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Protective Factors Among Transgender and Gender Variant Youth: A Systematic Review by Socioecological Level

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Abstract

Transgender and gender variant (GV) youth experience elevated risk for poor health and academic outcomes due mainly to social experiences of stigma and discrimination. To supplement the growing evidence on health risks encountered by transgender/GV youth, we identified factors theorized to be protective for these youth across all four levels of Bronfenbrenner’s socioecological model (individual, relationship, community, societal). We conducted a systematic search of peer-reviewed research. The articles included in this review were published in peer-reviewed journals in English or Spanish between 1999 and 2014, analyzed data from a sample or subsample of transgender or GV participants with a mean age between 10 and 24 years, and examined the relationship of at least one theorized protective factor to a health or behavioral outcome. Twenty-one articles met inclusion criteria. Transgender/GV youth in included articles ranged from 11 to 26 years of age, were racially/ethnically diverse, and represented varied gender identities. Within these articles, 27 unique protective factors across four levels of the ecological model were identified as related to positive health and well-being. Self-esteem at the individual level, healthy relationships with parents and peers at the relationship-level, and gay-straight alliances at the community level emerged as protective factors across multiple studies. Our findings underscore the relative lack of research on transgender/GV youth and protective factors. Novel recruitment strategies for transgender/GV youth and better measurement of transgender identities are needed to confirm these protective relationships and identify others. Growth in these areas will contribute to building a body of evidence to inform interventions.

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Acknowledgements

This research has been supported by a grant from the Arcus Foundation awarded to the CDC Foundation. The authors would like to thank Riley Steiner and Nicole Liddon for their significant contributions to the conceptualization of this study and invaluable feedback during the writing process.

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  1. Division of Adolescent and School Health, Centers for Disease Control and Prevention, 1600 Clifton Road MS E-75, Atlanta, GA, 30333, USA

    Michelle Marie Johns, Paula E. Jayne & Lisa C. Barrios

  2. CDC Foundation, Atlanta, GA, USA

    Oscar Beltran & Heather L. Armstrong

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Johns, M.M., Beltran, O., Armstrong, H.L. et al. Protective Factors Among Transgender and Gender Variant Youth: A Systematic Review by Socioecological Level. J Primary Prevent 39, 263–301 (2018). https://doi.org/10.1007/s10935-018-0508-9

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  • DOI: https://doi.org/10.1007/s10935-018-0508-9

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