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Invited Commentary
July 28, 2020

Media Coverage and Care-Seeking for Transgender and Gender-Diverse Youth

Author Affiliations
  • 1Department of Human Development and Family Sciences, University of Texas at Austin
JAMA Netw Open. 2020;3(7):e2015373. doi:10.1001/jamanetworkopen.2020.15373

The health and well-being of transgender children and adolescents have been a growing concern in the fields of health and medicine as well as in public discourse and media. Only a decade ago, there was little scientific evidence regarding the health of transgender and gender-diverse (TGD) youth. Since then, media coverage has dramatically changed public awareness and understanding of TGD individuals, and this new public attention has disrupted the silence that had characterized the lives of TGD youth. At the same time, research has begun to clearly document the mental and behavioral health risks of TGD youth.1,2

Demand for specialized treatment and care for TGD individuals has grown dramatically. What had been unclear is the degree to which media attention could be a contributing factor to that demand. The new study by Pang and colleagues3 creatively investigates increases in weekly referrals to gender clinics that specialize in the care and treatment of TGD children and adolescents during an 8-year period. The investigators individually coded nearly 8000 local media items (from newspapers, online news sources, and television programs) and matched them with weekly referrals to 2 publicly funded gender clinics on opposite sides of the world. Increases in weekly referrals were associated with TGD-relevant media items with a 1- to 2-week lag. The investigators showed that the associations were stronger based on the relevance of media coverage: referrals were greater when media mentioned the 2 clinics being studied compared with coverage that was predominantly or only peripherally related to TGD issues.

This study is important for identifying media as a source of information and referral to support TGD youth. Several prior studies4,5 have documented the association between public attitudes and the population health of lesbian, gay, bisexual, and transgender (LGBT) people; however, those studies focused on the negative, undermining role of public stigma. For example, a 2018 study4 showed that LGBT people who lived in areas with low local approval of marriage for same-sex couples reported poorer general health. One of the only similar studies that has focused on youth5 showed that rates of homophobic bullying accelerated in the period leading up to the passage of Proposition 8 (the 2008 California voter referendum that restricted marriage to heterosexual couples) and declined thereafter. Clearly, public and media discourse matters, and media attention has been presumed in prior studies to be a primary mechanism for public opinion and awareness. The study by Pang and colleagues3 reminds us that although media may reinforce bias or stigma, it may also offer information and education. On one hand, media related to voter referenda that would ban marriage for same-sex couples promulgated stigma.5 On the other hand, this study3 found that media may raise awareness of and understanding for TGD youth, leading them to supportive, specialized clinical care and treatment.

Supporting the social transition of TGD youth is crucial for their mental health,6 and access to specialized gender care is critical to support the well-being of TGD children and adolescents.7 Media coverage focused on TGD issues, especially when educating about specialized gender care, may serve a crucial role in normalizing gender diversity. The results of the study by Pang and colleagues3 suggest that TGD education and literacy is essential for journalists and other media writers, particularly because media continues to be a primary source of information on gender diversity for children and families and serves as a motivator or conduit for care-seeking. Furthermore, the study highlights that identifying specialized care is an important role of media so that legitimate and trusted care can be made known and accessible.

Finally, the study by Pang and colleagues3 suggests that the media can play a critical role in naming groups who are hidden or marginalized and in illuminating their distinct experiences and needs while identifying strategies or solutions for support and care. It identifies a potentially rich area of study for developing new strategies to identify, understand, and anticipate the needs of marginalized groups and to meet their needs for care and support.

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Article Information

Published: July 28, 2020. doi:10.1001/jamanetworkopen.2020.15373

Open Access: This is an open access article distributed under the terms of the CC-BY License. © 2020 Russell ST. JAMA Network Open.

Corresponding Author: Stephen T. Russell, PhD, Department of Human Development and Family Sciences, University of Texas at Austin, 108 E Dean Keeton St, Stop A2702, Austin, Texas 78712-1248 (stephen.russell@utexas.edu).

Conflict of Interest Disclosures: Dr Russell reported receiving grants from the Eunice Kennedy Shriver National Institute of Child Health and Human Development and the Priscilla Pond Flawn Endowment at the University of Texas at Austin outside the submitted work.

Connolly  MD, Zervos  MJ, Barone  CJ  II, Johnson  CC, Joseph  CLM.  The mental health of transgender youth: advances in understanding.   J Adolesc Health. 2016;59(5):489-495. doi:10.1016/j.jadohealth.2016.06.012PubMedGoogle ScholarCrossref
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Pang  KC, de Graaf  NM, Chew  D,  et al.  Association of media coverage of transgender and gender diverse issues with rates of referral of transgender children and adolescents to specialist gender clinics in the UK and Australia.   JAMA Netw Open. 2020;3(7):e2011161. doi:10.1001/jamanetworkopen.2020.11161Google Scholar
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Hatzenbuehler  ML, Shen  Y, Vandewater  EA, Russell  ST.  Proposition 8 and homophobic bullying in California.   Pediatrics. 2019;143(6):e20182116. doi:10.1542/peds.2018-2116PubMedGoogle Scholar
Russell  ST, Pollitt  AM, Li  G, Grossman  AH.  Chosen name use is linked to reduced depressive symptoms, suicidal ideation, and suicidal behavior among transgender youth.   J Adolesc Health. 2018;63(4):503-505. doi:10.1016/j.jadohealth.2018.02.003PubMedGoogle ScholarCrossref
de Vries  ALC, McGuire  JK, Steensma  TD, Wagenaar  ECF, Doreleijers  TAH, Cohen-Kettenis  PT.  Young adult psychological outcome after puberty suppression and gender reassignment.   Pediatrics. 2014;134(4):696-704. doi:10.1542/peds.2013-2958PubMedGoogle ScholarCrossref
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