Date of Award

Summer 2025

Document Type

Dissertation

Degree Name

Doctor of Psychology (PsyD)

Department

Psychology

Committee Chairperson

Susan Gans, PhD

Committee Member

Lauren Brumley, PhD

Committee Member

Tiffany Gray, EdD

Committee Member

Liam Lair, PhD

Abstract

Gender expansive individuals are at an elevated risk for stress and poor psychological outcomes such as depression, substance abuse, and death by suicide due to minority stress. Family variables can either protect against or perpetuate poor psychological outcomes. There is need to examine specific protective and risk factors in families with gender expansive children. The present study explores the relationship between family and caregiver relationship variables and well-being in a sample of 39 gender expansive individuals. Participants completed an online survey consisting of questionnaires measuring current internalizing and externalizing symptoms and their perception of their family structure, functioning, and parental bonding. Preliminary analyses included descriptive statistics and correlations. Next, two multiple linear regressions were performed to examine family and caregiver variables as predictors of internalizing and externalizing symptoms. Both internalizing and externalizing symptoms were significantly positively correlated with disengaged and chaotic family systems and negatively correlated with family satisfaction, flexibility, and communication. In regression analyses, age, family cohesion, and general functioning accounted for 40% of the variance in internalizing symptoms and over 60% of the variance in externalizing symptoms. Results of this study suggest that gender expansive individuals living in families with disengaged and chaotic features may be at risk for experiencing poor mental health outcomes, and gender expansive individuals living in families with higher cohesion, communication, and satisfaction may experience more positive mental health outcomes. Family systems-based clinical interventions may improve caregiver-child communication and relationship satisfaction, reduce family chaos, and protect against societal stressors for gender expansive youth.

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