Date of Award

May 2019

Degree Type

Dissertation

Degree Name

Doctor of Philosophy

Department

Nursing

First Advisor

Peninnah M Kako

Committee Members

Gary Harper, Lucy Mkandawire-Valhmu, Lance Weinhardt

Keywords

health equity, intersectionality, parent support, qualitative inquiry, resilience, transgender youth

Abstract

Transgender youth of color experience alarming rates of marginalization and victimization within society, including experiences of rejection from parents/ guardians, which has been associated with various adverse health outcomes. Health care providers are encouraged to facilitate parent/guardian support for transgender youth to improve long term health, however nurses report feeling underprepared to care for transgender populations and nursing transgender health research is lacking. Therefore, the purpose of this study was to describe how transgender youth of color experience and navigate parent/guardian support, considering the broader societal context.

This study was informed by critical and intersectionality theory. A qualitative secondary approach was used to analyze previously collected semi-structured qualitative interviews from a nation-wide study with transgender youth (n=24). Data was analyzed using narrative inquiry to describe stories of transgender youth of color age 16-18 years and their experiences regarding parent/guardian support related to their overall health and well-being, while navigating intersecting marginalization. The overarching theme It’s a Process described the ways that transgender youth of color navigated various barriers and milestones in pursuit of living their lives with authenticity. Additional subthemes emerged, including We Need Your Help, I’m Lucky to Have Support, Self-Advocacy/Resistance, and Having Hope/Resilience. This study was the first to explore the pivotal experiences of transgender youth turning 18, a turning point when youth were finally able to consent for their own health care, but may face limited access if still on their parent/guardian’s insurance without parent/guardian support.

Findings of this study have important implications for nursing education, practice, and research as well as health care policy. Increased understanding about the ways transgender youth of color navigate intersecting barriers can improve nursing education and clinical care. Future research can develop clinical tools that will facilitate resistance and resilience processes for transgender youth of color, as well as parent/guardian support, ensuring culturally and developmentally appropriate interventions. Future research can also explore the structural causes of health inequities found in this study to inform policy change.

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