Family Boundary Ambiguity Among Transgender Youth

Objective: To explore family boundary ambiguity in the parent–child relationships of transgender youth. Background: Transgender youth may perceive a lack of clarity about whether parents will accept their authentic gender expression, continue to support them physically and emotionally, and regard them as a member of the family. Uncertainty about being in or out of the family and whether family relationships endure is stressful and can lead to psychological distress, a sense of ambiguous loss, and frozen grief. Method: Ethnographic content analysis was conducted based on interviews with 90 transgender youth recruited from community centers in 10 regions across 3 countries. Results: Narratives revealed that transgender youth experienced family boundary ambiguity related to relational ambiguity, structural ambiguity, and identity ambiguity. Each experience of ambiguity obscured whether participants remained in the family and interpersonally connected to their parents. Conclusion: Transgender youth actively navigated complex and ambiguous parent–child relationships whereby participants attempted to reconcile their need for authentic gender expression combined with their need for family connectedness and acceptance. Implications: Family clinicians, educators, and policymakers are urged to consider family and transgender resilience through a lens of ambiguous loss and to promote a gender-affirmative life-span approach to clinical care for transgender individuals and their families.