of transgender youth experience stigma?by?association. Journal of Applied Social Psychology 54(4), 209–220. https://doi.org/10.1111/jasp.13024
- Motsa, N. D. (2018). Masculinities and femininities through teachers’ voices: Implications on gender-equitable schooling for vulnerable children from three primary schools in Swaziland. TD: The Journal for Transdisciplinary Research in Southern Africa, 14(1), a540. https://doi.org/10.4102/td.v14i1.540
- Mugerwa-Sekawabe, M. (2023). An examination of policies regulating the participation of transgender learners in South African high school sports. Obiter, 44(4), 879-899.
- Mustanski, B., Andrews, R., & Puckett, J. A. (2016). The effects of cumulative victimization on mental health among lesbian, gay, bisexual, and transgender adolescents and young adults. American Journal of Public Health, 106(3), 527-533. https://doi.org/10.2105/AJPH.2015.302976
- Ortiz-Myers, M., & Costello, K. L. (2021). The information practices of parents of transgender and non-binary youth: an exploratory study. Library Trends, 70(2), 105-132. https://doi.org/10.1353/lib.2021.0018
- Pollitt, A. M., Ioverno, S., Russell, S. T., Li, G., & Grossman, A. H. (2021). Predictors and mental health benefits of chosen name use among transgender youth. Youth & Society, 53(2), 320-341. https://doi.org/10.1177/0044118X19855898
- Price, M. A., Hollinsaid, N. L., Bokhour, E. J., Johnston, C., Skov, H. E., Kaufman, G. W., Sheridan, M., & Olezeski, C. (2023). Transgender and gender diverse youth’s experiences of gender-related adversity. Child and Adolescent Social Work Journal, 40(3), 361-380. https://doi.org/10.1007/s10560-021-00785-6
- Price-Feeney, M., Green, A. E., & Dorison, S. (2020). Understanding the mental health of transgender and nonbinary youth. Journal of Adolescent Health, 66(6), 684-690. https://doi.org/10.1016/j.jadohealth.2019.11.314
- Richardson, E. M. (2021). Policy and practice in South African schools. In Oxford Research Encyclopedia of Education.
- Romito, M., Salk, R. H., Roberts, S. R., Thoma, B. C., Levine, M. D., & Choukas-Bradley, S. (2021). Exploring transgender adolescents’ body image concerns and disordered eating: Semi-structured interviews with nine gender minority youth. Body Image, 37, 50-62. https://doi.org/10.1016/j.bodyim.2021.01.008
- Sahara-Ghana, L., Matemba, Y. H., Addai-Mununkum, R., Nthontho, M., & Museka, G. (2023). Religious Minorities at School South of the. In Fraser-Pearce, J. & Fraser, J. W. (eds), The Bloomsbury Handbook of Schools and Religion (pp. 303). London: Bloomsbury Publishing plc.
- Sandnabba, N. K., & Ahlberg, C. (1999). Parents' attitudes and expectations about children's cross-gender behavior. Sex Roles, 40(3), 249-263.
- Schneider, M. S., & Dimito, A. (2008). Educators' beliefs about raising lesbian, gay, bisexual, and transgender issues in the schools: The experience in Ontario, Canada. Journal of LGBT Youth, 5(4), 49-71. https://doi.org/10.1080/19361650802223003
- Shah, T. N., Parodi, K. B., Holt, M. K., Green, J. G., Katz-Wise, S. L., Kraus, A. D., Kim, G. S., & Ji, Y. (2024). A qualitative exploration of how transgender and non-binary adolescents define and identify supports. Journal of Adolescent Research, 39(1), 133-164. https://doi.org/10.1177/07435584221123123
- Simon, K. A., Wang, Y., & Farr, R. H. (2024). Stigma and lesbian, gay, bisexual, transgender, and queer (and additional identities) (LGBTQ+) parent socialization self-efficacy: Mediating roles of identity and community. Journal of family psychology, 38(4), 643-653. https://dx.doi.org/10.1037/fam0001203
- Siwela, V., Sikhwari, T., & Mutshaeni, N. (2018). Exploring challenges faced by homosexual youths and their parents in Driekoppies, Enhlanzeni district, Mpumalanga province, South Africa. Gender and Behaviour, 16(1), 10677-10685. https://hdl.handle.net/10520/EJC-fcc56c2d0
- Skelton, J. W. (2022). Schools often fail to expect trans and nonbinary elementary children: What gender independent, nonbinary, and trans children desire. Teachers College Record, 124(8), 244-274. https://doi.org/10.1177/01614681221126243
- Smith, R., Parr, T., & Friston, K. J. (2019). Simulating emotions: An active inference model of emotional state inference and emotion concept learning. Frontiers in Psychology, 10, 2844. https://doi.org/10.3389/fpsyg.2019.02844
- Tarrayo, V. N., & Salonga, A. O. (2023). Queering English language teaching: Insights from teachers in a Philippine state university. Critical Inquiry in Language Studies, 20(4), 360-385. https://doi.org/10.1080/15427587.2022.2112532
- Taube, L. N., & Mussap, A. J. (2022). Growth from adversity in trans and gender diverse people of color. International Journal of Transgender Health, 23(1-2), 194-213. https://doi.org/10.1080/26895269.2020.1777615
- Tsypes, A., Lane, R., Paul, E., & Whitlock, J. (2016). Non-suicidal self-injury and suicidal thoughts and behaviors in heterosexual and sexual minority young adults. Comprehensive Psychiatry, 65, 32-43. https://doi.org/10.1016/j.comppsych.2015.09.012
- Tyler, T. R., & Abetz, J. S. (2022). Relational turning points in the parent and LGBTQ child coming out process. Journal of Family Studies, 28(3), 858-878. https://doi.org/10.1080/13229400.2020.1761863
- Tyler, T. R., Huddleston, B. S., Barnett, F. A., Kohring, C. L., & Spaeth, C. M. (2020). Parents learning about their children’s TGNC identities. Journal of Gay & Lesbian Social Services, 32(4), 393-420. https://doi.org/10.1080/10538720.2020.1763224
- Ubisi, L. (2021). Queering South Africa’s protective school policy for LGBT+ youth: The Nare Mphale case. Journal of Educational Studies, 2021(si1), 106-138. https://hdl.handle.net/10520/ejc-jeds_v2021_nsi1_a7
- Ullman, J., Ferfolja, T., & Hobby, L. (2022). Parents’ perspectives on the inclusion of gender and sexuality diversity in K-12 schooling: Results from an Australian national study. Sex Education, 22(4), 424-446. https://doi.org/10.1080/14681811.2021.1949975
- Weiselberg, E. C., Shadianloo, S., & Fisher, M. (2019). Overview of care for transgender children and youth. Current Problems in Pediatric and Adolescent Health Care, 49(9), 100682. https://doi.org/10.1016/j.cppeds.2019.100682