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The Mental Health of Transgender Young People in Secondary Schools: A Scoping Review

Abstract

This paper aims to summarise peer-reviewed literature into the mental health of transgender young people within a secondary schooling environment. A scoping review was conducted using literature across four databases. The search was limited to English language peer-reviewed articles that reported upon the association between school factors and the mental health outcomes of transgender young people in secondary schools. The review resulted in seven relevant studies, which reported numerous school factors related to mental health outcomes for transgender young people. The factors that related to mental health of transgender young people in schools include peer victimisation and bullying, perceived safety and a sense of school belonging or connectedness. Clinical and practical implications are provided for policy makers, educational institutions and school mental healthcare professionals. It is recommended that future research is needed to investigate the mental health services provided within the schooling environment.

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Fig. 1

Notes

  1. 1.

    Scare quotations are used here as the term transgender is a contested term that can mean different things to different people. It is an identity category that is not necessarily fixed or stable; thus, the meaning behind this term can be fluid or malleable for different people and communities.

References

*Article included in the current scoping review

  1. Abreu, R. L., Kenny, M. C., Hall, J. G., & Huff, J. (2020). Supporting transgender students: School counsellor’s preparedness, training, efforts, and necessary supports. Journal of LGBT Youth, 17(1), 107–122. https://doi.org/10.1080/19361653.2019.1662755.

    Article  Google Scholar 

  2. Arksey, H., & O’Malley, L. (2005). Scoping studies: Towards a methodological framework. International Journal of Social Research Methodology, 8(1), 19–32. https://doi.org/10.1080/1364557032000119616.

    Article  Google Scholar 

  3. Becerra-Culqui, T. A., Liu, Y., Nash, R., Cromwell, L., Flanders, D., Getahun, D., et al. (2018). Mental health of transgender and gender nonconforming youth compared with their peers. Paediatrics, 14(5), 1–13. https://doi.org/10.1542/peds.2017-3845.

    Article  Google Scholar 

  4. Bowers, S., Lewandowski, J., Savage, T. A., & Woitaszewski, S. A. (2015). School psychologists’ attitudes toward transgender students. Journal of LGBT Youth, 12, 1–18. https://doi.org/10.1080/19361653.2014.930370.

    Article  Google Scholar 

  5. Carr, A. (2016). The handbook of child and adolescent clinical psychology (3rd ed.). London: Routledge.

    Google Scholar 

  6. Clark*, T. C., Lucassen, M. F. G., Bullen, P., Denny, S. J., Fleming, T. M., Robinson, E. M., et al. (2014). The health and well-being of transgender high school students: Results from the New Zealand Adolescent Health Survey (Youth’12). Journal of Adolescent Health, 55, 93–99. https://doi.org/10.1016/j.jadohealth.2013.11.008.

    Article  Google Scholar 

  7. Collier, K. L., van Beusekom, G., Bos, H. M. W., & Sandfort, T. G. M. (2013). Sexual orientation and gender identity/expression related peer victimisation in adolescence: A systematic review of associated psychosocial and health outcomes. Journal of Sex Research, 50(3–4), 299–317. https://doi.org/10.1080/00224499.2012.750639.

    Article  PubMed  PubMed Central  Google Scholar 

  8. Colvin, S., Egan, J. E., & Coulter, R. W. S. (2019). School climate & sexual and gender minority adolescent mental health. Journal of Youth and Adolescence, 48, 1938–1951. https://doi.org/10.1007/s10964-019-01108-w.

    Article  PubMed  Google Scholar 

  9. Creswell, J. W., & Creswell, J. D. (2017). Research design: Qualitative, quantitative, and mixed methods approaches (5th ed.). Thousand Oaks: SAGE Publications.

    Google Scholar 

  10. Day, J. K., Perez-Brumer, A., & Russell, S. T. (2018). Safe schools? Transgender youth’s school experiences and perceptions of school climate. Journal of Youth and Adolescence, 47, 1731–1742. https://doi.org/10.1007/s10964-018-0866-x.

    Article  PubMed  PubMed Central  Google Scholar 

  11. Denzin, N. K., & Lincoln, Y. S. (2017). The SAGE handbook of qualitative research (5th ed.). Thousand Oaks: SAGE Publications.

    Google Scholar 

  12. Donatone, B., & Rachlin, K. (2013). An intake template for transgender, transsexual, genderqueer, gender nonconforming, and gender variant college students seeking mental health services. Journal of College Student Psychotherapy, 27(3), 200–211. https://doi.org/10.1080/87568225.2013.798221.

    Article  Google Scholar 

  13. Espelage, D. L., Merrin, G. J., & Hatchel, T. (2018). Peer victimisation and dating violence among LGBTQ youth: The impact of school violence and crime on mental health outcomes. Youth Violence and Juvenile Justice, 16(2), 156–172. https://doi.org/10.1177/1541204016680408.

    Article  Google Scholar 

  14. Gay and Lesbian Alliance against Defamation (GLAAD). (2016). Media reference guide (10 ed.). Retrieved December 9, 2020, from https://www.glaad.org/sites/default/files/GLAAD-Media-Reference-Guide-Tenth-Edition.pdf.

  15. Goldblum*, P., Testa, R. J., Hendricks, M. L., Bradford, J., & Bongar, B. (2012). The relationship between gender-based victimisation and suicide attempts in transgender people. Professional Psychology: Research and Practice, 43(5), 468–475. https://doi.org/10.1037/a0029605.

    Article  Google Scholar 

  16. Gower*, A. L., Rider, N., Brown, C., McMorris, B. J., Coleman, E., Taliaferro, L. A., et al. (2018). Supporting transgender and gender diverse youth: Protection against emotional distress and substance use. American Journal of Preventive Medicine, 55(6), 787–794. https://doi.org/10.1016/j.amepre.2018.06.030.

    Article  PubMed  PubMed Central  Google Scholar 

  17. Hatchel, T., Espelage, D. L., & Huang, Y. (2018). Sexual harassment victimisation, school belonging, and depressive symptoms among LGBTQ adolescents: Temporal insights. American Journal of Orthopsychiatry, 88(4), 422–430. https://doi.org/10.1037/ort0000279.

    Article  Google Scholar 

  18. Hatchel, T., Ingram, K. M., Mintz, S., Hartley, C., Valido, A., Espelage, D. L., et al. (2019a). Predictors of suicidal ideation and attempts among LGBTQ adolescents: The roles of help-seeking beliefs, peer victimisation, depressive symptoms, and drug use. Journal of Child and Family Studies, 28, 2443–2455. https://doi.org/10.1007/s10826-019-01339-2.

    Article  Google Scholar 

  19. Hatchel, T., Merrin, G. J., & Espelage, D. (2019b). Peer victimisation and suicidality among LGBTQ youth: The roles of school belonging, self-compassion, and parental support. Journal of LGBT Youth, 16(2), 134–156. https://doi.org/10.1080/19361653.2018.1543036.

    Article  Google Scholar 

  20. Hatchel*, T., Valido, A., De Pedro, K. T., Huang, Y., & Espelage, D. L. (2019). Minority stress among transgender adolescents: The role of peer victimisation, school belonging, and ethnicity. Journal of Child and Family Studies, 28, 2467–2476. https://doi.org/10.1007/s10826-018-1168-3.

    Article  Google Scholar 

  21. Healey, J. (2014). Sexual orientation and gender identity. Thirroul, NSW: Spinney Press.

    Google Scholar 

  22. Heck, N. C., Flentje, A., & Cochran, B. N. (2011). Offsetting risks: High school gay-straight alliances and lesbian, gay, bisexual and transgender (LGBT) youth. School Psychology Quarterly, 26(2), 161–174. https://doi.org/10.1037/a0023226.

    Article  Google Scholar 

  23. Hunt, J. (2014). An initial study of transgender people’s experiences of seeking and receiving counselling or psychotherapy in the UK. Counselling and Psychotherapy Research, 14(4), 288–296. https://doi.org/10.1080/14733145.2013.838597.

    Article  Google Scholar 

  24. Jagose, A. (1996). Queer theory. New York: NYU Press.

    Google Scholar 

  25. Johnson, L., & Federman, E. J. (2014). Training, experience, and attitudes of VA psychologists regarding LGBT issues: Relation to practice and competence. Psychology of Sexual Orientation and Gender Diversity, 1(1), 10–18. https://doi.org/10.1037/sgd0000019.

    Article  Google Scholar 

  26. Kosciw, J. G., Bartkiewicz, M., & Greytak, E. A. (2012). Promising strategies for prevention of the bullying of lesbian, gay, bisexual, and transgender youth. Prevention Research, 19(3), 10–14.

    Google Scholar 

  27. Kosciw, J. G., Greytak, E. A., Giga, N. M., Vilenas, C., & Danischewski, D. J. (2016). The 2015 National School Climate Survey: The experiences of lesbian, gay, bisexual, transgender and queer youth in our nation’s schools. New York: GLSEN.

    Google Scholar 

  28. Kosciw, J. G., Palmer, N. A., & Kull, R. M. (2015). Reflecting resiliency: Openness about sexual orientation and/or gender identity and its relationship to well-being and educational outcomes for LGBT students. American Journal of Community Psychology, 55(1–2), 167–178. https://doi.org/10.1007/s10464-014-9642-6.

    Article  PubMed  Google Scholar 

  29. Levac, D., Colquhoun, H., & O’Brien, J. K. (2010). Scoping studies: Advancing the methodology. Implementation Science, 5(69), 1–9. https://doi.org/10.1186/1748-5908-5-69.

    Article  Google Scholar 

  30. Maguen, S., & Shipherd, J. C. (2010). Suicide risk among transgender individuals. Psychology & Sexuality, 1(1), 34–43. https://doi.org/10.1080/19419891003634430.

    Article  Google Scholar 

  31. McGuire, J. K., Anderson, C. R., Toomey, R. B., & Russell, S. T. (2010). School climate for transgender youth: A mixed method investigation of student experiences and school responses. Journal of Youth Adolescence, 39, 1175–1188. https://doi.org/10.1007/s10964-010-9540-7.

    Article  PubMed  Google Scholar 

  32. Moleiro, C., & Pinto, N. (2015). Sexual orientation and gender identity: review of concepts, controversies and their relation to psychopathology classification systems. Frontiers in Psychology, 6, 1–6. https://doi.org/10.3389/fpsyg.2015.01511.

    Article  Google Scholar 

  33. Munn, Z., Peters, M. D. J., Stern, C., Tufanaru, C., McArthur, A., & Aromataris, E. (2018). Systematic review or scoping review? Guidance for authors when choosing between a systematic or scoping review approach. BMC Medical Research Methodology, 18(143), 1–7. https://doi.org/10.1186/s12874-018-0611-x.

    Article  Google Scholar 

  34. National LGBTI Health Alliance. (2020). Snapshot of mental health and suicide prevention statistics for LGBTI people. Australia. Retrieved December 9, 2020, from: https://lgbtihealth.org.au/statistics/?fbclid=IwAR1nf-oMRve-LZUpSuYdHOdsfstlQ9NwtG4cAHy1V8a3S_oSU4urRutTJSE.

  35. O’Hara, C., Dipenza, F., Brack, G., & Blood, R. A. C. (2013). The preparedness of counsellors in training to work with transgender clients: A mixed methods investigation. Journal of LGBT Issues in Counselling, 7(3), 236–256. https://doi.org/10.1080/15538605.2013.812929.

    Article  Google Scholar 

  36. Perez-Brumer*, A., Day, J. K., Russell, S. T., & Hatzenbuehler, M. L. (2017). Prevalence and correlates of suicidal ideation among transgender youth in California: Findings from a representative, population-based sample of high school students. Journal of the American Academy of Child and Adolescent Psychiatry, 56(9), 739–746. https://doi.org/10.1016/j.jaac.2017.06.010.

    Article  PubMed  PubMed Central  Google Scholar 

  37. Porta, C. M., Singer, E., Mehus, C. J., Gower, A. L., Saewyc, E., Fredkove, W., et al. (2017). LGBTQ youth’s views on Gay-Straight Alliances: Building community, providing gateways, and representing safety and support. Journal of School Health, 87(7), 489–497. https://doi.org/10.1111/josh.12517.

    Article  Google Scholar 

  38. Reisner, S. L., Vetters, R., Leclerc, M., et al. (2015). Mental health of transgender youth in care at an adolescent urban community centre: A matched retrospective cohort study. Journal of Adolescent Health, 56, 274–279. https://doi.org/10.1016/j.jadohealth.2014.10.264.

    Article  Google Scholar 

  39. Riggs, D. W., & Bartholomaeus, C. (2015). The role of school counsellors and psychologists in supporting transgender people. The Educational and Developmental Psychologist, 32(2), 158–170. https://doi.org/10.1017/edp.2015.19.

    Article  Google Scholar 

  40. Riggs, D. W., & Sion, R. (2017). Gender differences in cisgender psychologists’ and trainees’ attitudes toward transgender people. Psychology of Men & Masculinity, 18(2), 187–190. https://doi.org/10.1037/men0000047.

    Article  Google Scholar 

  41. Scandurra, C., Amodeo, A. L., & Valerio, P. (2017). Minority stress, resilience, and mental health: A study of Italian transgender people. Journal of Social Issues, 73(3), 563–585. https://doi.org/10.1111/josi.12232.

    Article  Google Scholar 

  42. Schnarrs, P. W., Stone, A. L., Salcido, R., Jr., Baldwin, A., Georgiou, C., & Nemeroff, C. B. (2019). Differences in adverse childhood experiences (ACEs) and quality of physical and mental health between transgender and cisgender minorities. Journal of Psychiatric Research, 119, 1–6. https://doi.org/10.1016/j.jpsychires.2019.09.001.

    Article  PubMed  Google Scholar 

  43. Smith, E., Jones, T., Ward, R., Dixon, J., Mitchell, A., & Hillier, L. (2014). From blues to rainbows: The mental health and well-being of gender diverse and transgender young people in Australia. Melbourne: Australian Research Centre in Sex, Health and Society (ARCSHS), LaTrobe University.

    Google Scholar 

  44. Strauss, P., Cook, A., Winter, S., Watson, V., Wright Toussaint, D., & Lin, A. (2020). Associations between negative life experiences and the mental health of trans and gender diverse young people in Australia: Findings from Trans Pathways. Psychological Medicine, 50(5), 808–817. https://doi.org/10.1017/S0033291719000643.

    Article  PubMed  Google Scholar 

  45. Taliaferro*, L. A., McMorris, B. J., Rider, N., & Eisenberg, M. E. (2019). Risk and protective factors for self-harm in a population-based sample of transgender youth. Archives of Suicide Research, 23(2), 203–221. https://doi.org/10.1080/13811118.2018.1430639.

    Article  PubMed  Google Scholar 

  46. Tebbe, E. A., & Moradi, B. (2016). Suicide risk in trans populations: An application of minority stress theory. Journal of Counseling Psychology, 63(5), 520–533.

    Article  Google Scholar 

  47. Telfer, M., Tollit, M., & Feldman, D. (2015). Transformation of health-care and legal systems for transgender population: The need for change in Australia. Journal of Paediatric Child Healthcare, 51(11), 1051–1053. https://doi.org/10.1111/jpc.12994.

    Article  Google Scholar 

  48. Testa, R. J., Michaels, M. S., Bliss, W., Rogers, M. L., Balsam, K. F., & Joiner, T. (2017). Suicidal ideation in transgender people: Gender minority stress and interpersonal theory factors. Journal of Abnormal Psychology, 126(1), 125–136. https://doi.org/10.1037/abn0000234.

    Article  PubMed  Google Scholar 

  49. Toomey, R. B., Ryan, C., Diaz, R. M., Card, N. A., & Russell, S. T. (2010). Gender non-conforming lesbian, gay, bisexual, and transgender youth: School victimisation and young adult psychosocial adjustment. Developmental Psychology, 46(6), 1580–1589. https://doi.org/10.1037/2329-0382.1.S.71.

    Article  PubMed  Google Scholar 

  50. Valentine, S. E., & Shipherd, J. C. (2018). A systematic review of social stress and mental health among transgender and gender non-conforming people in the United States. Clinical Psychology Review, 66, 24–38. https://doi.org/10.1016/j.cpr.2018.03.003.

    Article  PubMed  PubMed Central  Google Scholar 

  51. Veale, J. F., Watson, R. J., Peter, T., & Saewyc, E. M. (2017). Mental health disparities among Canadian transgender youth. Journal of Adolescent Health, 60, 44–49. https://doi.org/10.1016/j.jadohealth.2016.09.014.

    Article  Google Scholar 

  52. Veale*, J. F., Peter, T., Travers, R., & Saewyc, E. M. (2017). Enacted stigma, mental health, and protective factors among transgender youth in Canada. Transgender Health, 2(1), 207–216. https://doi.org/10.1089/trgh.2017.0031.

    Article  PubMed  PubMed Central  Google Scholar 

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Acknowledgements

The authors thank Sylvia Pilz for her guidance and knowledge throughout the methodology of this scoping review.

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The authors declare no funding was used for this study.

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All authors contributed to the final draft of the manuscript. The conception of the review, material preparation, data collection and analysis were performed by GM. KL also contributed to the later stages of the data collection. The first draft of the manuscript was written by GM, and all authors contributed feedback and comments on all versions. All authors read and approved the final manuscript.

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Correspondence to Grace Mackie.

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Appendix

Appendix

The final terms used for the search were [transgender OR transgender youth OR transgender adolescent* OR transgender teen* OR transgender young people OR transgender young person* OR LGBT* youth OR LGBT* adolescent* OR LGBT* young people OR LGBT* young person* OR trans* youth OR trans* adolescent* OR trans* teen* OR trans* young people OR trans* young person* OR gender diverse youth OR gender diverse adolescent* OR gender diverse teen* OR gender diverse young people OR gender diverse young person* OR non-binary youth OR non-binary adolescent* OR non-binary teen* OR non-binary young people OR non-binary young person*] AND [school* or schools] AND [mental health].

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Mackie, G., Lambert, K. & Patlamazoglou, L. The Mental Health of Transgender Young People in Secondary Schools: A Scoping Review. School Mental Health 13, 13–27 (2021). https://doi.org/10.1007/s12310-020-09403-9

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Keywords

  • Transgender
  • Youth mental health
  • Secondary schooling
  • Young people
  • Scoping review