Transgender young people may face a number of challenges to their well-being, including depression, self-harm and suicide; physical health issues; alcohol and substance misuse; higher incidence of violence, harassment, and discrimination; and challenges in social relations with family and friends (Higgins et al., 2016; McNeil, Bailey, Ellis, Regan, and Transgender Equality Network Ireland (TENI), 2013). Research shows that a family’s behaviours towards a transgender family member, whether affirming or rejecting, can seriously impact on a transgender young person’s mental health and resilience (Ryan, Russell, Huebner, Diaz, and Sanchez, 2010). Within Ireland, transgender young people themselves have identified the importance of family support for their own well-being (Dunne and Turraoin, 2016). Although the importance of family support is essential for the well-being of transgender young people, many transgender people within Ireland report being rejected or not supported by their family (Dunne and Turraoin, 2016; McNeil et al., 2013). Within the literature, education and information have been identified as playing an important role in a family’s ability to accept and support a transgender family member (Dunne and Turraoin, 2016; Riley, Sitharthan, Clemson, and Diamond, 2011). While there is a growing body of literature on the importance of education and information for families of transgender people, there have been no studies exploring the education needs of these families in an Irish context.

Aims and objectives

This PhD study aims to explore the education needs of families of transgender young people in the Republic of Ireland and how best to address these needs. The objectives are: 

1 to identify the education needs of family members of transgender young people in the
Republic of Ireland; 
2 to design, develop, and evaluate an education programme for these families which takes into account their identified needs; and
3 to make recommendations for developing the programme, future research, policy and practice.

Methodology

This study is informed by Community-Based Participation Research (CBPR) and a Family Life Education (FLE) framework. CBPR is defined as “an alternative research paradigm” which, “… focuses on relationships between academic and community partners, with principles of co-learning, mutual benefit, and long-term commitment” (Wallerstein and Duran, 2006:312). CBPR values the strengths, knowledge, and skills of both community partners and the academicresearcher, suggesting the importance of building partnerships to develop and conduct a needs-based and relevant research study (Minkler and Wallerstein, 2003). Family Life Education (FLE) is a strengths-based approach to family education, using a preventative framework to promote positive well-being and healthy family functioning (National Council on Family Relations (NCFR), 2016). In addition, the study is guided by the gender affirmative theory and model, which asserts that gender may be fluid and diverse, that its development is complex, and that this is a natural, not pathological, phenomenon (Hidalgo et al., 2013). Within this approach, there is no need to attempt to change or ‘treat’ a gender diverse child or young person, as there is nothing viewed as inherently requiring alteration as regards their gender identity (Hidalgo et al., 2013). The voice of the child is central, with the child presumed to be capable, free and able to understand and assert their identity (Hidalgo et al., 2013). The underlying basis for this approach is the belief that by affirming and supporting their transgender family member, families and parents can promote healthy adjustment (Hidalgo et al., 2013). 

This mixed methods study has three primary phases: Consultation; Design and Development; and Evaluation. This article will focus on findings related to the Consultation phase, which aimed to conduct a needs analysis with key stakeholders in order to identify their education needs. The first sub-phase included seven in-depth, semi-structured interviews with family members of transgender young people and professionals working in organisations that support transgender young people and their families. The next sub-phase of the consultation included surveys with two cohorts: 1. family members (n=18) and 2. transgender young people (n=14). The aim of these surveys was to identify key areas of questions/concerns for the cohorts. The family survey asked family members about questions/concerns they had regarding their transgender family member, whereas the transgender young people’s survey asked them about questions/concerns they had relating to their family. 

Ethical approval to conduct this study was received from the researcher’s university. The lower age limit for youth participation in the anonymous survey was 14 years and return of the survey implied consent to participate. No parent/guardian consent was sought. Strategies to off-set the absence of parent/guardian consent included utilising young person-friendly protocols and consent procedures; partnering with experienced community youth agencies; and maximising attention towards confidentiality, anonymity, and voluntary participation (Flicker and Guta, 2008). 

All data were analysed using the iterative, six step process for inductive, semantic, thematic data analysis developed by Braun and Clarke (Braun and Clarke, 2006). This is a data-driven process in which the data from participants drives the generation of themes, which explain the data and answer the research question. 

Brief overview of consultation findings

Within the interviews, all of the participants alluded to the fact that families are often completely unaware and uninformed about what it means to be transgender. One mother succinctly phrased her confusion: 

Transgender, what the f*** is that like? You know? — Sinead, mother to a transgender female aged 16.

This lack of knowledge can lead to families feeling confused and overwhelmed. One professional participant noted that:

Quite often, you know, the parents know absolutely nothing about the area, so it comes totally out of the blue. People are absolutely shell shocked. They don’t know where to turn. They don’t know where to go…They don’t know what to do. — Professional 4

The issue of not having Irish-specific education resources was highlighted by all of the participants and there were no ongoing or
sustainable education programmes available to families:

Like there would be, I think there is a definite lack of information in Ireland for parents and for young people — Professional 1

Within the survey, the family members identified 92 areas of questions/concerns in relation to having a transgender family member, with five primary themes emerging: health; emotional responses; social issues; general support and moving forward; and other issues. The most common questions/concerns were healthrelated issues, including both physical and mental health and how to access support:

What does this mean medically speaking? — Mother

Other family’s questions/concerns were classed as emotionally-based responses and were defined by emotions such as fear and worry of finding out their family member was transgender: 

“ I felt heartbroken for my child and for myself” — Mother. 

There were also a number of questions/concerns around social issues, particularly as regards whether their family member would be
accepted or discriminated against and how best ‘come out’ to other people: 

How will he make friends? Is social life going to be a nightmare that kills us? — Father

Families also had questions/concerns about how to move forward in supporting their transgender family member and how to access support. There were a number of other concerns around areas including school, legal and administrative issues, and impact on siblings. Within the young people’s survey, the transgender young people provided 44 individual responses, with eight separate themes emerging: understanding; acceptance, respect, and perception; doubt, belief, or ‘it’s just a phase’; emotional responses; support; negative behaviour; coming out to others; and language/pronouns. The majority of their questions/concerns were around whether their family members would understand who they are — both literally in the sense of what it means to be transgender and more figuratively in the sense that being transgender is an innate part of their being.

Will my family understand what it means to be transgender? — Male, 18 years old

In addition, there were a number of questions/concerns around how participants’ family members would perceive them upon realising they were transgender, and whether their family would be able accept them for who they are: 

I was worried I wouldn’t be accepted — Female, 18 years old.

Several participants were concerned that their family would not believe they were transgender or think ‘it’s just a phase’. Nearly fifteen per cent expressed explicitly that they were ‘afraid’ or ‘worried’ about their family’s reaction. Others had questions / concerns over whether they would receive support from their family, while some feared being at the receiving end of negative behaviours such as being kicked out of the house. Smaller percentages had questions/concerns over coming out to others and around whether their family would use the appropriate language when speaking with them. 

In summary, the findings from the consultation underscored the need for the development of an education programme for families and identified key areas for consideration in its development. It was of critical importance to ensure that families’ and young people’s areas of questions / concerns were included within the education programme. With this in mind, the education programme content was reviewed and modified to reflect these findings from the consultation phase. For example, as health was such a prominent concern for families, the health module content was reviewed and modified to ensure that it addressed clearly both the physical and mental health needs of transgender young people and how to access healthcare supports. As emotional responses appeared to be so significant to families, the content was reviewed to ensure that each module addressed not only the factual or information elements of the topic, but also explicitly addressed the emotional elements. Where appropriate, additional emotionally-based text and videos were added to the education programme. In terms of young people’s concerns, the education programme content was modified to reflect more fully the questions/concerns of young people around coming out within the family. This was accomplished by including written text about their questions/concerns, as well as personal stories from transgender young people about their experiences of coming out within a family context. A similar process of reviewing and modifying the module content, as well as the overall education programme, was conducted to reflect these findings. The study is currently in the development sub-phase. Once the education programme is developed, the researcher will conduct a mixed methods evaluation of the programme to explore participants’ experiences with the education programme and to evaluate its impact.

Discussion and conclusion 

This PhD research aims to explore the education needs of families of transgender young people and to address these needs by designing, developing, and evaluating a gender-affirmative education programme for these families. The findings of the study to date reflect much of the literature, indicating that education plays an important role in families’ ability to accept and support a transgender family member (Gray, Sweeney, Randazzo, and Levitt, 2015; Kuvalanka, Weiner, and Mahan, 2014; Meadow 2011; Norwood 2013; Pearlman 2006; Rahilly 2015; Riley et al., 2011; Riley, Sitharthan, Clemson, and Diamon, 2013; Wren, 2002). However, the study findings have also shown a lack of educational opportunities for families of transgender young people in the Republic of Ireland, as well as identified a number of areas of educational importance for families and transgender young people. It is hoped that this education programme can help families by providing an innovative, needs-based resource for information and education, which in turn, may foster enhanced resilience for transgender young people.