Background: Researchers combined both versions of the original Utrecht Gender Dysphoria Scale (UGDS) to create a single gender spectrum version (UGDS-GS) which measures dissatisfaction with gender identity and expression over time as well as comfort with affirmed gender identity. Aim: This study examined the construct validity of the newly revised, UGDS-GS. Method: Tests of measurement invariance were conducted in stages to assess measurement invariance of the UGDS-GS across three groups: cisgender, binary transgender, and nonbinary/genderqueer. Results: Findings indicate that the UGDS-GS functions acceptably in all three gender groups (configural and metric invariance). Also, across binary transgender and nonbinary/genderqueer groups, the measure functions very similarly with all four types of invariance. Item level findings highlight the specificity of the measure to distinguish experiences of binary transgender and nonbinary/genderqueer persons differently from cisgender LGBQ individuals. Conclusions: The UGDS-GS demonstrates a large degree of invariance across binary transgender, nonbinary/genderqueer, and cisgender LGBQ subgroups; and therefore, findings indicate this revision to be a substantial improvement. This 18-item self-report, Likert-type scale measure is a) inclusive of all gender identities and expressions (e.g., transfeminine spectrum, transmasculine spectrum, genderqueer, nonbinary, cisgender); b) appropriate for use longitudinally from adolescence to adulthood; and c) administered at any point in the social or medical transition process, if applicable, or in community-based research focused on gender dysphoria that examines cisgender and transgender persons.

Existing research on transgender individuals often frames the transgender population as homogeneous and tends to stratify the population into categories based on only sex assigned at birth. A growing body of literature has focused on the different experiences of those who identify as binary and those genderqueer or nonbinary (GQNB) individuals who defy binary categorization. Important distinctions between health outcomes between these subcategories of the population have begun to be elucidated. At the same time, little is known about differences in developmental trajectories between binary transgender and GQNB individuals. By understanding differences across the life span, researchers may be better suited to identify underlying milestones that serve as critical points in the development of discrepant health outcomes and use them to promote optimal health. Using data collected from the 2015 U.S. Transgender Survey (James et al., 2016), we identified 7 different transition milestones guided by Johnson's (2016) transnormative framework. Analyses of variance examined differences between binary transgender individuals and GQNB individuals. Post hoc analyses examined group differences between trans men, trans women, assigned female at birth genderqueer, and assigned male at birth genderqueer individuals. Significant differences were observed among the average age of each group with respect to each developmental milestone. Results suggest that applying a transnormative narrative to understanding the development of GQNB individuals may inadvertently marginalize the unique experiences of this heterogeneous population. Implications are discussed from clinical and social justice perspectives. Recommendations for honoring individual differences among GQNB persons are made for psychologists working this population.

Researchers have identified important psychosocial distinctions between three emergent gender categories: cisgender, binary transgender and non-binary transgender. The present study further examines such heterogeneous experiences and explores the methodological implications for research of the transgender community. Participants were 153 cisgender, 201 binary transgender and 164 non-binary transgender American adults who completed questionnaires on the topics of life satisfaction, gender determinism and perceived social support. Results demonstrate that non-binary transgender participants report lower gender determinism than both cisgender and binary transgender participants. Furthermore, correlations between significant other support and life satisfaction were higher in cisgender participants than either binary or non-binary transgender participants, whereas the correlation between friend support and life satisfaction was higher in both cisgender and binary transgender participants than in non-binary transgender participants. These results threaten the methodological coherence of studying a unitary 'transgender community', and suggest that some meaningful group differences can be attributed to one of two dimensions of gender variance: cisgender versus transgender identity, or binary versus non-binary gender identity. Future survey research should further explore the methodology of assessing non-binary identity and transgender identity using separate items.

Abstract Introduction: The Genderqueer Identity Scale (GQI; McGuire et al., this issue) – a newly developed and validated measure – assesses genderqueer identity via four subscales: challenging the gender binary, the extent to which participants actively work to dismantle gender binaries in identity and expression); social construction of gender, or the degree to which participants interpret their gender identity as something that develops versus an innate essentialist phenomenon; theoretical awareness of gender, the degree of social and political intention attached to gender identity; and gender fluidity, or repeated shifting of gender expression across periods of time. Aim: This descriptive study examined the predictive validity of the GQI and group differences in genderqueer identity with a sample of transgender, genderqueer and nonbinary spectrum, and cisgender sexual minority adults (N = 510). Methods: We hypothesized that Genderqueer Non-binary (GQNB) participants would score higher on GQI subscale scores compared to transgender participants who identify within the gender binary. Results: Results from ANOVA models indicated a statistically significant difference in intrapersonal subscales across sexual minority and transgender binary or genderqueer groups. For the interpersonal subscales there were differences across all three groups. Cisgender sexual minority participants reported the lowest levels on all scales, while genderqueer participants reported the highest, and transgender binary were in-between. Discussion: The GQI demonstrates strong predictive validity in distinguishing binary transpersons from GQNB and cisgender sexual minority persons. Findings reveal that these three subgroups who might otherwise be similarly categorized (i.e., LGBTQ) show significant differences on challenging the binary, social construction, theoretical awareness, and gender fluidity constructs.

ObjectiveTo explore family boundary ambiguity in the parent–child relationships of transgender youth.BackgroundTransgender 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.MethodEthnographic content analysis was conducted based on interviews with 90 transgender youth recruited from community centers in 10 regions across 3 countries.ResultsNarratives 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.ConclusionTransgender 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.ImplicationsFamily 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.

Background: Non-binary gender measurement has grown out of a need for accurate representation in scholarship and public health services available to a diverse gender population. Aims: The Genderqueer Identity Scale (GQI) was developed to allow for a multidimensional assessment of genderqueer identity, including non-binary identity, socially constructed versus essentialist gender, theoretical awareness of gender concepts, and gender fluidity. The GQI was designed to assess gender identity across a full spectrum of gender, at any age after mid-adolescence, and at various stages of gender identity development, including prior to, during, and after a gender transition, where applicable. Two of the GQI subscales focus on intrapersonal processes, while two focus on interpersonal processes. Methods: The measure was piloted and refined across four distinct samples: a U.S. university based LGBT sample, consecutive clinical referrals at the Center of Expertise on Gender Dysphoria in Amsterdam, the Netherlands, a Dutch LGB community sample, and an online survey forum (LGBTQ). Results: The first exploratory factor analysis identified minor potential adjustments, which were refined and retested. Researchers evaluated and cross-validated the hypothesized factor structure and determined that the three factor GQI subscales and the unidimensional Gender Fluidity measure yielded internally consistent and valid scores among transgender individuals seeking clinical treatment and LGB individuals within a community setting. The exploratory and confirmatory factor analyses provide evidence of good reliability, construct validity, and internal consistency of all four subscales. Discussion: The subscales were appropriate across a spectrum of gender identities and can be taken in the same form over time and across gender transition statuses, making them suitable for clinical evaluation and community based longitudinal research with trans-identified or gender nonconforming persons. The development of the GQI fills critical gaps in gender-related measurement including the ability to assess multiple dimensions of gender identity, and to assess gender identity across time.

Background and Aims: Increasingly, research is emerging on the subjective experience of genderqueer people. This study explored how genderqueer identities are understood and managed in both personal and social domains. Method: Interview data from 25 genderqueer-identified American adolescents and emerging adults, aged 15 to 26 (M = 21.28, SD = 3.20), were pulled from a larger study of 90 transgender and genderqueer participants. The 90-minute semi-structured interviews included questions about gender identity, the developmental pathway of participants, and relationships with others regarding gender. Results: Participants described "genderqueer" as a sufficiently broad category to capture their diverse experiences, and descriptions of genderqueer identities were heterogeneous, directly contradicting binary understandings of gender identity. A thematic analysis of interview transcripts resulted in three themes: intrapsychic experience, descriptions of master narratives about gender identity, and the co-construction of identities. Discussion: Participants described navigating a series of master and alternative narratives, such that all transgender people transgress a cisnormative master narrative, but genderqueer people further transgress normative understandings of a medicalized, binary transgender identity. The experience of co-creating identities was the process by which participants actively navigated constraints of the master narrative experience. Participants described the integral role of language in crafting new narratives to legitimize genderqueer experiences, as well as the subsequent intragroup conflict resulting from conflicting relationships to narratives in the transgender community. This study highlights genderqueer identities as a source of strength and positivity, and the importance of expanding beyond the hegemonic gender binary within research and clinical practice.

The presence of a trans* family member can challenge existing theoretical notions about the development of gender in families. Emerging knowledge about trans* identities consolidates around 5 primary challenges to existing theoretical notions of gender: (a) non‐dimorphic sex, (b) nonbinary gender, (c) the biological and social construction of gender, (d) gender identity development, and (e) family meaning making about transgender identity. These challenges structure an examination of hetero‐ and cisnormative expectations within family theory and help unpack long‐standing tensions between essentialist and social constructionist views of gender development. This can play out in family theory through a recognition of the tension between upholding and decentering cisnormativity within families. This article pinpoints locations where current family theories require reexamination and expansion to accurately conceptualize the flexibility and variability of families with trans* members.

The goal of this study was to examine the ways in which transgender youth experience their bodies with regard to gender and body size. Ninety transgender youth and young adults completed in-depth interviews in eight metropolitan areas of the United States, Canada, and Ireland. Using a queer perspective, qualitative analyses revealed two broad conceptual categories: body dissatisfaction and body satisfaction. Within these categories, participants focused on body issues related to gender characteristics and body size. Findings revealed evidence of self-criticism and social distress related to body image dissatisfaction and self-acceptance and social acceptance related to body image satisfaction. Data demonstrated how gender, body size, and the intersection of gender and body size influenced personal perceptions of body dissatisfaction and satisfaction. Developmental processes were evident: participants further along in consolidating a gender identity described gaining a sense of social awareness, self-acceptance, and body satisfaction reflecting a sense of resilience.

In this article, we use an ambiguous loss framework to guide a process for decentering cisnormativity (the assumption that biological sex and gender are aligned) within families, specifically for those experiencing the gender identity transitions of family members. Individual family members have varied experiences with regard to gender transition and may or may not experience ambiguous loss depending on their position within the family system. Trans* persons themselves may also experience ambiguous loss as a result of the dialectical tension of acceptance and rejection by family members. We apply resilience processes developed for work with persons facing ambiguous loss to support trans* persons and their families as they navigate gender transitions.