Attachment Patterns in Children and Adolescents With Gender Dysphoria
The current study examines patterns of attachment/self-protective strategies and rates of unresolved loss/trauma in children and adolescents presenting to a multidisciplinary gender service. Fifty-seven children and adolescents (8.42–15.92 years; 24 birth-assigned males and 33 birth-assigned females...
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2021-01-01
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| Series: | Frontiers in Psychology |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fpsyg.2020.582688/full |
| _version_ | 1819298695922843648 |
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| author | Kasia Kozlowska Kasia Kozlowska Catherine Chudleigh Georgia McClure Ann M. Maguire Ann M. Maguire Geoffrey R. Ambler Geoffrey R. Ambler |
| author_facet | Kasia Kozlowska Kasia Kozlowska Catherine Chudleigh Georgia McClure Ann M. Maguire Ann M. Maguire Geoffrey R. Ambler Geoffrey R. Ambler |
| author_sort | Kasia Kozlowska |
| collection | DOAJ |
| description | The current study examines patterns of attachment/self-protective strategies and rates of unresolved loss/trauma in children and adolescents presenting to a multidisciplinary gender service. Fifty-seven children and adolescents (8.42–15.92 years; 24 birth-assigned males and 33 birth-assigned females) presenting with gender dysphoria participated in structured attachment interviews coded using dynamic-maturational model (DMM) discourse analysis. The children with gender dysphoria were compared to age- and sex-matched children from the community (non-clinical group) and a group of school-age children with mixed psychiatric disorders (mixed psychiatric group). Information about adverse childhood experiences (ACEs), mental health diagnoses, and global level of functioning was also collected. In contrast to children in the non-clinical group, who were classified primarily into the normative attachment patterns (A1-2, B1-5, and C1-2) and who had low rates of unresolved loss/trauma, children with gender dysphoria were mostly classified into the high-risk attachment patterns (A3-4, A5-6, C3-4, C5-6, and A/C) (χ2 = 52.66; p < 0.001) and had a high rate of unresolved loss/trauma (χ2 = 18.64; p < 0.001). Comorbid psychiatric diagnoses (n = 50; 87.7%) and a history of self-harm, suicidal ideation, or symptoms of distress were also common. Global level of functioning was impaired (range 25–95/100; mean = 54.88; SD = 15.40; median = 55.00). There were no differences between children with gender dysphoria and children with mixed psychiatric disorders on attachment patterns (χ2 = 2.43; p = 0.30) and rates of unresolved loss and trauma (χ2 = 0.70; p = 0.40). Post hoc analyses showed that lower SES, family constellation (a non-traditional family unit), ACEs—including maltreatment (physical abuse, sexual abuse, emotional abuse, neglect, and exposure to domestic violence)—increased the likelihood of the child being classified into a high risk attachment pattern. Akin to children with other forms of psychological distress, children with gender dysphoria present in the context of multiple interacting risk factors that include at-risk attachment, unresolved loss/trauma, family conflict and loss of family cohesion, and exposure to multiple ACEs. |
| first_indexed | 2024-12-24T05:34:00Z |
| format | Article |
| id | doaj.art-4e1182eabd9a4b46a18a182acb2b9068 |
| institution | Directory Open Access Journal |
| issn | 1664-1078 |
| language | English |
| last_indexed | 2024-12-24T05:34:00Z |
| publishDate | 2021-01-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Psychology |
| spelling | doaj.art-4e1182eabd9a4b46a18a182acb2b90682022-12-21T17:13:05ZengFrontiers Media S.A.Frontiers in Psychology1664-10782021-01-011110.3389/fpsyg.2020.582688582688Attachment Patterns in Children and Adolescents With Gender DysphoriaKasia Kozlowska0Kasia Kozlowska1Catherine Chudleigh2Georgia McClure3Ann M. Maguire4Ann M. Maguire5Geoffrey R. Ambler6Geoffrey R. Ambler7Department of Psychological Medicine, The Children’s Hospital at Westmead, Westmead, NSW, AustraliaDiscipline of Child and Adolescent Health, University of Sydney Medical School, Darlington, NSW, AustraliaDepartment of Psychological Medicine, The Children’s Hospital at Westmead, Westmead, NSW, AustraliaDepartment of Psychological Medicine, The Children’s Hospital at Westmead, Westmead, NSW, AustraliaDiscipline of Child and Adolescent Health, University of Sydney Medical School, Darlington, NSW, AustraliaDepartment of Endocrinology, The Children’s Hospital at Westmead, Westmead, NSW, AustraliaDiscipline of Child and Adolescent Health, University of Sydney Medical School, Darlington, NSW, AustraliaDepartment of Endocrinology, The Children’s Hospital at Westmead, Westmead, NSW, AustraliaThe current study examines patterns of attachment/self-protective strategies and rates of unresolved loss/trauma in children and adolescents presenting to a multidisciplinary gender service. Fifty-seven children and adolescents (8.42–15.92 years; 24 birth-assigned males and 33 birth-assigned females) presenting with gender dysphoria participated in structured attachment interviews coded using dynamic-maturational model (DMM) discourse analysis. The children with gender dysphoria were compared to age- and sex-matched children from the community (non-clinical group) and a group of school-age children with mixed psychiatric disorders (mixed psychiatric group). Information about adverse childhood experiences (ACEs), mental health diagnoses, and global level of functioning was also collected. In contrast to children in the non-clinical group, who were classified primarily into the normative attachment patterns (A1-2, B1-5, and C1-2) and who had low rates of unresolved loss/trauma, children with gender dysphoria were mostly classified into the high-risk attachment patterns (A3-4, A5-6, C3-4, C5-6, and A/C) (χ2 = 52.66; p < 0.001) and had a high rate of unresolved loss/trauma (χ2 = 18.64; p < 0.001). Comorbid psychiatric diagnoses (n = 50; 87.7%) and a history of self-harm, suicidal ideation, or symptoms of distress were also common. Global level of functioning was impaired (range 25–95/100; mean = 54.88; SD = 15.40; median = 55.00). There were no differences between children with gender dysphoria and children with mixed psychiatric disorders on attachment patterns (χ2 = 2.43; p = 0.30) and rates of unresolved loss and trauma (χ2 = 0.70; p = 0.40). Post hoc analyses showed that lower SES, family constellation (a non-traditional family unit), ACEs—including maltreatment (physical abuse, sexual abuse, emotional abuse, neglect, and exposure to domestic violence)—increased the likelihood of the child being classified into a high risk attachment pattern. Akin to children with other forms of psychological distress, children with gender dysphoria present in the context of multiple interacting risk factors that include at-risk attachment, unresolved loss/trauma, family conflict and loss of family cohesion, and exposure to multiple ACEs.https://www.frontiersin.org/articles/10.3389/fpsyg.2020.582688/fullattachmentgender dysphoriatransgenderdynamic maturation model of attachment (DMM)children and adolescents |
| spellingShingle | Kasia Kozlowska Kasia Kozlowska Catherine Chudleigh Georgia McClure Ann M. Maguire Ann M. Maguire Geoffrey R. Ambler Geoffrey R. Ambler Attachment Patterns in Children and Adolescents With Gender Dysphoria Frontiers in Psychology attachment gender dysphoria transgender dynamic maturation model of attachment (DMM) children and adolescents |
| title | Attachment Patterns in Children and Adolescents With Gender Dysphoria |
| title_full | Attachment Patterns in Children and Adolescents With Gender Dysphoria |
| title_fullStr | Attachment Patterns in Children and Adolescents With Gender Dysphoria |
| title_full_unstemmed | Attachment Patterns in Children and Adolescents With Gender Dysphoria |
| title_short | Attachment Patterns in Children and Adolescents With Gender Dysphoria |
| title_sort | attachment patterns in children and adolescents with gender dysphoria |
| topic | attachment gender dysphoria transgender dynamic maturation model of attachment (DMM) children and adolescents |
| url | https://www.frontiersin.org/articles/10.3389/fpsyg.2020.582688/full |
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