Since 2010, there has been a rapid increase in children who seek medical and psychological services related to the stress they experience regarding the nonconformity between their assigned sex at birth (male or female) and how they experience their gender in daily life (male, female, both, or neither), also known as gender dysphoria. There has been significant concern about the mental health of these youth, especially concerning the risk of adverse mental health events, including suicide. However, research shows that when nonconforming adolescents are well-supported, they have similar levels of depression to other adolescents. For such adolescents who seek medical intervention, these support systems may include parents as advocates and/or healthcare professionals who specialize in serving them. In these cases, decisions about steps towards intervention are made between the adolescents, their parents, as well as the physicians. Findings from this in-depth interview study will help inform healthcare professionals about ways in which medical services can improve for these adolescents. This research will also provide information for families and other stakeholders about how to advance the health and wellbeing of adolescents. This project provides a platform for adolescents to describe their lived experiences, which can benefit the medical field and families that need their expertise.

Studying gender non-conforming adolescents provides researchers with the opportunity to analyze the processes that contribute to the creation of their identities. This project will explain how non-conforming adolescents who receive medical interventions address the complexity of their identities. Data collection involves 60 in-depth, semi-structured face-to-face interviews with three groups: 20 non-conforming adolescents, 20 parents of such adolescents, and 20 physicians who work with such adolescents. Participants in this study will be identified through a combination of personal contacts and snowball sampling. Interview questions with physicians include exploring reasons for approving or denying medical services to adolescents, how they help facilitate discussions between parents and adolescents, and ways in which healthcare for these adolescents can be improved. Interviews with the parents focus on their child’s behaviors and interactions with doctors. Questions with the adolescents will probe for reasons behind their decisions to seek information about medical intervention and their experiences with this process. Interview data will be subjected to open coding to derive themes present in the data using NVIVO to manage transcripts and data analysis. This project addresses the gap in our knowledge on the behaviors and beliefs of non-conforming adolescents and will provide insight into medical technologies to support them. Findings will also inform sociological theories related to gender and social identities, particularly for adolescents as they transition to adulthood.

This award reflects NSF's statutory mission and has been deemed worthy of support through evaluation using the Foundation's intellectual merit and broader impacts review criteria.

National Science Foundation (NSF)
Division of Social and Economic Sciences (SES)
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Melanie Hughes
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Wayne State University
United States
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