2 - (SYM 39) Longitudinal Trajectories of Support and the Relationship to Mental Health for Transgender Youth

Transgender youth are at risk for adverse mental health outcomes, with parent and family support having been established as a protective factor, particularly for transgender youth. Research examining the longitudinal trajectories of parent support for is limited. The present study aims to identify patterns of change in general family support and gender-specific parent support for transgender youth over the development span of adolescence into emerging adulthood. Participants were transgender youth (n=617), ages 12 - 18 years, who initiated care at a multidisciplinary gender-affirming clinic in Dallas, Texas before the age of 18. Participants completed self-report measures at an initial assessment with a mental health provider in the program prior to starting medical treatment. Follow-up study measures were completed yearly and included the Multidimensional Scale of Perceived Social Support (MSPSS; family support subscale), Perceived Parental Attitudes of Gender Expansiveness (PAGES; gender-related parental non-affirmation and acceptance subscales), Quick Inventory of Depressive Symptomology (QIDS), Screen for Child Anxiety Related Disorders (SCARED), and the Pediatric Quality of Life Inventory (PedsQL). Using growth mixture models, longitudinal trajectories from 12 to 21 years of age were conducted using four years of data. Missing data were imputed using multiple imputations with chained equations. Quadratic growth mixture models were estimated with varying k-class solutions, and fit indices were assessed to determine the optimal solution. A 3-class solution was retained for MSPSS family, and a 2-class solution was retained for a multivariate model for combined PAGES acceptance and non-affirmation subscales. For MSPSS, two classes emerged showing high and moderately high and stable support while one class demonstrated a curvilinear trajectory with an initial decrease then an increase entering adulthood. PAGES classes exhibited stable and moderately high and high support. ANOVAs will be conducted to compare group differences in demographic data, characterize classes, and compare differences in mental health outcomes among classes. These results illustrate heterogeneous experiences of parent support over time for transgender youth receiving gender affirming care, with implications for addressing long-term mental health outcomes. Limitations include the restricted context within which to understand the mechanism(s) underlying differential changes in support over time.