Breaking the Binary: Restriction and reclamation of power among transgender and gender diverse young adults

Abstract

Binary gender norms in the U.S. contribute to the systemic marginalization of transgender and gender diverse (TGD) individuals. These norms shape beliefs and assumptions about a TGD young adults; they inform the policies that govern their rights, the settings they occupy, and research conducted about them. Experiences based on binary conceptions of gender may leave TGD young adults feeling disempowered and require they develop resilient strategies to maintain or reclaim power and control over their lives and decisions. The purpose of this study was to explore the mechanisms through which young adults (ages 18 to 24) demonstrate resilience and resist oppressive gender norms. In collaboration with a TGD young adult advisory team, we used a participatory focus group method (Youth GO) to engage TGD participants in critically examining power and powerlessness in the context of their multiple identities and life experiences. Findings revealed distinct mechanisms of power that work to either restrict or restore TGD young adults’ power over their identity and autonomy. Mechanisms operated differently as a function of age, race, gender identity, gender presentation, and socio-economic status. Findings point to concrete and actionable policy and practice interventions that would foster validation and inclusion of TGD young adults.

Introduction

Transgender and gender diverse (TGD) young adults in the United States face marginalization due to a lack of affirming policies, resources, and protections (Du Bois et al., 2018; Feldman et al., 2021; Hughto et al., 2015; James et al., 2016). Societal stigmas about sex and gender are woven into society’s basic organization and shape the beliefs and assumptions of people who interact with TGD young adults, the settings they occupy, the policies that govern their rights, and the research conducted on their behalf (Hendricks & Testa, 2012; Sevelius, 2013). In most settings that TGD young adults encounter (e.g., school, home, healthcare, legal, employment), binary notions of gender are overwhelmingly normalized. TGD young people are forced interact with people who do not understand, acknowledge, or accept them and to participate in institutions that are not designed to accommodate their needs or identities (Day et al., 2018; Mountz, 2020; Shelton & Bond, 2017). TGD young people who resist these norms and attempt to live in ways that align with their self-conception may suffer ridicule, rejection, stigma, discrimination, violence, and oppression (Bauer et al., 2009; Grant et al., 2011; Grossman & D’Augelli, 2006; Johns et al., 2019; McCann et al., 2017; Reisner et al., 2015).

In a binary world, navigating basic social systems may require TGD young adults advocate for their basic human rights, often without institutional support (Frohard-Dourlent, 2018; Hill et al., 2017; Ingrey, 2019; Kaufman et al., 2007; Veale et al., 2015). Self-advocacy efforts may be further impeded by the fact that many systems, such as healthcare, are designed for adults, resulting in health and healthcare access disparities for young people (Hendricks & Testa, 2012). Young people may be especially prone to feel that they have little power in these settings or ability to claim agency over important aspects of their lives. Many TGD young adults report shame, fear, and rejection in such settings, leading them to avoid further interaction with healthcare systems (Bockting et al., 2013). This avoidance, in turn, contributes to health disparities (Gordan & Meyer, 2007; Grant et al., 2015; Reisner et al., 2015).

Despite negative experience and outcomes, TGD young people demonstrate profound resilience and resistance against the people and systems that discredit their identity and restrict their access to basic services (Robinson et al., 2021; Singh et al., 2014). Theories of gender and power offer frameworks to understand such mechanisms (Connell 2013; Prilleltensky, 2008; Rosenthal and Levy 2010). Overcoming barriers to equitable access for TGD young adults requires an awareness of the oppressive power structures that impede their well-being and ability to flourish. For instance, Pratto and Walker’s Theory of Gender and Power (2004), developed to explain the systems of power that harm cisgender heterosexual women, identified four heteropatriarchal mechanisms of gendered power that work to maintain gendered inequality: 1) shared cultural beliefs about gender; 2) allocation and control of resources; 3) violence and force; and 4) obligations to social systems. Although this theory fails to reflect non-binary conceptions of gender, it still highlights how power can manifest in societal hierarchies to disenfranchise people through systematic perpetuation of discrimination, stigma, and exclusion. To dismantle powerful heteropatriarchal systems, we must understand how power is exercised to limit, to control, and to liberate TGD young adults. Given that the bulk of research on TGD individuals focuses on barriers to care, minority stressors, and negative health outcomes, we lack an understanding of the mechanisms by which youth and young adults demonstrate resilience and resistance against the oppressive people and systems abundant in their everyday lives.

The purpose of this study was to explore how TGD young adults (ages 18 to 24) conceive of and experience power, with a specific focus on health and wellbeing. Using Youth GO—a youth participatory data collection and analysis technique—we sought to engage TGD young people in defining power and critically examining power and powerlessness in the context of their multiple identities and life experiences.

Methods

Research Team Description

The first author—a queer, White, cisgender woman— led the project as a graduate student supervised by a faculty member (third author). Equitable and intentional collaboration with TGD young adults as co-researchers was crucial to this study. A TGD young adult research advisory team was created specifically for this project (second author was a member of The Advisory Team). Team members’ ages range from 18 to 22 years old, and all identified as transgender or gender nonconforming. The Advisory Team had meaningful engagement opportunities and power over decisions regarding the research design, data collection, analysis, and dissemination of findings.

Participant Recruitment

We recruited a purposive sample of TGD young adults between the ages of 18 and 24 to participate in focus groups. Young adults were recruited from three Michigan cities (e.g., Cities A-C) by: 1) networking with contacts at local LGBTQ groups, Gay Straight Alliances, University groups and events, 2) posting flyers in community spaces that young TGD individuals frequent, and 3) posting on local social media. 25 TGD people expressed interest in the study, of whom 19 were eligible and consented to participate. We held five focus groups, which is sufficient to thematic reach saturation (Hennink et al., 2019; Morgan, 1993). We hoped for each group to be diverse in terms of gender and race/ethnicity, however, our groups’ demographic makeup varied significantly by location. Across groups, we were able to recruit a diverse sample, however, within groups, racial and gender diversity was minimal. The composition of the groups likely reflects the extent to which Michigan is racially segregated geographically and also the degree of gender identity segregation (Menendian et al., 2021). Table 1 provides a detailed description of the demographics of each group.

Table 1.

Description of Focus Group Participants

#	Location	n	Race/Ethnicity	Gender	Age
1	City A	3	White	Gender queer masculine	Mean =21.3 Range =18–24
			White	Transgender man
			Asian/Mixed	Transgender man
2	City B	5	White	Trans masculine non-binary/genderqueer	Mean =22.6 Range =20–24
			White	Transgender / Nonbinary / Agender
			White	Non-Binary / Gender Fluid / Genderfuck
			Asian	Genderfluid/transgender
			White	Transsexual male
3	City C	5	Black	Transgender woman	Mean = 23.6. Range = 21–26
			Black	Transgender woman
			Black	Transgender woman
			Black	Transgender woman
			White	Transgender woman
4	City C	3	Black	Transgender woman	Mean = 23 Range = 20–26
			Black	Transgender woman
			Black	Androgynous man
5	Virtual (City A)	3	White	Transgender woman	Mean = 21.3 Range = 20–22
			White	Transgender woman
			White	Transgender man

Data Collection Procedures

We used a modified version of a participatory focus group approach called Youth GO (Stacy et al., 2018; Stacy et al., 2020). Youth GO was developed to engage youth meaningfully in data collection, analysis, and interpretation (Stacy, et al., 2018). As part of the focus group procedures, Youth GO exposes participants to three important aspects of qualitative data analysis: data reduction, data organization, and conclusion drawing and verification. The five-stage Youth GO protocol has youth generate data, learn basic qualitative analysis techniques, categorize and organize the data, and interpret the findings. In Figure 1, we display the stages of our modified version of the Youth GO protocol.

Figure 1.

Modified Youth GO Process

Youth GO Procedures

Upon arrival at the focus group venue¹, participants and facilitators reviewed the consent form and the agenda for the group. Participants were compensated for their time and transportation costs before we began the groups so that a participant could leave the group freely should they decide they no longer wanted to participate. We began by facilitating an icebreaker to build rapport and encourage dialogue among the participants.

In stage 1, participants created a set of ground rules to guide discussion and manage group dynamics. The co-created rules addressed the importance of confidentiality, privacy, and making space for others. During stage 2, we revealed a series of prompts on a flip chart wherein participants were encouraged to reflect on the prompt and then write down their thoughts on sticky notes. Notes were added to the flip chart while facilitators led a discussion on the posted responses and sought clarifications of what was written.

After having elicited responses to the prompts, participants played an item-sorting game (Stage 3) to introduce them to data organization skills in a developmentally appropriate fashion. Then, the participants repeated the sorting game using the sticky notes that had been generated in response to the question prompts. Participants sorted responses and then placed responses onto colored sheets of paper and created labels to signify the underlying theme for each set of responses that they had grouped together. Participants collaboratively worked to identify and define central categories for the themes. Definitions of categories and themes and placement of items were refined until the group achieved consensus. Facilitators recorded the groups’ discussion throughout this process (akin to a group analytic memoing process). This study was approved by the Social Science Institutional Review Board at Michigan State University.

Analytic Plan

By design, within-group analysis was conducted by the focus group participants (Stages 3–5 of Youth GO). For cross-group analysis, we took a note-based analysis approach (Krueger, 1998) in which the primary analysis document was an analytic packet comprised of field notes, flip chart responses, themes (labels, definitions, examples) and analytic memos. Using a variable-oriented strategy (Miles et al., 2014), we explored similarities and differences between groups by looking for themes that were consistent and unique. We also considered gender identities, ethno-racial identities, and ages in our analyses. To confirm and visualize our findings, we constructed an overview grid and concept map to summarize and describe all focus group discussions, group different codes, and draw links between concepts and hypotheses (Morgan, 1993). To ensure trustworthiness, we relied upon member checking as a strategy to maintain credibility (Lincoln & Guba, 1986). Throughout each phase of the Youth GO protocol, the team routinely reflected, debriefed, and reviewed the findings and how these were being interpreted. In addition to focused reflection on our own biases at the beginning of the study, we maintained a practice of reflection through discussion and journaling.

Results

We sought to understand what circumstances or settings contribute to young TGD individuals’ feelings of power(lessness). Participants characterized power as agency over decisions about their bodies, their identities, and their ability to lead healthy, successful lives. Participants believed power was multisystemic and could be controlled or created at an individual- and macro-level. Power was also described as impermanent and an agent of prejudice that could clash or converge with other meaningful social identities.

Mechanisms of Power

In discussing the settings and circumstances in which participants felt powerful or powerless, several mechanisms of gendered power emerged that either restricted or restored young people’s power. Table 2 provides an overview of the restrictive and restorative mechanisms of power identified in this study.

Table 2.

Overview of Findings

	Current Study’s Mechanisms of Gendered Power	Description
Restrictive Mechanisms of Gendered Power Strategies and tactics used to limit, threaten, or control TGD youth’s agency over their identity	Gatekeeping	Prohibitory people and policies that restrict or control another individual or groups’ access over resources, opportunities, or advancement
	Violent Control	Name calling, misgendering, misnaming, or harassing someone based on identification with a marginalized social group
	Reifying Cispatriarchy	Enforcing societal expectations and norms about gender
Restorative Mechanisms of Gendered Power Strategies and tactics to reclaim to dignity, self-worth, and control over identity	Bodily Autonomy and Expression	Making changes to the physical appearance.
	Disrupting Imbalance	Pursuing actionable changes to the contexts that disempowered them.
	Lifting up self and the TGD community	Harnessing hateful energy to turn it into a positive and productive force.
	Educating and advocating	Staying informed on TGD topics and providing information and support to TGD peers.

Restrictive Mechanism 1: Gatekeeping

Gatekeeping emerged as a primary restrictive mechanism. Participants discussed prohibitory people and systems (e.g., laws, procedures, policies) that controlled an individual’s or group’s access to necessary resources, opportunities, and advancement. Through various types of gatekeeping, participants reported feeling powerless to the external forces that governed personal decisions over their bodies, identities, and futures.

Among the youngest participants, parents were gatekeepers of vital resources necessary for survival (e.g., housing, money, transportation, health insurance). Access to these resources was contingent upon complying with parental rules and expectations, often meaning that TGD young people had to present as their birth sex to maintain access to resources. Participants also expressed feeling powerlessness when parents or other adults did not trust them to make decisions about their lives. For participants who were still covered by their parents’ insurance plans, parents had control over medical procedures, medications, and services they desired. One participant specifically noted that after coming out, their parents threatened to drop them from their medical insurance coverage.

Gatekeeping was also discussed outside the home as blocking opportunities, whether from educational advancement or employment. One participant who felt he lost a promotion opportunity because of his gender expression said: “They’re not giving me the position I deserve so that I can be making the money I deserve because I am a gay androgynous male.” This conversation continued, with participants discussing a place of employment that refused to hire transgender or gay girls and instead would only place them as volunteers. One participant described feeling powerless because they felt “too trans to get a good job.” Participants also discussed how school administrations restricted their power to be educated by enforcing transphobic policies (e.g., policies about clothing and hair length that discouraged their attendance, inclusion, and engagement). Transphobia also extended beyond formal administrative policies into a toxic school climate through disrespectful daily interactions with school faculty and staff. One participant said: “… [attending school was] definitely a point of contention for me since it was the place...to hear these respected leaders spout so much hateful rhetoric.”

Participants discussed ways in which the healthcare system restricted them from having access to decision-making power over their bodies. Participants described how each step to accessing transition-related healthcare was another opportunity to be shut out, invalidated, and left to feel powerless over their bodies. One youth described encountering multiple providers who could not, or would not provide quality care, and another discussed switching doctors because of long wait times to get the ‘good’, gender-affirming doctors. Similarly, several focus group participants discussed needing to overcome various obstacles to access hormone replacement therapy (HRT). One participant wrote: “I needed therapy letters to continue HRT after being 3+ years on HRT.” This type of gatekeeping was particularly acute for nonbinary participants, who were more likely to encounter barriers trying to access gender-related healthcare. One participant expressed fear even in asking: “I haven’t been able to go on T [Testosterone]. I’m afraid they won’t give it to me because I’m nonbinary.”

Restrictive Mechanism 2: Violent Control

Power was restricted through violent control. Participants in every group reported being victim to violence and harassment intended to other them into the gender status quo. Participants provided examples of verbal and emotional violence perpetrated by peers, family members, strangers, medical providers, teachers, administrators, and policy makers. One participant observed: “Some of them [cis/het people] are scared of us [trans people] …They try their best to tear us down and make us not feel comfortable.”

Harassment was discussed as endemic in healthcare settings. Several participants described powerlessness through their experiences of being misgendered, treated poorly, and objectified. Participants discussed these experiences contributing to feelings of fear and distrust. Gender-based violence was evidenced in examples of physical and emotional abuse from parents and loved ones. One participant asked for the recorders to be shut off while she disclosed her experience with homelessness, sexual assault, victimization, and human trafficking. In the focus groups that were comprised predominately of Black young people, participants discussed community violence, lamenting the violent killings of Black trans women in their community.

Discussions of gender-based violence were deeply entwined with the notion of gender passing – the idea of attaining credible embodiment of a socially desired gender identity. Some participants, desired a future where they could ‘pass’ as cisgender men or women to avoid discrimination and attain the social rewards and validation that come with ‘passing’ successfully. Participants who classified themselves as ‘not passing’ felt subjected to increased harassment and violence compared to their ‘passing’ peers. One youth said, “The more easily mockable I appear, the less power I have.”

Mechanism 3: Reifying Cispatriarchy

Participants discussed how othering and disempowering it felt when society privileges the cisgender identity, especially the cis-masculine identity. Feeling pressured to comply with gender norms to avoid social sanctions was a prominent discussion among nonbinary participants. One participant wrote: “Dressing within the binary earns me more respect.” Even participants who felt pride in their defiance of gender norms discussed the negative outcomes that resulted from defiance as a form of powerlessness. One participant expressed that their ambiguous gender presentation led people to ‘invalidate’ their perception of reality.

Within the healthcare system, participants felt cis-gendered individuals were prioritized, citing the lack of awareness and availability of gender-specific resources, medication, policies, and protections. One participant plainly stated: “Being nonbinary makes healthcare a nightmare.” Participants who ‘passed’ as men reflected on being the beneficiary of male privilege as compared to when they were perceived as women. A participant describing this experience noted: “My chest, if unbound, almost always demolishes my own power in non-queer spaces.” In some cases, societal views about gender intersected with those about race, compounding feelings of powerlessness. For instance, one participant observed that society’s view of women as “emotional” and trans Black women as “traumatized” led coworkers to invalidate her opinions.

Restorative Mechanisms of Gendered Power

A central feature of y participants’ discussions of gendered power focused on strategies to reclaim or restore power. Restorative mechanisms permitted TGD young adults to feel comfortable and in control of their bodies, decisions, and identities.

Bodily autonomy and expression

The most common way to reclaim power was through enacting bodily autonomy and physical expression. A participant explained: “When I dress and present the way I want regardless of how people feel about me makes me feel like I took my power back.” Several participants mentioned getting tattoos, cutting their hair, getting piercings, or binding their chest as acts of taking back control of their body. Other participants, particularly the nonbinary participants, found power in defying traditional gender norms: “…being genderfluid is kind of a way for me to take back some of that power.” Finally, some participants noted that exercising or engaging in other physical activities helped them take power back: “Going dancing. It’s one of the few things that lets me feel in control of my body.”

Disrupting imbalance

Participants also reclaimed power by pursuing changes to or separating themselves from the contexts that disempowered them. Leaving home, getting a job, managing their own finances, and going to college were all examples of actions in which youth took back or generated power. Participants discussed feeling empowered when systems and institutions implemented policies validating their gender and supporting their ability to access resources (e.g., new state policy permitting changes to gender markers on identification cards) (Michigan Secretary of State, 2019). A participant mentioned a recent change to health insurance coverage ordered by the governor which provided better options for TGD individuals. (Michigan Department of Health and Human Services, 2020; Patient Protection and Affordable Care Act, Section 1557, 2010). Similarly, participants described gender-affirming practices within healthcare, university, or workplace settings as feeling like their power was being restored (e.g., names on employee nametag; pronouns use in class).

Some participants did not wait for the system to change. Instead, they reported taking back power by combating adversity through changing the people and settings that oppressed them. One participant discussed how they took the lead to implement a LGBTQ+ training at their workplace because of mistreatment they had experienced. Another discussed how she leveraged her experiences as a transgender teen with teachers and administrators to make her school and the school district a safer place for TGD youth. She said: “…Training happened because of me. Because I stepped up. I made it more powerful than it was.”

Lifting up the self and TGD community

Many participants discussed lifting themselves and the TGD community up as a source of restorative power. Participants described harnessing hateful energy to turn it into a positive and productive force. One participant said: “The love and hate I receive from people provide me with strength and confidence.” Additionally, several participants discussed finding power and validation through giving back to the community and supporting other TGD individuals. Participants enjoyed being able to support others simply through their visibility: “My visible queerness allows me to signal to other queer folks in spaces. I cherish that power.” Participants also felt powerful due to their personal success and the collective success of the queer community. Those who had overcome hardship felt especially powerful for achieving their goals. This was particularly prominent in the two focus groups comprised predominately of Black participants.

Educating and advocating

Many participants reclaimed power through education and advocacy. Staying informed on the health needs of TGD people provided participants with the necessary knowledge to advocate for themselves, particularly in healthcare settings. In one group, participants discussed not learning about TGD topics in school. They then took it upon themselves to gain information on gender, transitioning, sexual health and other important topics via informal conversations or the internet. Several participants also discussed feeling powerful when they pay that knowledge forward. One individual wrote: “Being able to be here [University] and help educate people, finding spaces where I’m wanted and change them for the better.”

Power and Intersectionality

A salient theme throughout all focus group discussions was my “gender identity does not encompass all that I am.” Participants observed gender-based oppression occurs in the context of other forms of identity-based oppression. For instance, Black participants discussed powerlessness stemming from the historical oppression of Black people and TGD people. Black participants often discussed gatekeeping within the context of being withheld access from basic needs (e.g., housing, food stamps, employment) due to racism. In contrast, White participants often referred to gatekeeping solely within the healthcare system and in ways unrelated to their race. Furthermore, participants felt that identifying as both Black and trans exponentially diminished their power over their future advancement and ability to obtain basic resources. As one participant stated, “I have to fight harder to get those certain things…Because… I’m two things the world don’t accept. I’m black and I’m trans.”

In many cases, participants felt that their socioeconomic status kept them from making important medical decisions about their bodies. Participants described transitioning as a financial privilege. One participant elaborated “Growing up high SES with wealthy parents, yes, gave me more power over transition-related decisions.” Participants of lower economic status and/or those impacted by racial oppression felt they were rendered powerless by their financial situation. During one focus group, a participant laid out all her medications in her purse to illustrate the expense of this basic need. Another participant noted the medical costs of transition limited the money available to them for other needed services, such as mental healthcare. Binary and nonbinary gender identities emerged as important moderators of power. Nonbinary participants said they felt poorly understood compared to transgender people who observed binary norms and that they struggled to gain access to healthcare and social privilege. Finally, misogyny and male privilege impacted perceptions of power such that participants with conventionally masculine presentations were perceived as, and in some cases, felt more powerful. One participant said: “In queer spaces, my whiteness and (incorrectly) perceived masculinity give me power and preference.”

Discussion

TGD young adults encounter manifestations of gendered power in every aspect of their lives. External forces limit young people’s ability to define themselves and make critical decisions about their life, health, and wellbeing. This study is one of the first to ask transitional-aged TGD young people to define, explore, and theorize about their perceptions of power and the relationship of power to their gender identities and healthcare needs.

Mechanisms of Power

Participants in this study spoke about power in a robust and profound way, delineating distinct mechanisms of power and powerlessness. Restrictive mechanisms were deeply rooted in systems of oppression and were used to limit, threaten or control young TGD individual’s agency over their identity and, in doing so, restricted youth’s control over decisions, access to information, resources, and opportunities directly pertinent to young people’s health and general wellbeing. Participants were acutely aware of the ways in which their gender identity was managed and controlled by others. One major insight from this project is a novel conceptualization of power as focused explicitly on controlling one’s expression of identity. Existing theories conceptualize gendered power as controlling behaviors to support the supremacy of one group (e.g., men) over another (e.g., women). Although these types of control were evidenced, in this study power was primarily exercised to control or limit identity.

Another central finding was the emergence of mechanisms through which young adults reclaimed power. Participants in this study found creative ways to reclaim control over their lives and decisions and achieve autonomy that signaled their power. The current study’s findings offer a conceptualization of power reminiscent of Foucault’s in which power is not only negative, but also a productive and positive force necessary for liberation (Fendler, 2010; Foucault, 1990). Foucault argued against the traditional conception of power as repressive, arguing instead that oftentimes power is a productive form of resistance (Foucault, 1991: 75). For participants in this study, feeling powerful occurred when their outward identity coincided with and reflected their inner sense of self. It also occurred when they felt informed, part of a community, and when challenging the dominance of cis-normativity and heteronormativity.

Finding creative ways to reclaim control over their lives and decisions signaled to TGD young people they possessed power. Participants countered parental gatekeeping by moving out of parent or guardian’s homes and rejecting financial and emotional support. Participants countered systemic gatekeeping by organizing and advocating for change within oppressive institutions. Participants countered invalidation and violence when they stood up for themselves, their identities, and their community. Participants felt powerful in opposition of cispatriarchy when they took control of where they acquire information, educated others, and presented themselves in their preferred gender, chipping away at cis-normative forms of expression and identity. For young people in this study, reclamation of power came through actions of young TGD people and through allied people and systems. Gender affirming services, access to comprehensive and accurate information, policies and protections, and accurate representation in the media all created conditions in which youth experienced a new sense of control or a regaining of control over their bodies and lives.

To date, very little has been published on the ways in which power can be reclaimed, resisted, or restored for TGD young adults. For example, Austin and colleagues discuss artistic expression as one form of resilience for TGD youth in their recent article (Austin et al., 2021). The current study suggests that resilience and power reclamation may can come in many shapes and sizes. Findings from this study are consistent recent writing on transgender resilience among youth. For example, in their book “The Trans Generation: How Trans kids and their parents are creating a gender revolution,” Travers describes transgender youth conceptualizing gender in sophisticated and complex ways from very young ages (Travers, 2018). Future research should continue exploring how and in what ways TGD young adults reclaim power. Theory might also better capture how specific reclamation strategies operate relative to mechanisms of powerlessness and to the intersectionality of TGD youth’s identities.

Intersectionality and Powerlessness

Consistent with prominent intersectionality research (Bowleg 2012; Buchanan and Ormerod 2002), we found that gender-based oppression, and consequently gendered power, cannot be neatly separated from other forms of oppression. Participants discussed gendered power in tandem with their other social identities, acknowledging and reflecting on how their seen and unseen identities intersect with their gender identity. As such, each mechanism’s execution or manifestation differed as a function of the unique combination of participant’s identities, including gender identity. Unsurprisingly, racial identities most explicitly impacted mechanisms of gendered power. Participants of Color discussed the impact of racism on their lives broadly and specifically as TGD persons, underscoring how both racism and transphobia contributed to powerlessness. Black participants consistently identified both their race and gender when discussing power. For these participants, those identities were inseparable.

Findings from this study provide further evidence for the intersectional nature of gendered power. Research among TGD young people often draws the distinction between TGD populations and cisgender populations, grouping all TGD individuals into one group (Bauer et al. 2009). This has the potential to erase or minimize the experiences (Bowleg 2012). In this study, by highlighting intersectionality and attending to our participants’ multiple social identities, we were able to delineate differences in the execution and functioning of gendered power across gender identity, gender expression, race, and socioeconomic status, even if not to the degree necessary for a robust understanding of these issues. Given the exploratory nature of this study and the small sample of young adults, future research must examine these differences more fully and closely to verify the patterns observed here.

Limitations

Although the findings that emerged in this study was derived directly from TGD young people’s voices, we still cannot be certain whether we may have overlooked other mechanisms of gendered power. Additionally, in the focus groups, we employed structured prompts and probes that may have constrained participant responses. To minimize this possibility, we first tested these prompts in mock focus groups, but that does not ensure participants spoke freely on the topics. Relatedly, we did not account for where, if at all, participants were in their transition. Future research might consider investigating how gendered power changes over the developmental trajectory for TGD youth.

Although we strived to be inclusive of multiple identities in the design and implementation of our focus group protocol, only one out of our five prompts explicitly encouraged discussion of identities other than gender. Furthermore, although sample was racially diverse, we lacked ethnic diversity with no Latinx participants. Additionally, at the intersection of gender and race, we did not have any Black transgender male participants. Although we found racial and other identity-based differences, a more explicit examination of these other identities (perhaps with additional prompts) would likely have yielded richer and more informative results. Relatedly, our TGD Research and Advisory Team was not ethnically or racially diverse, which may have impacted the design, data collection, and analysis. As a group, we often reflected on this limitation by discussing potential biases. During recruitment and screening, we hired a young Black queer woman experienced in facilitating focus groups about race, gender, and power to bring needed diversity to our team. We believe her involvement assisted us in limiting the potential biases of our racial makeup on racial minority participants. The positive remarks young people made about their groups inspires confidence that who we were did not severely undermine our ability to obtain their candid observations on the topics discussed

Implications

Findings from this research point to important policy and practice interventions to promote TGD young people’s reclamation of gendered power and engagement in healthcare. Interventions should build on the existing strategies TGD young people are already engaging in to reclaim power, such as creating opportunities that help youth reduce self-stigma, engage in advocacy and education on TGD health concerns, and support TGD young adult’s autonomy in key decision making (e.g., creation or use of young adult advisory boards and councils in schools, organizations, communities, and healthcare settings). Participants in this study were eager to enact change and advocate for their needs and the needs of other TGD young people. This is highly consistent with existing research evaluating the impact of educational and leadership projects among LGBTQ young people (Barcelos, et al., 2021). As such, the development of more TGD young adult advisory or support groups throughout communities show promise as an avenue to promote power reclamation. Another future avenue for research is the intentional inclusion of TGD young adults in social change research projects (Cosgrove, et al., 2022; Travers et al., 2022). For example, Travers and colleagues (2020) write about a social action research project informed by gender justice theory to develop a video game prototype to communicate the experiences of transgender young people. Such research projects, advocacy work or advisory boards that include TGD young people’s voices and expertise have the potential to encourage TGD young people to reclaim power and make a real impact for other TGD young people.

This study also points to implications for how we go about research with TGD populations. In this study, participants disclosed surviving tremendous amounts of early and ongoing trauma and violence. These experiences often contributed to feelings of fear and anxiety when seeking out services. These findings are consistent with Hendricks and Testa’s gender inclusive adaptation of Meyer’s (2003) minority stress theory which argues that increased exposure of victimization among transgender people contributes to is related to their gender identity or presentation, which in turn has an impact on mental health (Hendricks & Testa, 2012). This suggest that research with TGD populations should be both gender-affirming and trauma-informed. Trauma-informed research practices emphasize the importance of giving participants a sense of agency, choice, and control over the research at multiple stages throughout the process (Campbell et al., 2019). Therefore, future research and interventions with TGD youth should be trauma-informed in design and practice, paying attention to the ways in which experiences of violence and trauma may impact help seeking (Elliott et al., 2005; Harris & Fallot, 2001).

Restrictive mechanisms of power similarly point to policy and practice interventions. These interventions should be multi-level and multi-sectoral in nature and geared toward both TGD individuals and cisgender individuals. Interventions should attend to those who interact with young TGD people (e.g., teachers, employers, providers) to redress gender-based oppression and create opportunities for TGD youth to regain control of their identities and their decisions. For instance, we must create and expand programming and support structures for adults who interact with youth and highlight the consequences of gatekeeping and violent control on the health and wellbeing on TGD young people. Further, an important step in TGD research has been the shift away from research concentrated solely on changing individual behaviors and focus on community mobilization efforts that span multiple settings and stakeholders (e.g., parents, youth, teachers, administrators, providers, politicians) and multiple ecological levels, to support the creation of gender-affirming and gender-literate communities (Rahilly, 2015).

Implications to restore and reclaim power of among TGD individuals must also consider the state powers that control bodily rights of queer and transgender individuals. This is particularly relevant in the current political climate. Recent research has continuously evidenced the both the emotional and physical health consequences of oppressive and anti-transgender policies in the U.S. (Du Bois, 2018; Hughto, 2021). A more radical disruption of state power, such as building relationships and creating coalitions to create alternative models of power, as modeled by queer indigenous activists, may be especially relevant for reclamation of power among TGD young adults (Morgensen, 2011). However, significantly more research is needed about the types of interventions and actions that could effectively and ethically facilitate those relationships.

Finally, results also highlight the need for gender affirming policies within institutions that promote the validation, inclusion, and safety of TGD young people. Within schools, programming should be geared primarily toward administrators, teachers, staff, and parents to educate on the needs of TGD young people and the ways in which current regulations in schools may be perceived as violent or silencing to the TGD community. Within healthcare settings, findings point to the need for revised medical training curriculum for practitioners of family medicine, pediatrics, and reproductive health on gender diversity and affirming TGD care. Relatedly, findings suggest greater implementation of gender affirming documents and protocols that allow youth to feel welcome and validated when filling out legal, medical, or employment-related paperwork.

Conclusion

Several mechanisms of gendered power exist that either restrict or restore TGD young adults power over their body, decisions, and wellbeing. These findings help to inform our understanding of how gendered power impacts identity and access to resources among TGD young people. Further, this study underscores the value of applying an intersectional lens to research among TGD populations. Finally, research, that impacts the lives of TGD young people has rarely included their perspectives despite calls to action for their inclusion. The absence of their voices has stymied conceptual and empirical research growth and restricted the development of evidence-based programming, practices, and policies. We hope this project highlights the importance of intentionally including TGD young adults as decision-makers and experts in research and programming that concerns them.