JMIR Publications

ABSTRACT

Background:

Transgender, nonbinary, and gender diverse (TNG) youth encounter barriers to psychosocial wellness and also describe exploring identities and communities online. Studies of cisgender youth connect increased digital technology use with loneliness and decreased body image. However, little is known about psychosocial factors associated with digital technology use among TNG compared to cisgender youth.

Objective:

Our goal in this study was to examine associations between psychosocial measures and digital technology use for cisgender and TNG youth.

Methods:

We surveyed a nationally representative sample of adolescents (ages 13-18) about psychosocial wellness and digital technology use. Psychosocial measures included assessment of body image, parental support, loneliness, well-being, and fear of missing out (FOMO). Digital media use assessments included the short Problematic and Risky Internet Use Screening Scale (PRIUSS-3) and the Adolescent Digital Technology Interactions and Importance (ADTI) scale and subscales. The psychosocial outcomes were compared between gender groups while adjusting for age and parent social media use using PROC GLM. Stratified correlations were compared between gender identity groups for parent support, body image, loneliness, well-being, and FOMO compared with ADTI and PRIUSS-3 scores using PROC NLMIXED to compare the regression coefficients of standardized values between gender groups. All comparisons were adjusted for age and parent social media use.

Results:

Among 4575 adolescents, 53 (1.16%) self-identified as TNG youth. TNG youth had lower well-being (23.52 versus 26.78, P<.001), lower parent support (19.57 versus 23.44, P<.001), lower body image (13.72 versus 17.09, P<.001), and higher loneliness scores (9.01 versus 6.59, P<.001) compared to cisgender peers. In a pattern different from cisgender peers, problematic internet use scores for TNG youth correlated positively with body image (0.26 vs. -0.17, P=.003) and well-being (0.33 vs. -0.08, P=.002). Parental support also correlated positively with ADTI 2 scores for TNG youth (0.05), though correlated negatively with ADTI 2 scores for cisgender youth (-0.22, P=.04).

Conclusions:

Overall, this study supports previous findings that show that TNG youth experience barriers to psychosocial wellness, and adds that this includes loneliness. This study also suggests that the correlation of PIU with both well-being and improved body image shows that PIU may not be unilaterally problematic amongst TNG youth, which may be because of specific digital media affordances that TNG youth engage. Whether this more complicated picture of PIU applies to other minority populations besides TNG youth will be an important area for future research.