Operationalising social transition in trans and gender diverse youth: a scoping review of definitions and measures
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Background
Social transition can be an important and accessible aspect of gender affirmation, allowing trans and gender diverse young people to authentically express their identities, including through adoption of chosen name, pronouns, and changes to appearance. These changes may take place in a single context, such as at home, or across multiple settings, including school, with friends, and online. Currently, it is unclear how this process is being captured in the literature, including whether it has been measured comprehensively and consistently.
Methods
This scoping review explored how social transition has been defined and operationalised in studies involving trans young people (under 18), detailing practices (i.e. specific changes) of social transition and contexts where these changes occurred. Systematic searches were conducted in Embase, MEDLINE, and PsycInfo databases. Studies were eligible if they included a definition and/or measure of social transition.
Findings
Among 40 included studies, definitions (n=37 studies) and measures (n=29 studies) varied widely. Some studies did not distinguish between specific practices of social transition, such as changes to name, pronouns, or appearance, when defining (5/37) and measuring (8/29) the construct. Similarly, many studies omitted reference to the contexts in which these practices occurred (18/37 definitions; 11/29 measures), assuming practices took place uniformly across all contexts. Many also relied on a binary measure of social transition (15/29 measures), failing to capture the diverse ways in which individuals enact their social transition. No measurement tools were used consistently.
Interpretation
Current definitions and measures of social transition in research with trans and gender diverse young people are inconsistent and incomplete. As a result, they fail to capture the complex nature of social transition, limiting comparability between studies and hindering understanding of its complexities and impacts. Comprehensive, standardised measures to capture this concept are urgently required.
Funding
There was no funding source for this study.
Research In Context
Evidence before this study
This scoping review examines how social transition, i.e., the process by which transgender and gender diverse people outwardly express their gender identity, has been operationalised in the literature regarding young people. While social transition is often described/reported to be complex and fluid, most studies appear to overlook this complexity. To date, no review has systematically and quantitatively assessed: (i) how social transition has been defined in empirical studies, or (ii) the breadth, depth, and consistency of the measures used to capture social transition.
To address these evidence gaps, we searched Embase, MEDLINE and PsycInfo databases until September 14 th , 2024, using terms relating to transgender identity (e.g. “transgender” or “gender diverse”), children and adolescents (e.g. “child” or “adolescent” or “adolescence”) and social transition (e.g. “social transition” or “pronoun” or “name”). From the included studies, we extracted information on how social transition was defined and measured. We focused on the extent to which studies recognised the specific practices (i.e. changes) involved, and the contexts in which these changes may occur (which may differ between individuals based on underlying levels of safety and support).
Added value of this study
This scoping review identified significant variability and oversimplification in how social transition has been defined and measured in studies with trans and gender diverse young people. Key aspects of social transition, such as the contexts in which changes occur, desire to make social transition changes, and some specific practices, were frequently underrepresented. Measures were also often based on narrow or binary constructs, applied inconsistently across studies, limiting their accuracy and comparability.
Implications of all the available evidence
By highlighting gaps in current measures of social transition, this study provides a foundation for future research to adopt more accurate and meaningful approaches for understanding and measuring social transition in line with the real-world experiences of transgender and gender diverse young people. Ensuring consistent measurement is essential to strengthen the evidence base and improve comparability and to support future research to accurately guide policy and clinical care for trans and gender diverse young people worldwide.
