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Author ORCID Identifier


Campus-Only Access for Five (5) Years

Document Type


Degree Name

Doctor of Philosophy (PhD)

Degree Program


Year Degree Awarded


Month Degree Awarded


First Advisor

Lisa M. Chiodo

Second Advisor

Kimberly Dion

Third Advisor

Sally Campbell Galman

Subject Categories

Pediatric Nursing | Psychiatric and Mental Health Nursing | Public Health and Community Nursing


Background: There are high rates of depression and suicidality in transgender young adults (TGYA) in response to parental rejection. The impact of sibling rejection on TGYA mental health relationship is not clear. There is also a lack of evidence on the impact of gender identify specific support. Purpose: The purpose of this study was to develop a measure of siblling gender identity-specific social support and to explore the impact of both parent and sibiling acceptance-rejection on depression and suicidality in TGYA. Method: Content experts and members of the transgendered community were included in the development of the sibling gender specific support scale. 470 TGYA between 18 and 25 years were recruited online using paid social media and completed all survey instruments online. Measures included sibling gender identity specific social support, parent and sibling acceptance-rejection, depression, suicidality, friend social support, connectedness to the transgender community, and demographic information. Principal components analysis, multiple regression, and logistic regression were conducted to answer the research questions. Results: Mean participant age was 21.4. The sample was predominantly Caucasian (79.6%) and assigned female at birth (93.6%). Items on the measure of gender identity specific support demonstrated adequate reliability and validity. Factor structure for received support differed based on TGYA and sibling sex assigned at birth constellation. Alarmingly high rates of depression, lifetime, and past year suicidality were reported. Higher perceived rejection from each family member significantly predicted an increase in TGYAs depression, and rejection from family members was cumulative. Having a genderqueer/nonbinary identity and less connection to the transgender community increased depression. Cumulative negative support for gender identity increased risk of depression and lifetime suicidality. Being older was associated with decreased depression and suicidality. Conclusion: TGYA perception of sibling rejection had a unique contribution to TGYAs depression symptoms even after controlling for parental rejection. Understanding the impact of the TGYA/sibling relationship may inform interventions to reduce depression and suicidality in this vulnerable population. Implications: It is critical to screen TGYA for depression and suicidality and to provide TGYA and their parents with information and support