Studies of mental health among transgender people in the United States have been consistently grim, showing higher rates of depression, anxiety and .
But almost nothing is known about the mental health of a new and growing generation of transgender Americans 鈥� prepubescent children who are living openly as transgender with the support of their families. How do those children fare in an environment of openness and family support? When their gender identity is affirmed, are they happy?
New 91探花 research suggests the answer is yes. Published Feb. 26 in Pediatrics, the is believed to be the first to look at the mental health of transgender children who have 鈥渟ocially transitioned,鈥� changing their preferred pronouns and typically, their names, clothing and hairstyles.
The research found that the 73 children, age 3 to 12, had rates of depression and anxiety no higher than two control groups 鈥� their own siblings and a group of age- and gender-matched children. And their rates of depression and anxiety were significantly lower than those of gender-nonconforming children in previous .
The findings, said lead author , challenge long-held assumptions that mental health problems in transgender children are inevitable, or even that being transgender is itself a type of mental disorder.
鈥淭he thinking has always been that kids who are not acting gender-stereotypically are basically destined to have mental health problems,鈥� said Olson, a 91探花assistant professor of psychology. 鈥淚n our study, that鈥檚 not the case.鈥�
Co-author , a 91探花assistant professor of psychology, called the findings 鈥渋ncredibly promising.鈥�
鈥淭hey suggest that mental health problems are not inevitable in this group, and that family support might buffer these children from the onset of mental health problems so commonly observed in transgender people,鈥� she said.
The study involved having parents complete two short surveys under the National Institutes of Health鈥檚 . The surveys asked parents whether their children had experienced symptoms of depression or anxiety during the past week 鈥� for example, feeling sad or being worried when going to bed.
The research found that the transgender children鈥檚 levels of depression averaged a score of 50.1, almost the same as the national norm of 50. Their anxiety rates were 54.2, only slightly higher than the national norm.
The higher anxiety rates aren鈥檛 exactly surprising, Olson said. Though transgender children are becoming increasingly visible in the mainstream media 鈥� the most well-known, 15-year-old , is the subject of a new documentary series 鈥� their reality remains little understood even within the medical community.
Transgender people were long classified under the umbrella of 鈥済ender identity disorder鈥� by the widely used Diagnostic and Statistical Manual of Mental Disorders (). The term was with 鈥済ender dysphoria鈥� in 2013, after considerable debate and lobbying from advocates to remove the word 鈥渄isorder鈥� from its name.
鈥淚t is hard to be transgender in 2016 in the United States,鈥� Olson said. 鈥淚f peers know that a child is transgender, they often tease that child. If peers do not know, the transgender child has to worry about being found out. It鈥檚 not surprising that transgender children would have some more anxiety, given the state of the world for transgender children right now.鈥�
The researchers acknowledge that the positive mental health among study participants might be explained by factors other than just parental support. Parents could be biased in their reporting, for example, wanting their kids to appear healthier than they are. Or the children themselves might have personality traits, such as confidence, that correlate to a healthy emotional state. Future studies will investigate these possibilities.
The study is part of the t that Olson leads. The initiative is the first large-scale, longitudinal study of transgender children in the U.S. It currently involves more than 150 transgender children and families from about 25 states, and Olson is recruiting additional participants. The project鈥檚 initial , published in 2015, found that transgender children鈥檚 gender identities were as deeply rooted as those of their non-trans peers.
The researchers next plan to look at how factors outside of the family, such as treatment by peers, might predict mental health in transgender children, and whether the age of transition makes a difference.
鈥淚t will be important to follow these children over time, particularly during the transition to adolescence, to understand patterns of mental health and positive adjustment across development for transgender youth who are supported by their families,鈥� McLaughlin said.
Olson said while there is still a tremendous amount to be learned about transgender children, the study鈥檚 findings suggest it鈥檚 possible for them to live happier lives than previous generations of transgender people.
鈥淚 think they鈥檙e proof that you can be a young transgender kid today and be happy and healthy and doing just as well as any other kid,鈥� she said. 鈥淚t鈥檚 some good news, finally, which I don鈥檛 think there鈥檚 much of in what we hear about transgender kids.鈥�
Other co-authors are and , the project coordinators of the TransYouth Project.