Adaptive transition decisions and identity exploration among transgender and nonbinary persons exposed to gender identity conversion efforts.

Abstract

Introduction: Transgender and nonbinary (TNB) persons' healthcare experiences and related transition decisions have received increasing attention in recent years. Growing literature indicates gender non-affirming practices, such as gender identity conversion efforts (GICE), are harmful for the wellbeing of TNB persons. Yet, how exposure to GICE is linked to transition related decisions among TNB persons remains unexplored. This study examines links between GICE and TNB persons' transition decisions and identity exploration, using a conceptual framework that distinguishes adaptive transition decisions (e.g. transition interruptions due to interpersonal coercion) from identity-related transition decisions.

Methods: This study is a secondary data analysis of the 2015 U.S. Transgender Survey (N = 27,630). Multinomial logistic regression was conducted to examine the relationship between GICE and transition decisions among TNB persons while controlling for demographic covariates.

Results: Overall, 13.5% of TNB participants experienced GICE. Participants interrupted their transition due to interpersonal coercion (4.9%), structural factors (2.0%), and identity-related factors (0.4%). Participants with GICE exposure were more likely to report interrupting their transition due to interpersonal coercion than not interrupting their transition. However, GICE-exposed participants did not have a higher chance of identity-related transition interruptions than no interruptions.

Conclusions: These findings point to a potentially harmful role GICE may play in the transition decisions of TNB persons. Our analysis adds to evidence indicating the need for banning GICE and calls for a more nuanced understanding, recognition, and respect for TNB persons' non-linear transitioning trajectories. Otherwise, we risk vilifying gender-affirming practices and pathologizing adaptive transitioning decisions of TNB persons.