There were two cases where the estrangement was initiated by the parent because the AYA’s outbursts were affecting younger siblings or there was a threat of violence made by the AYA to the parent. This sample is distinctively different than what is described in previous research about gender dysphoria because of the distribution of cases occurring in friendship groups with multiple individuals identifying as transgender, the preponderance of adolescent (natal) females, the absence of childhood gender dysphoria, and the perceived suddenness of onset. If similar mechanisms are at work in the context of gender dysphoria, this greatly complicates the evaluation and treatment of impacted AYAs. The current “About” section states that requests to join the group “will be denied if you are not the parent (or immediate caregiver or family member) of a transgender, gender-fluid, gender-questioning, agender, or other gender-nonconforming child (of any age); or if you are uncooperative during screening” and that the “group is comprised of parents and parenting figures, as well as a select group of advocates INVITED by the admin[istrative] staff to assist & help us with understanding legal and other concerns” [52]. They are heritable, but also may occur throughout the lifespan, and are potentially reversible. Website moderators and potential participants were encouraged to share the recruitment information and link to the survey with any individuals or communities that they thought might include eligible participants to expand the reach of the project through snowball sampling techniques. [citation needed], Many people with eating disorders also have body dysmorphic disorder, altering the way a person sees oneself. https://doi.org/10.1371/journal.pone.0202330.t004, At the time the AYA announced they were transgender-identified (“came out”), most were living at home with one or both parents (88.3%) and a small number were living at college (6.2%). [99], Social isolation has been shown to have a deleterious effect on an individual's physical and emotional well-being. Additionally, nearly half were described as having engaged in self-harm prior to the onset of their gender dysphoria. Website moderators and potential participants were encouraged to share the recruitment information and link to the survey with any individuals or communities that they thought might include eligible participants to expand the reach of the project through snowball sampling techniques. The trajectories of the AYAs were not consistent with the narrative of discovering one’s authentic self and then thriving. Overall, 41% of the AYAs expressed a non-heterosexual sexual orientation prior to disclosing a transgender-identification. IRB approval for the study from the Icahn School of Medicine at Mount Sinai in New York, NY was received. Participants had the option to withdraw consent at any time prior to submitting responses. It has been shown that maladaptive parental behavior has an important role in the development of eating disorders. It’s hard to have a steady hand and say no to medical transition when the other option is dead kid. [145] Compared to Western patients, individuals with this variant anorexia demonstrated bulimic symptoms less frequently and tended to have lower pre-morbid body mass index. The requirement of six-month duration of symptoms was not included. The site, as seen in digitally archived screenshots from 2015 and 2016, stated that it is a “safe place for gender-skeptical parents and their allies”, offered support for parents, and expressed concern about the rush to diagnose young people as transgender and the rush to proceed to medical treatment for them [2, 48]. Treatment varies according to type and severity of eating disorder, and usually more than one treatment option is utilized. It would also be worthwhile to explore whether parents favor affirming the child as a person or affirming the child’s gender identity and whether parents hold liberal, cautious, or negative views about the use of medical and surgical interventions for gender dysphoria in AYAs. The survey was active from June 29, 2016 to October 12, 2016 (3.5 months) and took 30–60 minutes to complete. [247] The American Psychiatric Association (APA) recommends a team approach to treatment of eating disorders. [152] Additional studies in 2011 found that social network media exposure, independent of direct media and other cultural exposures, was also associated with eating pathology. As recently as 2012, there were only two clinics (one in Canada and one in the Netherlands) that had gathered enough data to provide empirical information about the main issues for gender dysphoric adolescents [25]. 2001). One participant wrote, “At [the] first visit, [my] daughter's dialogue was well-rehearsed, fabricated stories about her life told to get [the] outcome she desired. "The medical history is the most powerful tool for diagnosing eating disorders"(American Family Physician). Sores along the lining of the stomach called peptic ulcers begin to appear and the chance of developing pancreatitis increases. More than a third (33.7%) of the AYAs asked for medical and/or surgical transition at the same time that they announced they were transgender-identified. Like to use [certain, specific] words [with] the therapist when describing your GD, because [they are] code for potentially suicidal and will get you a diagnosis and Rx for hormones.” Another parent disclosed, “The threat of suicide was huge leverage. Seven major themes were identified from the comments provided by participants and are described, with representative supporting quotes. To explore the differences between the AYAs who had exposure to social influence (friend group, internet/social media, or both) and AYAs who did not have a clear exposure to social influence (neither and don’t know), a series of chi-squared calculations were performed for selected variables. [1], Treatment can be effective for many eating disorders. This research does not imply that no AYAs who become transgender-identified during their adolescent or young adult years had earlier symptoms nor does it imply that no AYAs would ultimately benefit from transition. "The magnitude of risk associated with social isolation is comparable with that of cigarette smoking and other major biomedical and psychosocial risk factors." Gay men are at greater risk of eating disorder symptoms than heterosexual men. [302] AN has one of the highest mortality rates among mental illnesses. Eating disorders have been associated with a fragile sense of self and with disordered mentalization. A 14-year-old natal female and three of her natal female friends were taking group lessons together with a very popular coach. This is an observation that demands urgent further investigation. No, Is the Subject Area "Child abuse" applicable to this article? The study’s eligibility criteria included parental response that their child had a sudden or rapid onset of gender dysphoria and parental indication that their child’s gender dysphoria began during or after puberty. For more information about PLOS Subject Areas, click One parent, in response to the question about if their child had very high expectations that transitioning would solve their problems elaborated, “Very much so. A gastric rupture is when there is a sudden rupture of the stomach lining that can be fatal.The acids that are contained in the vomit can cause a rupture in the esophagus as well as tooth decay. There has been controversy over various editions of the DSM including the latest edition, DSM-V, due in May 2013.
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