The Impact of Peer and Family Functioning on Transgender and Gender-Diverse Children's Mental Health

Although high levels of internalizing and externalizing psychopathology have been documented among transgender and gender-diverse (TGD) youth, contextual factors influencing the development of psychopathology among TGD children are relatively understudied. The current study tested the interaction between two relational factors, children's caregiver-reported peer relations and family functioning, on TGD children's internalizing and externalizing symptoms. The sample consisted of 49 primary caregivers of TGD children, who were age 6-12 at baseline. A cross-sectional path analysis was run to test the relations between peer relations, family functioning, and their interaction on internalizing and externalizing symptoms. A longitudinal path analysis was run to test the relations between variables over time. In the cross-sectional model, among families with adequate family functioning, peer problems were associated with greater internalizing symptoms. Among families that were functioning poorly, there was not a significant relationship between peer problems and internalizing symptoms. Further, among children who did not experience peer problems, poorer family functioning was associated with greater internalizing symptoms. Peer problems, but not family functioning or the interaction term, was associated with externalizing symptoms. Longitudinal analyses did not support the hypothesis of an interaction between peer relations and family functioning. The current research indicated that poor peer relations and poor family functioning each confer risk for internalizing symptoms among TGD children, and poor peer relations carries risk for externalizing symptoms among TGD youth.