Transgender Identification in Adolescent Population: Sexuality, Suicidality, and Involvement in Bullying

Gender identity has become a hot topic both in research as well as in public discussion in the past twenty years. Simultaneously, referrals of adolescents experiencing gender dysphoria to gender clinics have greatly increased.

Adolescents referred to gender clinics present with psychiatric comorbidity while transgender adolescents in population-based samples report adversities in many aspects of life.

These adversities are often attributed to so-called external stressors, factors that relate to how others perceive and treat transgender individuals. However, the currently available research is somewhat flawed as many studies have not been able to consider confounding by these very factors.
This study uses two data sets with unselected samples of Finnish adolescents. The first data set is from the biennial School Health Promotion Study, which is a cross-sectional study designed to examine the health, health behaviors, and school experiences of 8th and 9th grade adolescents in the compulsory comprehensive school and second-year students in vocational and upper secondary schools. The second data set is from the Adolescent Mental Health Cohort and Replication study, which is a mental health survey among 9th grade students of the mandatory comprehensive school, designed to produce epidemiological data on adolescent mental health.

Associations between transgender identity and severe suicidal ideation, bullying involvement, and normative and negative sexual experiences were examined.

The results show that transgender identity was associated with severe suicidal ideation and that peer rejection variables did not play a significant role in explaining severe suicidal ideation in this population.

Transgender identity was generally associated with being bullied, and the associations were stronger among the late adolescents in the sample. Additionally, non-binary identity was associated with bullying others. The results corroborate previous research, but additionally suggest that perhaps those transgender adolescents who are still involved in bullying in late adolescence, especially non-binary individuals, are the ones facing most developmental challenges.

Regarding sexuality, the transgender adolescents in our sample presented neither with excessive nor scarce romantic and sexual experiences, thus suggesting that transgender identity need not interfere with normative sexual development. In crude estimates, transgender identity was first associated with subjection to sexual coercion as well as perpetration of dating violence. However, these associations leveled out after depression was controlled for, suggesting that depression plays a larger role than the gender identity itself in the health and well- being of the transgender adolescents.

The study findings are discussed in light of adolescent development and implications for practice and future research are suggested. In conclusion, developing adolescents need to be allowed sufficient time to explore their gender identity and this exploration does not automatically indicate the need for interventions. In future, longitudinal studies are needed to fully understand how transgender identity affects the onset of various adversities experienced by transgender adolescents.