"Rosie's mother said she felt extremely pressured by the surgeons to consent to surgery on [Rosie as an Intersex baby] even after she voiced her concerns." - CNN

"Rosie is now in the process of figuring out her gender identity on her own terms. While she says she still likes to use female pronouns for now and wants to keep her name, Rosie says that sometimes she feels like a boy and other times, nonbinary. "Because I am both!" she said.

"Rosie's mother, Stephani Lohman, said she felt extremely pressured by the surgeons to consent to surgery even after she voiced her concerns about the procedure, including the evidence that these surgeries can have devastating side effects including a loss of sexual function, psychological trauma and life-long pain.

Pending legislation in California and New York would effectively ban these surgeries in those places by requiring informed consent from the patient before a cosmetic genital surgery.

As of 2013, the United Nations has condemned the practice on the grounds that an infant cannot consent.

Three former US surgeons general agreed, writing in July 2017, "these surgeries violate an individual's right to personal autonomy over their own future."

In 2017, Human Rights Watch concluded the surgeries violate a patient's human rights. Their research found that these surgeries can cause life-long pain, scarring, loss of sexual function, the need for life-long hormone replacement and maintenance surgeries, and psychological harm similar to that of child sexual abuse victims.

Dr. Ilene Wong Gregorio is a practicing urologist and intersex rights advocate who supports the legislation.

"Doctors have been imposing their assumptions on heteronormativity and what a child should look like, and intersex bodies, for decades," she said. "There are still people who practice outdated medicine and the only way to protect children from these people, who through culture or ignorance or hubris, are doing these things, is to actually put something in writing in the court of law."

 

"Individual self-esteem, healthy relationships w/ parents & peers, and GSAs are most common protective factors." (J Prim Prev)

Protective Factors Among Transgender and Gender Variant Youth: A Systematic Review by Socioecological Level

From abstract

Transgender and gender variant (GV) youth experience elevated risk for poor health and academic outcomes due mainly to social experiences of stigma and discrimination. To supplement the growing evidence on health risks encountered by transgender/GV youth, we identified factors theorized to be protective for these youth across all four levels of Bronfenbrenner's socioecological model (individual, relationship, community, societal). We conducted a systematic search of peer-reviewed research. The articles included in this review were published in peer-reviewed journals in English or Spanish between 1999 and 2014, analyzed data from a sample or subsample of transgender or GV participants with a mean age between 10 and 24 years, and examined the relationship of at least one theorized protective factor to a health or behavioral outcome. Twenty-one articles met inclusion criteria. Transgender/GV youth in included articles ranged from 11 to 26 years of age, were racially/ethnically diverse, and represented varied gender identities. Within these articles, 27 unique protective factors across four levels of the ecological model were identified as related to positive health and well-being. Self-esteem at the individual level, healthy relationships with parents and peers at the relationship-level, and gay-straight alliances at the community level emerged as protective factors across multiple studies. Our findings underscore the relative lack of research on transgender/GV youth and protective factors. Novel recruitment strategies for transgender/GV youth and better measurement of transgender identities are needed to confirm these protective relationships and identify others. Growth in these areas will contribute to building a body of evidence to inform interventions.

Citation

Johns et al. (2018) Protective Factors Among Transgender and Gender Variant Youth: A Systematic Review by Socioecological Level. Journal of Primary Prevention. 2018 Jun;39(3):263-301. doi: 10.1007/s10935-018-0508-9.

Heteronormative safety policies, violence, & harassment at schools cause decrease in perceived safety for gender-nonconforming students in 28 high schools. (J. Adolesc)

Heteronormativity, school climates, and perceived safety for gender nonconforming peers.

Abstract

Students' perceptions of their school climates are associated with psychosocial and academic adjustment. The present study examined the role of school strategies to promote safety in predicting students' perceptions of safety for gender nonconforming peers among 1415 students in 28 high schools. Using multilevel modeling techniques, we examined student- and school-level effects on students' perceptions of safety for gender nonconforming peers. We found that older students, bisexual youth, Latino youth, and youth who experienced school violence perceived their gender nonconforming male peers to be less safe. Similarly, we found that older students and students who experienced school violence and harassment due to gender nonconformity perceived their gender nonconforming female peers to be less safe. At the school-level, we found that when schools included lesbian, gay, bisexual, transgender, and queer (LGBTQ) issues in the curriculum and had a Gay-Straight Alliance, students perceived their schools as safer for gender nonconforming male peers.

Citation

Toomey et al. (2012) Heteronormativity, school climates, and perceived safety for gender nonconforming peers. Journal of Adolescence. 2012 Feb;35(1):187-96. doi: 10.1016/j.adolescence.2011.03.001. Epub 2011 Apr 8.

Study of 245 lgbt adults finds LGBT-related school victimization links adolescent gender nonconformity w/ adult happiness. (Dev. Psychol.)

Gender-nonconforming lesbian, gay, bisexual, and transgender youth: school victimization and young adult psychosocial adjustment.

From the abstract:

Past research documents that both adolescent gender nonconformity and the experience of school victimization are associated with high rates of negative psychosocial adjustment. The participants included 245 LGBT young adults ranging in age from 21 to 25 years. Using structural equation modeling, we found that victimization due to perceived or actual LGBT status fully mediates the association between adolescent gender nonconformity and young adult psychosocial adjustment (i.e., life satisfaction and depression).

Citation

Toomey et al. (2010) Gender-nonconforming lesbian, gay, bisexual, and transgender youth: school victimization and young adult psychosocial adjustment. Journal of Developmental Psychology. 2010 Nov;46(6):1580-9. doi: 10.1037/a0020705.

W. Canada schools w/ GSAs of 3+yrs consistently reduces suicidal ideation for ALL students regardless of orientation (Int'l Journal of Child Youth Family Studies)

School-Based Strategies to Reduce Suicidal Ideation, Suicide Attempts, and Discrimination among Sexual Minority and Heterosexual Adolescents in Western Canada.

Excerpt from abstract:

Analyses of the province-wide random cluster-stratified 2008 B.C. Adolescent Health Survey (n =21,70 8) compared students in schools with GSAs or policies implemented at least 3 years, and less than 3 years, with those in schools without GSAs or anti-homophobia policies, using multinomial logistic regression, separately by gender. LGB students had lower odds of past year discrimination, suicidal thoughts and attempts, mostly when policies and GSAs had been in place for 3+ years; policies had a less consistent effect than GSAs. Heterosexual boys, but not girls, also had lower odds of suicidal ideation and attempts in schools with longer-established anti-homophobic bullying policies and GSAs. 

Citation

Saewcy EM, Konishi C, Rose HA, Homma Y. School-based strategies to reduce suicidal ideation, suicide attempts, and discrimination among sexual minority and heterosexual adolescents in Western Canada. External  International Journal of Child, Youth and Family Studies 2014;1:89‒112.

"The presence of a GSA correlates with fewer depressive symptoms & mental health referrals for suicidal thoughts." (Journal of Youth & Adolescence)

School Climate & Sexual and Gender Minority Adolescent Mental Health.

Excerpt from abstract:

This study uses a survey that measures all four measures of school environment with a national sample of 240 sexual/gender minority high school students ages 14-18 (mean age 15.77) where 53% of participants had a Gay-Straight Alliance in their school. The sample is 53% cisgender, 100% sexual minority and 62% white. Adjusting for demographics and presence of a Gay-Straight Alliance, fewer depressive symptoms were associated with lower help-seeking intentions for suicidal thoughts. The presence of Gay-Straight Alliance was not statistically associated with past-month help-seeking intentions or behaviors. Additionally, a more supportive school climate was associated with lower anxiety and depressive symptoms. However, the presence of a Gay-Straight Alliance was not statistically associated with anxiety or depressive symptoms. These findings suggest that a supportive school climate and supportive school personnel may be important for supporting the mental health of sexual/gender minority students.

Citation

Colvin et al. (2019) School Climate & Sexual and Gender Minority Adolescent Mental Health. (2019) J. Youth Adolesc. 2019 Oct;48(10):1938-1951. doi: 10.1007/s10964-019-01108-w. Epub 2019 Aug 24.

Using a Transgender Person's Name Can Decrease Their Risk of Depression and Suicide (Teen Vogue)

A new study from The University of Texas at Austin has shed light on the importance of name usage for transgender youth. The study, which was published in the Journal of Adolescent Health in preparation for the annual Transgender Day of Visibility, concluded that when young transgender people are able to use their names in areas of everyday life, their risk of suicide and depression decreases.

They found that young people who could use their names in all four scenarios experienced 71% fewer symptoms of depression, 34% fewer symptoms of suicidal ideation, and a 65% decrease in attempted suicide than those who were not able to use their names.

Read the article here: https://www.teenvogue.com/story/using-transgender-persons-name-decrease-risk-of-depression-suicide

Using Chosen Names Reduces Odds of Depression and Suicide in Transgender Youths (Journal of Adolescent Health)

“It’s practical to support young people in using the name that they choose It’s respectful and developmentally appropriate.”
— Stephen T. Russell (University of Texas at Austin)

After interviewing 129 youths in 3 US cities, the researchers found that having even one context in which a chosen name could be used was associated with a 29 percent decrease in suicidal thoughts.

The research was funded by a grant from the National Institute of Mental Health and supported by the UT Population Research Center and a grant from the Eunice Kennedy Shriver National Institute of Child Health and Human Development.

Citation: Stephen T. Russell, Amanda M. Pollitt, Gu Li, & Arnold H. Grossman. (2018) Chosen Name Use Is Linked to Reduced Depressive Symptoms, Suicidal Ideation, and Suicidal Behavior Among Transgender Youth. Journal of Adolescent Health, Volume 63, Issue 4, 503 - 505. DOI: https://doi.org/10.1016/j.jadohealth.2018.02.003

Victimization of Transgender Youths Linked to Suicidal Thoughts, Substance Abuse (Journal of Adolescent Health)

In two peer-reviewed papers, researchers at The University of Texas at Austin have found that transgender adolescents are twice as likely to have suicidal thoughts as the general population, and they are up to four times as likely to engage in substance use. Depression and school-based victimization factored heavily into the disparities in both cases.

Read more: https://cns.utexas.edu/news/victimization-of-transgender-youths-linked-to-suicidal-thoughts-substance-abuse