Examining Relationships between Developmental Assets and Risky Sexual Behaviors in Transgender and Gender Expansive Adolescents

Abstract

Abstract Aims: The aims of this study were: to describe the sample of transgender and gender expansive adolescents with regard to risky sexual behaviors and developmental assets in comparison to cisgender adolescents, to identify the relationships between risky sexual behaviors and developmental assets in the transgender and gender expansive adolescent population, and to compare those relationships among biologically male and female transgender adolescents. Sample: Data are from 80,929 adolescents who completed the 2016 Minnesota Student Survey. Responses from students were recorded from all parts of the state to help ensure a diverse sample was available. Methods: This is a secondary analysis of a cross sectional survey administered in schools affiliated with school districts in Minnesota in 2016. The survey assesses a number of adolescent risk factors including alcohol and drug use, irresponsible driving, and sexual activity. Gender identity was measured with a survey item which read “Do you consider yourself transgender, genderqueer, genderfluid, or unsure about your identity?” Risky sexual behavior was measured by items regarding inconsistent or noncondom use, lifetime sexual partners, use of an unreliable or no contraceptive, and sex under the influence of alcohol or drugs. Developmental assets are internal and external characteristics that assist adolescents in their transition to adulthood. Analyses were conducted to investigate 1) differences between cisgender and transgender adolescents in terms of developmental assets and risky sexual behaviors, 2) relationships between developmental assets and sexual behavior for transgender youth, and 3) differences between transgender males and females using two-tailed t-tests and Chi-square tests. Results: Of the 80,929 adolescent participants in the Minnesota Student Survey, 15,749 (22.0%) cisgender and 572 (22.9%) transgender and gender expansive adolescents reported ever having had sexual intercourse. Cisgender adolescents reported higher levels of all positive developmental assets and less engagement in all risky sexual behavior than transgender and gender expansive adolescents (p < 0.001). Within the transgender and gender expansive subsample, positive identity was negatively related to having multiple sexual partners (p < 0.005), empowerment was related to inconsistent or Noncondom use (p < 0.008), having sexual intercourse under the influence of alcohol or drugs (p < 0.042), and using an unreliable or no contraceptive (p < 0.021). Social competency was related to having multiple sexual partners and having sexual intercourse under the influence of alcohol or drugs (p < 0.001). Biological female students reported higher levels of positive developmental assets (positive identity and empowerment, p < 0.001) and engaged in more risky sexual behaviors (having multiple sexual partners, p < 0.026 and having sex under the influence of alcohol or drugs, p < 0.001) than biological males. Recommendations: More research is needed on the differences between transgender and gender expansive females and males. High developmental assets are protective for adolescents and can help prevent engagement in risky sexual behaviors. Social and healthcare programs can help develop assets to help prevent and reduce engagement in risky sexual behaviors. Nurses working with transgender and gender expansive adolescents should assess for levels of positive developmental assets to determine which transgender and gender expansive adolescents are more or less likely to engage in risky sexual behavior. All adolescents should be provided more LGBTQ-inclusive sexual education.