School victimization in transgender people: A systematic review

https://doi.org/10.1016/j.childyouth.2020.105480Get rights and content

Highlights

  • This review examines the factors that influence the victimization of transgender people.
  • This study establishes a basis for the development of specific school victimization prevention strategies for transgender students.
  • The support of teachers, students, and family is indicated as an essential element for prevention of school victimization.
  • The need for the participation of the institutions in the prevention of school victimization of transgender people is highlighted.

Abstract

Background

The term transgender refers to people whose gender identity does not conform to that associated with the sex assigned to them at birth. Scientific evidence has shown that transgender adolescents have an increased risk of being victims of violence during the school stage. This study aims to synthesize and analyze the findings of the individual studies carried out so far in order to report on the circumstances that influence the process of victimization of this collective.

Methods

A systematic search was carried out following the recommendations of the PRISMA statement in the following databases: Pubmed/Medline, PsycINFO, Cochrane, Lilacs, and Web of Science, where relevant qualitative and quantitative design studies were identified, which met previously established eligibility criteria. Quality was assessed through bias-risk analysis, and data were extracted from a previously elaborated template.

Results

The systematic review finally included 19 quantitative studies (N = 23,749). The results of this review indicate the existence of a number of sociodemographic, family, school and individual factors that influence the victimization of transgender people. The high heterogeneity found among the outcome measures of the quantitative studies prevented performing a meta-analysis, as recommended in the PRISMA declaration.

Conclusions

The results of this review suggest the importance of identifying the different factors that influence victimization and intervening in them as a relevant measure for the prevention of bullying.

Introduction

The term transgender refers to people whose gender identity does not conform to that associated with the sex assigned to them at birth. The situation of mismatch between felt gender and assigned sex manifested by these persons can significantly affect the different stages of their lives (Meier & Labuski, 2013). According to the American Psychiatric Association (2019), people whose assigned sex is female but who identify and live as males are known as trans men. In contrast, people whose assigned sex is male, but who identify and live as females are known as trans women. In addition, there is another category called “queer,” which refers to people who identify their gender outside of the binary construct “man” and “woman”. On the other hand, people whose gender identity corresponds to their biological sex are defined as cisgender (D’Elio et al., 2016).
Transgender people often change their bodies through hormones, surgery, or other means to match their gender identity as much as possible, The process of transition through medical interventions is generally known as gender reassignment (Winter et al., 2016). The process of changing trans people includes various stages of transition, from the physical transition—consisting of matching the physical aspect to the felt gender identity—to the social transition, which includes revealing their gender identity to friends and family, changing their name or requesting people to use the pronoun corresponding to the felt gender identity (White et al., 2018). When this stage of change occurs during childhood and adolescence, it is a complex process due to the impact on the person's psychosocial sphere (Brown, 2018), largely because of the influence exerted on them by the gender norms—a set of norms or ideas determined by a culture, society, or community about how each sex should behave and which greatly conditions their role expectation (European Institute for Gender Equality, 2019).
School violence has traditionally been defined as a physical and/or psychological persecution behavior that one or more students perform against another repeatedly and which place the victim in a situation of helplessness. This provokes negative consequences for victims, such as decreased self-esteem, anxiety, and depression, which makes it difficult for them to be integrated in the school environment and hinders their normal development during their schooling (Jiménez-Barbero et al., 2016, Olweus, 1994, Olweus, 1996). This phenomenon is especially concerning in the case of transgender people, as various studies have reported that this group suffers more bullying than other students (Moran et al., 2018, Walls et al., 2018). Especially traumatic in this group may be the presence of poly-victimization, which is understood as the experimentation of five or more forms of victimization (Finkelhor, Ormrod, & Turner, 2007). In fact, studies such as Sterzing, Ratliff, Gartner, McGeough, and Johnson (2017) have reported significantly higher poly-victimization figures in transgender adolescents than their cisgender peers, identifying themselves as the most frequent: physical assault (81.3%), bullying victimization (88.8%), sexual victimization (80.6%), child maltreatment (78.8%), property victimization (80.1%), and indirect or witnessed forms of victimization.
There are a number of individual, family, and social circumstances that could be influencing the victimization of transgender people during this stage and that would require careful study (Walls et al., 2018). To this is added the fact that transgender adolescents are twice as likely to experience absenteeism (Day et al., 2018) due to the consequences of victimization in school, which, according to other authors, hinders their training and limits their future professional development (Poteat, Mereish, DiGiovanni, & Koenig, 2011).
In this regard, it has been reported that LGBTQ inclusive education and accessibility of LGBTQ-related information in schools promotes a greater perception of safety among the transgender collective (Toomey, McGuire, & Russell, 2012). In addition, support from classmates, teachers, and parents has been linked to a reduction in the negative consequences of victimization (Moran et al., 2018, Ruiz-Hernández et al., 2019) and, indeed, according to Gower et al., 2018, Gower et al., 2018, the perception of a safe school climate has important implications in the academic performance and psychosocial development of transgender people that would promote their inclusion.
In this sense, the literature highlights the need for schools to implement prevention programs against prejudice-based bullying towards transgender people (Jiménez-Barbero et al., 2016). Similarly, schools are encouraged to support transgender youth by creating support groups for them, employing trained teachers, and including content on this topic in the school planning (Clark, 2017).
Scientific evidence reveals a number of circumstances that influence the victimization of transgender people in school. Several authors indicate the need to carry out interventions that guarantee the safety and development of transgender students through the involvement of peers, teachers, and other professionals (Bragg et al., 2018, Clark, 2017). Although there is a wealth of research on bullying in this collective, the findings of individual studies have not yet been synthesized to draw general conclusions about it. In fact, to our knowledge, this study is the first systematic review developed in accordance with the recommendations of the PRISMA statement (Moher et al., 2015), focused on the study of the factors that influence the victimization process of transgender adolescents.
The main objective of our study was to examine the factors that influence the victimization of transgender people during the school stage. In addition, some secondary objectives were proposed: (a) to determine the magnitude of the different types of victimization in transgender students; (b) to analyze the consequences of the school victimization process in transgender students; and (c) to review the transgender victimization prevention strategies used in schools.

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Section snippets

Method

The protocol used by this systematic review follows the recommendations of The Preferred Reporting Items for Systematic Reviews and Meta Analyses guidelines (PRISMA; Moher et al., 2015). Similarly, the methods used in the review were specified in advance and documented in a protocol, which is available online: (https://www.crd.york.ac.uk/PROSPEROFILES/125932_PROTOCOL_20191020.pdf).

Results

As shown in Fig. 1, the electronic search initially located 3.252 publications, of which 499 were excluded because they were duplicate documents. Subsequently, 24 works located in a secondary search were incorporated. After reading the title and abstract, 2651 articles were excluded. In the second phase of selection, after full-text reading, 75 articles were excluded for not meeting the inclusion criteria established in the checklist. Subsequently, after performing the risk-of-bias analysis, 30

Discussion

The main objective of this systematic review was to examine the factors influencing the victimization of transgender people during the school stage.
As had already been shown in previous studies (Bhoopsingh, 2016, Day et al., 2019, Schneeberger et al., 2014), school violence among the transgender collective is related to problems such as depression, absenteeism, school dropout, low grades, suicidal ideation, and substance consumption. Our results coincide with what has already been presented by

Conclusions

The studies included in this review allow us to draw the following conclusions, in accordance with the proposed objectives:
First, our study has reported that there are different factors (psychosocial, sociodemographic, personal, environmental, and individual) that influence the victimization of transgender people during the school stage. The results indicate that transgender people experience a higher rate of victimization than cisgender individuals, indicating verbal victimization as the most

Limitations and strengths

We think that this is the first review that has examined the factors that influence the victimization process of transgender people during the school years, developed in accordance with the recommendations of the PRISMA statement (Moher et al., 2015). In addition, this work also addressed aspects and variables related to school violence, such as the students' characteristics or the teacher's performance, which should be taken into account when elaborating programs aimed at preventing and/or

Recommendations

The following are evidence-based recommendations and implications for research and practice, which emerge from this review.

Declaration of Competing Interest

The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

Acknowledgements

We would like to thank the University of Murcia for its collaboration during the performance of this study.

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