First Advisor

Ben Anderson-Nathe

Term of Graduation

Spring 2025

Date of Publication

4-3-2025

Document Type

Dissertation

Degree Name

Doctor of Philosophy (Ph.D.) in Social Work and Social Research

Department

Social Work

Language

English

Subjects

Gender-nonconforming children -- Social networks, Child health services, Pediatrics, Children and adults, Gender-nonconforming children -- Psychology. and the Internet -- United States, Discourse analysis

DOI

10.15760/etd.3941

Physical Description

1 online resource (xi, 192 pages)

Abstract

A growing number of children identify in various gender-creative ways, likely due to broader social awareness and affirmation of transgenderism. Gender-creative children face higher risks for adverse social, academic, mental health, and healthcare outcomes compared to non-transgender peers. Support from loved ones along with guidance from pediatric providers can mitigate poor outcomes and ensure that gender-creative children live healthy and happy lives. Young gender-creative children's perspectives about the aforementioned topics are markedly absent from the literature, which instead highlights adolescent and adult proxy perspectives.

In this participatory arts-based study anchored by a constructivist epistemology and informed by post-structuralist, queer, and transgender theories, I sought to hear directly from gender-creative children about their social supports and experiences with pediatric clinical care using the Draw-and-Tell Conversations (DTC) method. I wanted to know what would help gender-creative children feel safe to express thoughts, feelings, and experiences related to gender; who they go to when they want to talk about their health and/or gender, and why; and what it is like for them to attend pediatric health care visits. I recruited a United States-based bicoastal sample of 12 school-aged (5–10 years old; median age 6) gender-creative children. Participants were predominantly white (n=10/12; 83.3%) and from highly educated families (n=12/12; 100%).

Findings suggest that gender-creative children often rely on primary caregivers, trusted loved ones, and teachers for support. Children preferred not to talk to pediatric providers about gender and healthcare encounters were frequently described as uncomfortable. The study highlights the need for pediatric providers to continue adopting child-centered, gender-affirming practices, such as empowering children with agency in conversations and decision-making, using inclusive language, and incorporating tools like drawing to facilitate rapport and engagement.

Rights

In Copyright. URI: http://rightsstatements.org/vocab/InC/1.0/ This Item is protected by copyright and/or related rights. You are free to use this Item in any way that is permitted by the copyright and related rights legislation that applies to your use. For other uses you need to obtain permission from the rights-holder(s).

Comments

Supported by The National Center for Advancing Translational Sciences of the National Institutes of Health (TL1TR002371), the Portland State University School of Social Work John F. Longres Dissertation Fellowship, and the Portland State University School of Social Work Dean K. Nelson Fellowship.

Persistent Identifier

https://archives.pdx.edu/ds/psu/43888

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