Co-ordinating meaning within a gender identity development service: What can the theory of the co-ordinated management of meaning offer clinicians working with young people, and their families, exploring their gender identities

2019 ◽  
Vol 24 (2) ◽  
pp. 322-337 ◽  
Author(s):  
Ashley Miller ◽  
Sarah Davidson
Keyword(s):  
Young People ◽  
Identity Development ◽  
Gender Identity ◽  
Prior Experience ◽  
Language Family ◽  
Multiple Perspectives ◽  
Therapeutic Rapport ◽  
Management Of Meaning ◽  
The Many ◽  
Development Service

Working with young people who present with diverse gender identifications and their families requires consideration and acknowledgement of a range of contexts (including relationship, family, social and cultural) as well as the influences of prior experience and language. Family members often present with diverse understandings and hopes from their referral to the Gender Identity Development Service and look to us to meet these. This article considers the contribution of Cronen and Pearce who introduced the theory of the co-ordinated management of meaning (CMM). We focus on their ideas about communication, the complexities of communication, meaning, context and multiple perspectives. This article relates to our practice as well as considers useful ways to work with families and young people, within a highly contested field. Clinical examples are used to illustrate how we have made use of the theory and models of CMM to facilitate engagement, build therapeutic rapport, facilitate understanding and support those we see in a way which takes into account the many contexts of their lives.

scholarly journals Gender Dysphoria in looked-after and adopted young people in a gender identity development service

2018 ◽  
Vol 24 (1) ◽  
pp. 112-128
Author(s):  
Tom Matthews ◽  
Victoria Holt ◽  
Senem Sahin ◽  
Amelia Taylor ◽  
David Griksaitis
Keyword(s):  
Young People ◽  
Identity Development ◽  
Gender Identity ◽  
Gender Dysphoria ◽  
Case File ◽  
Clinical Notes ◽  
Birth Family ◽  
To Receive ◽  
Overall Functioning ◽  
Development Service

This research investigated the prevalence of looked-after and adopted young people within a case file review of 185 young people referred to a UK gender identity development service over a 2-year period (1 April 2009 to 1 April 2011). Data were extracted from referral letters, clinical notes and clinician letters. Looked-after young people were found to represent 4.9% of referrals in this cohort, which is significantly higher than within the English general population (0.58%). Adopted young people represented 3.8% of referrals. In addition, the findings showed that looked-after young people were less likely to receive a diagnosis of gender dysphoria compared with young people living within their birth family. There were no statistically significant differences in the gender ratio or age of first gender dysphoric experience between groups. Looked-after and adopted young people were also not found to be experiencing greater impairment in overall functioning compared to other young people referred to the gender identity development service. In conclusion, there are a substantial proportion of referrals pertaining to looked-after or adopted young people, and it appears the referral route and process through the service may be distinct, particularly for looked-after young people. This may be understood by considering the possible complexities in the presentation of these groups, alongside the established higher levels of complexity generally for those experiencing feelings of gender dysphoria.

Gender diversity and non-binary presentations in young people attending the United Kingdom’s National Gender Identity Development Service

2018 ◽  
Vol 24 (2) ◽  
pp. 277-290 ◽  
Author(s):  
Jos Twist ◽  
Nastasja M de Graaf
Keyword(s):  
Young People ◽  
Identity Development ◽  
Gender Identity ◽  
Gender Diversity ◽  
The Body ◽  
Intrinsic Factors ◽  
Gender Expression ◽  
And Gender ◽  
Development Service ◽  
Binary Gender

There has been a recent rise in the number of people who hold a non-binary gender identity. However, the proportion of young people attending gender services who identify as non-binary has not yet been investigated. This article presents the findings from a pilot study of newly designed questionnaire, the Gender Diversity Questionnaire, which included questions about gender identity and gender expression. Responses from 251 adolescents attending the United Kingdom’s National Gender Identity Development Service between June 2016 and February 2017 are reported here. The majority, 56.9%, of young people identified as trans, 29.3% identified as a binary gender (male or female), 11% identified as non-binary and 1.2% as agender. There were no significant differences in self-defined identities based on assigned gender or age. However, once young people were separated into these groups, some of them were very small; thus, a larger sample is required. In terms of aspects of gender expression that were important to the young people, the data formed five themes – name and pronouns, external appearance, the body, intrinsic factors and ‘other’. Strengths and weaknesses of the research are discussed as well as future work that will be conducted.

‘Taking the lid off the box’: The value of extended clinical assessment for adolescents presenting with gender identity difficulties

2019 ◽  
Vol 24 (2) ◽  
pp. 338-352 ◽  
Author(s):  
Anna Churcher Clarke ◽  
Anastassis Spiliadis
Keyword(s):  
Clinical Practice ◽  
Young People ◽  
Identity Development ◽  
Gender Identity ◽  
Developmental Pathways ◽  
Western World ◽  
Case Review ◽  
Making Sense ◽  
Case Vignettes ◽  
Development Service

As the number of young people referred to specialist gender identity clinics in the western world increases, there is a need to examine ways of making sense of the range and diversity of their developmental pathways and outcomes. This article presents a joint case review of the authors caseloads over an 18-month period, to identify and describe those young people who presented to the Gender Identity Development Service (GIDS) with gender dysphoria (GD) emerging in adolescence, and who, during the course of assessment, ceased wishing to pursue medical (hormonal) interventions and/or who arrived at a different understanding of their embodied distress. From the 12 cases identified, 2 case vignettes are presented. Implications for the development of clinical practice, service delivery and research are considered.

Thinking about ethnicity and gender diversity in children and young people

2018 ◽  
Vol 24 (2) ◽  
pp. 291-303 ◽  
Author(s):  
Nastasja M de Graaf ◽  
Ilham I Manjra ◽  
Anna Hames ◽  
Claudia Zitz
Keyword(s):  
Young People ◽  
Identity Development ◽  
Gender Identity ◽  
Gender Diversity ◽  
Age Groups ◽  
Chi Square ◽  
Children And Young People ◽  
And Gender ◽  
The Uk ◽  
Ethnicity Data

Background: Little is known about how social and cultural variants interact with gender identity development. This article aims to identify the ethnicities of children and young people referred to the United Kingdom’s national Gender Identity Development Service (GIDS), and compare the ethnicity data with the UK child population and referrals to Child and Adolescent Mental Health Services (CAMHS). Methods: GIDS referrals made between April 2012 and April 2015 for children and young people were retrieved. Ethnicity data were obtained by the ‘16 + 1’ ethnicity list. Chi-square and t-tests were performed on the demographics. Results: Less than 10% of the 995 referrals at GIDS were from Black and minority ethnic (BME) groups – an underrepresentation as compared with both the national population and CAMHS figures. No significant differences in ethnic representation were found between the demographic birth-assigned sexes, across age groups, or year of referral. Conclusions: Hypotheses proposed for this underrepresentation take into account both the potential barriers to accessing services and the possibility of cross-cultural variations in the conceptualisations of gender, gender roles and gender diversity. Ethnicity, culture and religion, and their overlapping relationship with gender need further exploration.

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