Social Supports, Social Stressors, and Psychosocial Functioning in a Sample of Transgender Youth Seeking Gender-Affirming Clinical Services

Transgender and gender-expansive (TGE) youth are at elevated risk for mental health problems, and evidence suggests that social factors play an important role in their psychosocial adjustment. This preliminary study describes nonfamilial social factors, such as peer relationships and school environments, in a sample of TGE youth seeking gender-affirming clinical services and investigates the relationships of these factors to youths' psychosocial functioning. TGE youth initiating medical transition (N = 53, ages 9-18) and their caregivers completed psychosocial questionnaires and semistructured clinical interviews. Interview summaries were coded for social variables, and analyses examined associations between social factors (e.g., friendships, school environments) and psychosocial variables. Having close/supportive friendships was associated with fewer depression symptoms, and unsupportive schools were associated with suicidal ideation. This study provides further evidence that peer- and school-based support play a crucial role in the mental health of TGE youth, and should be prioritized in further research and intervention development.