Johns Michelle Marie, Beltran Oscar, Armstrong Heather L, Jayne Paula E, Barrios Lisa C
Division of Adolescent and School Health, Centers for Disease Control and Prevention, 1600 Clifton Road MS E-75, Atlanta, GA, 30333, USA.
CDC Foundation, Atlanta, GA, USA.
J Prim Prev. 2018 Jun;39(3):263-301. doi: 10.1007/s10935-018-0508-9.
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.
跨性别和性别变异（GV）青少年面临着更高的健康风险和学业不良后果的风险，主要原因是他们遭受了耻辱和歧视等社会经历。为了补充关于跨性别/GV青少年所面临健康风险的越来越多的证据，我们确定了在布朗芬布伦纳社会生态模型的所有四个层面（个体、人际关系、社区、社会）中被认为对这些青少年具有保护作用的因素。我们对同行评审研究进行了系统检索。本综述纳入的文章发表于1999年至2014年期间的英文或西班牙文同行评审期刊，分析了年龄在10至24岁之间的跨性别或GV参与者样本或子样本的数据，并研究了至少一个理论上的保护因素与健康或行为结果之间的关系。21篇文章符合纳入标准。纳入文章中的跨性别/GV青少年年龄在11至26岁之间，种族/民族多样，代表了不同的性别认同。在这些文章中，生态模型四个层面的27个独特保护因素被确定与积极的健康和幸福相关。个体层面的自尊、人际关系层面与父母和同伴的健康关系以及社区层面的同性恋-异性恋联盟在多项研究中均作为保护因素出现。我们的研究结果强调了对跨性别/GV青少年和保护因素的研究相对不足。需要采用针对跨性别/GV青少年的新型招募策略，并更好地衡量跨性别身份，以确认这些保护关系并识别其他关系。这些领域的发展将有助于建立一系列证据，为干预措施提供参考。
