The Relationship Between Family Acceptance-Rejection and Transgender Youth Psychosocial Functioning

Objective: Transgender youth have a high risk of adverse mental health outcomes. Family acceptance may play a protective role in transgender youth’s psychosocial adjustment; however, studies have largely examined acceptance independent from gender identity, averaged across family members, and in extreme examples (i.e., high acceptance or high rejection). Grounded in interpersonal acceptance-rejection theory, this study documents transgender youth’s experiences of family acceptance-rejection across family members, including siblings, and investigates the relationship between family acceptance-rejection and youth psychosocial functioning. Method: Fifty-four youth completed psychosocial questionnaires, and youth and caregivers completed semistructured clinical interviews, which were coded for family acceptance-rejection. Analyses examined associations between acceptance-rejection and psychosocial variables. Results: Lower primary caregiver past acceptance predicted increased youth depressive/anxiety symptoms/internalizing problems. Higher secondary caregiver indifference predicted increased youth depressive symptoms. Lower sibling acceptance predicted increased youth suicidal ideation. Conclusions: Findings demonstrate that family acceptance-rejection plays an important role in the psychosocial adjustment of transgender youth. New to the existing literature are the findings that caregiver indifference and sibling acceptance are associated with mental health outcomes. Implications for Impact Statement Family acceptance and rejection play an important role in the adjustment of transgender youth. It is imperative for providers to evaluate acceptance and rejection across family members and to work with families to foster supportive relationships.