Silence and service gaps: strengthening dialogue with families of transgender youth
JM LarsenAbstract
Background
Families play a critical role in protecting the mental health and wellbeing of trans youth, yet they are rarely included as active participants in public health dialogue or service development. This study includes the only two municipal services targeting trans youths and their families in Norway.
Methods
The study employed qualitative observations and co-constructive discussions from the first ever peer support group for families of transgender youth led by a municipality. Five families with kids from 9 to 19 years participated. Transcripts were written from the conversations followed in real time digitally. Findings were compared with municipal staff and volunteers at another municipal initiative.
Results
Families described fragmented encounters with multiple services, including schools, health providers, and preventive services. Participants reported uncertainty about where to seek help, uneven competence across services, and fear of stigma when disclosing their child’s gender identity. These conditions often resulted in communicative withdrawal and reduced engagement with services despite significant support needs. In contrast, the support group functioned as a trusted dialogic arena where families collectively interpreted experiences and articulated concrete service improvements. Co-developed recommendations include structured family dialogue forums, cross-sector coordination mechanisms, and low-threshold feedback channels between families and public services.
Conclusions
Strengthening dialogue with families of trans youth is a key public health strategy for improving a fuller support-system surrounding trans youth. Establishing structured dialogic arenas within local health and welfare systems may reduce silence, increase trust and support more responsive service coordination. These findings have broader relevance for European public health systems seeking to improve inclusive and supportive approaches to LGBTQ+ youth health.