{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,31]],"date-time":"2026-03-31T11:39:02Z","timestamp":1774957142954,"version":"3.50.1"},"reference-count":67,"publisher":"MDPI AG","issue":"4","license":[{"start":{"date-parts":[[2023,2,8]],"date-time":"2023-02-08T00:00:00Z","timestamp":1675814400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Wihuri Foundation"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJERPH"],"abstract":"<jats:p>Sociodemographic and psychosocial family factors have profound implications for adolescent development, identity formation and mental health during the adolescent years. We explored the associations of sociodemographic and psychosocial family factors with transgender identity in adolescence and the role of these factors in the associations between gender identity and emotional disorders. Data from a large adolescent population survey from Finland were analysed using logistic regression models. Reporting transgender identity was associated with mother\u2019s low level of education, accumulating family life events, lack of family cohesion, perceived lack of family economic resources and female sex. A lack of family cohesion further differentiated between adolescents reporting identifying with the opposite sex and those reporting non-binary\/other gender identification. The associations between transgender identity, depression and anxiety were attenuated but did not level out when family factors were controlled for. Transgender identity in adolescence is associated with socioeconomic and psychosocial family factors that are known correlates of negative outcomes in mental health and psychosocial well-being. However, transgender identification is also associated with emotional disorders independent of these family factors.<\/jats:p>","DOI":"10.3390\/ijerph20042948","type":"journal-article","created":{"date-parts":[[2023,2,8]],"date-time":"2023-02-08T03:57:16Z","timestamp":1675828636000},"page":"2948","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":17,"title":["Family Characteristics, Transgender Identity and Emotional Symptoms in Adolescence: A Population Survey Study"],"prefix":"10.3390","volume":"20","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2783-3892","authenticated-orcid":false,"given":"Riittakerttu","family":"Kaltiala","sequence":"first","affiliation":[{"name":"Faculty of Medicine and Health Technology, Tampere University, 33014 Tampere, Finland"},{"name":"Department of Adolescent Psychiatry, Tampere University Hospital, 33520 Tampere, Finland"},{"name":"Vanha Vaasa Hospital, 65380 Vaasa, Finland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Elias","family":"Heino","sequence":"additional","affiliation":[{"name":"Faculty of Medicine and Health Technology, Tampere University, 33014 Tampere, Finland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mauri","family":"Marttunen","sequence":"additional","affiliation":[{"name":"Adolescent Psychiatry, Helsinki University Hospital, University of Helsinki, 00260 Helsinki, Finland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6383-9028","authenticated-orcid":false,"given":"Sari","family":"Fr\u00f6jd","sequence":"additional","affiliation":[{"name":"Department of Health Sciences, Faculty of Social Sciences, Tampere University, 33014 Tampere, Finland"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2023,2,8]]},"reference":[{"key":"ref_1","unstructured":"Havighurst, R.J. (1948). Developmental Tasks and Education, University of Chicago Press."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"33","DOI":"10.1016\/j.adolescence.2007.04.002","article-title":"Does successful attainment of developmental tasks lead to happiness and success in later developmental tasks? A test of Havighurst\u2019s (1948) theses","volume":"31","author":"Gelhaar","year":"2008","journal-title":"J. Adolesc."},{"key":"ref_3","first-page":"97","article-title":"Links of Adolescents Identity Development and Relationship with Peers: A Systematic Literature Review","volume":"25","year":"2016","journal-title":"J. Can. Acad. Child Adolesc. Psychiatry"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"100","DOI":"10.1016\/j.chiabu.2018.09.011","article-title":"Socioeconomic trends in school bullying among Finnish adolescents from 2000 to 2015","volume":"86","author":"Knaappila","year":"2018","journal-title":"Child Abuse Negl."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"295","DOI":"10.1080\/19317611.2018.1494077","article-title":"Adolescent sexual behavior\u2014Family characteristics, parental involvement, and associated mental disorders","volume":"30","author":"Savioja","year":"2018","journal-title":"Int. J. Sex. Health"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"95","DOI":"10.1093\/alcalc\/agw048","article-title":"Trends in Alcohol Use among Adolescents from 2000 to 2011: The Role of Socioeconomic Status and Depression","volume":"52","author":"Torikka","year":"2017","journal-title":"Alcohol Alcohol."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"1829","DOI":"10.1007\/s00127-013-0697-8","article-title":"Parents\u2019 education and the risk of major depression in early adulthood","volume":"48","author":"Park","year":"2013","journal-title":"Soc. Psychiatry Psychiatr. Epidemiol."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"1485","DOI":"10.1086\/428444","article-title":"First Grade and Educational Attainment by Age 22: A New Story","volume":"110","author":"Entwisle","year":"2005","journal-title":"Am. J. Sociol."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"401","DOI":"10.1016\/j.intell.2006.09.004","article-title":"Intelligence and socioeconomic success: A meta-analytic review of longitudinal research","volume":"35","author":"Strenze","year":"2007","journal-title":"Intelligence"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"1646","DOI":"10.1037\/a0023833","article-title":"Young adult identities and their pathways: A developmental and life course model","volume":"47","author":"Benson","year":"2011","journal-title":"Dev. Psychol."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"78","DOI":"10.1080\/08039480802533754","article-title":"Significance of family life events in middle adolescence: A survey on Finnish community adolescents","volume":"63","author":"Pelkonen","year":"2009","journal-title":"Nord. J. Psychiatry"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"e2032769","DOI":"10.1001\/jamanetworkopen.2020.32769","article-title":"Association of Youth Age at Exposure to Household Dysfunction with Outcomes in Early Adulthood","volume":"4","author":"Andersen","year":"2021","journal-title":"JAMA Netw. Open"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"223","DOI":"10.1177\/2167696817725608","article-title":"Adverse Childhood Experiences and Development in Emerging Adulthood","volume":"6","author":"Davis","year":"2018","journal-title":"Emerg. Adulthood"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"378","DOI":"10.1037\/cdp0000304","article-title":"The relationships between emerging adult transition themes, adverse childhood experiences, and substance use patterns among a community cohort of Hispanics","volume":"26","author":"Forster","year":"2020","journal-title":"Cult. Divers. Ethn. Minor. Psychol."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"59","DOI":"10.1016\/j.adolescence.2019.11.005","article-title":"\u201cNow what do I do?\u201c: Toward a conceptual understanding of the effects of traumatic events on identity functioning","volume":"79","author":"Waterman","year":"2020","journal-title":"J. Adolesc."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"452","DOI":"10.1097\/01.chi.0000198592.23078.8d","article-title":"Family discord, parental depression, and psychopathology in offspring: 20-Year follow-up","volume":"45","author":"Pilowsky","year":"2006","journal-title":"J. Am. Acad. Child Adolesc. Psychiatry"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"377","DOI":"10.1111\/j.1469-7610.2004.00228.x","article-title":"Major depression and conduct disorder in youth: Associations with parental psychopathology and parent-child conflict","volume":"45","author":"Marmorstein","year":"2004","journal-title":"J. Child Psychol. Psychiatry"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"695","DOI":"10.1007\/s00787-014-0637-5","article-title":"Risk and protective factors for the development of depressive symptoms in children and adolescents: Results of the longitudinal BELLA study","volume":"695","author":"Klasen","year":"2015","journal-title":"Eur. J. Child Adolesc. Psychiatry"},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"296","DOI":"10.1080\/08039480701415277","article-title":"The association of parental monitoring and family structure with diverse maladjustment outcomes in middle adolescent boys and girls","volume":"61","year":"2007","journal-title":"Nord. J. Psychiatry"},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"133","DOI":"10.1007\/s00787-008-1015-y","article-title":"Risk and protective factors for children\u2019s and adolescents\u2019 mental health: Results of the BELLA study","volume":"17","author":"Wille","year":"2008","journal-title":"Eur. Child Adolesc. Psychiatry"},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"546","DOI":"10.1037\/0893-3200.21.3.546","article-title":"Parental Psychological Control and Dimensions of Identity Formation in Emerging Adulthood","volume":"21","author":"Luyckx","year":"2007","journal-title":"J. Fam. Psychol."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"165","DOI":"10.1016\/j.adolescence.2007.04.003","article-title":"Dynamics of perceived parenting and identity formation in late adolescence","volume":"31","author":"Beyers","year":"2008","journal-title":"J. Adolesc."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"2092","DOI":"10.1037\/dev0000318","article-title":"Identity exploration and commitment in early adolescence: Genetic and environmental contributions","volume":"53","author":"Markovitch","year":"2017","journal-title":"Dev. Psychol."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"273","DOI":"10.1037\/sgd0000269","article-title":"Youth and caregiver experiences of gender identity transition: A qualitative study","volume":"5","author":"Haley","year":"2018","journal-title":"Psychol. Sex. Orientat. Gend. Divers."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"595","DOI":"10.1037\/fam0000815","article-title":"Conceptualizing relationships among transgender and gender diverse youth and their caregivers","volume":"35","author":"Bhattacharya","year":"2020","journal-title":"J. Fam. Psychol."},{"key":"ref_26","doi-asserted-by":"crossref","unstructured":"American Psychiatric Association (2013). Diagnostic and Statistical Manual of Mental Disorders: DSM-5, American Psychiatric Publishing. [5th ed.].","DOI":"10.1176\/appi.books.9780890425596"},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"40","DOI":"10.1080\/08039488.2019.1667429","article-title":"Time trends in referrals to child and adolescent gender identity services: A study in four Nordic countries and in the UK","volume":"74","author":"Kaltiala","year":"2020","journal-title":"Nord. J. Psychiatry"},{"key":"ref_28","doi-asserted-by":"crossref","unstructured":"Thompsonid, L., Sarovicid, D., Wilsonid, P., S\u00e4 Mfjordid, A., and Gillberg, C. (2022). A PRISMA systematic review of adolescent gender dysphoria literature: 1) Epidemiology. PLoS Glob. Public Health, 2.","DOI":"10.1371\/journal.pgph.0000245"},{"key":"ref_29","first-page":"31","article-title":"Gender dysphoria in adolescence: Current perspectives","volume":"9","author":"Bergman","year":"2018","journal-title":"Adolesc. Health Med. Ther."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"61","DOI":"10.1016\/j.eurpsy.2018.09.003","article-title":"Gender identities in adolescent population: Methodological issues and prevalence across age groups","volume":"55","author":"Lindberg","year":"2019","journal-title":"Eur. Psychiatry"},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"379","DOI":"10.1177\/1359104519838593","article-title":"Gender dysphoria in adolescent population: A 5-year replication study","volume":"24","author":"Lindberg","year":"2019","journal-title":"Clin. Child Psychol. Psychiatry"},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"165","DOI":"10.1080\/15532739.2011.700873","article-title":"Standards of Care for the Health of Transsexual, Transgender, and Gender-Nonconforming People, Version 7","volume":"13","author":"Coleman","year":"2012","journal-title":"Int. J. Transgenderism"},{"key":"ref_33","doi-asserted-by":"crossref","unstructured":"Heino, E., Fr\u00f6jd, S., Marttunen, M., and Kaltiala, R. (2021). Transgender identity is associated with severe suicidal ideation among Finnish adolescents. Int. J. Adolesc. Med. Health.","DOI":"10.3389\/fpsyg.2020.612424"},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"93","DOI":"10.1016\/j.jadohealth.2013.11.008","article-title":"The health and well-being of transgender high school students: Results from the New Zealand adolescent health survey (youth\u201912)","volume":"55","author":"Clark","year":"2014","journal-title":"J. Adolesc. Health"},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"521","DOI":"10.1016\/j.jadohealth.2017.04.014","article-title":"Risk and Protective Factors in the Lives of Transgender\/Gender Nonconforming Adolescents","volume":"61","author":"Eisenberg","year":"2017","journal-title":"J. Adolesc. Health"},{"key":"ref_36","doi-asserted-by":"crossref","unstructured":"Reisner, S.L., Conron, K.J., Tardiff, L.A., Jarvi, S., Gordon, A.R., and Austin, S.B. (2014). Monitoring the health of transgender and other gender minority populations: Validity of natal sex and gender identity survey items in a U.S. National cohort of young adults. BMC Public Health, 14.","DOI":"10.1186\/1471-2458-14-1224"},{"key":"ref_37","doi-asserted-by":"crossref","unstructured":"Heino, E., Ellonen, N., and Kaltiala, R. (2021). Transgender Identity Is Associated With Bullying Involvement Among Finnish Adolescents. Front. Psychol., 11.","DOI":"10.3389\/fpsyg.2020.612424"},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"67","DOI":"10.15585\/mmwr.mm6803a3","article-title":"Transgender Identity and Experiences of Violence Victimization, Substance Use, Suicide Risk, and Sexual Risk Behaviors Among High School Students\u201419 States and Large Urban School Districts, 2017","volume":"68","author":"Johns","year":"2019","journal-title":"MMWR Morb. Mortal Wkly. Rep."},{"key":"ref_39","doi-asserted-by":"crossref","unstructured":"Kaltiala, R., and Ellonen, N. (2022). Transgender identity and experiences of sexual harassment in adolescence. Child Abus. Rev., 31.","DOI":"10.1002\/car.2748"},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"65","DOI":"10.1037\/sgd0000081","article-title":"Development of the gender minority stress and resilience measure","volume":"2","author":"Testa","year":"2015","journal-title":"Psychol. Sex. Orientat. Gend. Divers."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"976","DOI":"10.2105\/AJPH.2014.301876","article-title":"Promoting the successful development of sexual and gender minority youths","volume":"104","author":"Mayer","year":"2014","journal-title":"Am. J. Public Health"},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"203","DOI":"10.1080\/13811118.2018.1430639","article-title":"Risk and Protective Factors for Self-Harm in a Population-Based Sample of Transgender Youth","volume":"23","author":"Taliaferro","year":"2019","journal-title":"Arch. Suicide Res."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"787","DOI":"10.1016\/j.amepre.2018.06.030","article-title":"Supporting Transgender and Gender Diverse Youth: Protection Against Emotional Distress and Substance Use","volume":"55","author":"Gower","year":"2018","journal-title":"Am. J. Prev. Med."},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"582","DOI":"10.1080\/00224499.2017.1415291","article-title":"Family Functioning and Mental Health of Transgender and Gender-Nonconforming Youth in the Trans Teen and Family Narratives Project","volume":"55","author":"Ehrensaft","year":"2018","journal-title":"J. Sex Res."},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"207","DOI":"10.1089\/trgh.2017.0031","article-title":"Enacted Stigma, Mental Health, and Protective Factors among Transgender Youth in Canada","volume":"2","author":"Veale","year":"2017","journal-title":"Transgend. Health"},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"2203","DOI":"10.1007\/s10461-016-1409-7","article-title":"The Impact of Discrimination on the Mental Health of Trans*Female Youth and the Protective Effect of Parental Support","volume":"20","author":"Wilson","year":"2016","journal-title":"AIDS Behav."},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"1487","DOI":"10.1007\/s00787-019-01308-6","article-title":"Risk factors for psychological functioning in German adolescents with gender dysphoria: Poor peer relations and general family functioning","volume":"28","author":"Levitan","year":"2019","journal-title":"Eur. Child Adolesc. Psychiatry"},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"108","DOI":"10.1177\/1359104514558431","article-title":"Young people with features of gender dysphoria: Demographics and associated difficulties","volume":"21","author":"Holt","year":"2016","journal-title":"Clin. Child Psychol. Psychiatry"},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"70","DOI":"10.1177\/26344041211010777","article-title":"Australian children and adolescents with gender dysphoria: Clinical presentations and challenges experienced by a multidisciplinary team and gender service","volume":"1","author":"Kozlowska","year":"2021","journal-title":"Hum. Syst. Ther. Cult. Attach."},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"483","DOI":"10.1080\/13625187.2016.1238893","article-title":"Early pubertal timing is common among adolescent girl-to-boy sex reassignment applicants","volume":"21","author":"Sumia","year":"2016","journal-title":"Eur. J. Contracept. Reprod. Health Care"},{"key":"ref_51","doi-asserted-by":"crossref","unstructured":"Toomey, R.B., Syvertsen, A.K., and Shramko, M. (2018). Transgender Adolescent Suicide Behavior. Pediatrics, 142.","DOI":"10.1542\/peds.2017-4218"},{"key":"ref_52","unstructured":"Halme, N., Hedman, L., Ikonen, R., and Rajala, R. (2018). Lasten ja Nuorten Hyvinvointi 2017. Kouluterveyskyselyn Tuloksia. [The Well-Being of Children and Adolescents 2017. Results from the School Health Promotion Survey], National Institute for Health and Welfare."},{"key":"ref_53","doi-asserted-by":"crossref","first-page":"1596","DOI":"10.1007\/s11606-007-0333-y","article-title":"Screening for depression in medical settings with the Patient Health Questionnaire (PHQ): A diagnostic meta-analysis","volume":"22","author":"Gilbody","year":"2007","journal-title":"J. Gen. Intern Med."},{"key":"ref_54","doi-asserted-by":"crossref","first-page":"1284","DOI":"10.1097\/01.MLR.0000093487.78664.3C","article-title":"The Patient Health Questionnaire-2 Validity of a Two-Item Depression Screener","volume":"41","author":"Kroenke","year":"2003","journal-title":"Med. Care"},{"key":"ref_55","doi-asserted-by":"crossref","first-page":"e1097","DOI":"10.1542\/peds.2009-2712","article-title":"Evaluation of the PHQ-2 as a brief screen for detecting major depression among adolescents","volume":"125","author":"Richardson","year":"2010","journal-title":"Pediatrics"},{"key":"ref_56","doi-asserted-by":"crossref","first-page":"30","DOI":"10.1016\/j.psychres.2018.12.004","article-title":"Psychometric properties of the 7-item Generalized Anxiety Disorder Scale (GAD-7) in a large representative sample of Finnish adolescents","volume":"272","author":"Tiirikainen","year":"2019","journal-title":"Psychiatry Res."},{"key":"ref_57","doi-asserted-by":"crossref","first-page":"1092","DOI":"10.1001\/archinte.166.10.1092","article-title":"A Brief Measure for Assessing Generalized Anxiety Disorder The GAD-7","volume":"166","author":"Spitzer","year":"2006","journal-title":"Arch. Intern. Med."},{"key":"ref_58","doi-asserted-by":"crossref","first-page":"266","DOI":"10.1097\/MLR.0b013e318160d093","article-title":"Validation and Standardization of the Generalized Anxiety Disorder Screener (GAD-7) in the General Population","volume":"46","author":"Decker","year":"2008","journal-title":"Med. Care"},{"key":"ref_59","doi-asserted-by":"crossref","first-page":"171","DOI":"10.3102\/0013189X14534297","article-title":"Inaccurate estimation of disparities due to mischievous responders: Several suggestions to assess conclusions","volume":"43","year":"2014","journal-title":"Educ. Res."},{"key":"ref_60","doi-asserted-by":"crossref","first-page":"345","DOI":"10.1080\/00332925.2017.1350804","article-title":"Outbreak: On Transgender Teens and Psychic Epidemics","volume":"60","author":"Marchiano","year":"2017","journal-title":"Psychol. Perspect."},{"key":"ref_61","doi-asserted-by":"crossref","unstructured":"Kozlowska, K., Chudleigh, C., McClure, G., Maguire, A.M., and Ambler, G.R. (2021). Attachment Patterns in Children and Adolescents With Gender Dysphoria. Front. Psychol., 11.","DOI":"10.3389\/fpsyg.2020.582688"},{"key":"ref_62","doi-asserted-by":"crossref","first-page":"551","DOI":"10.1037\/h0023281","article-title":"Development and Validation of Ego-Identity Status","volume":"3","author":"Marcia","year":"1966","journal-title":"J Pers Soc Psychol."},{"key":"ref_63","doi-asserted-by":"crossref","first-page":"683","DOI":"10.1016\/j.adolescence.2009.11.002","article-title":"Identity status change during adolescence and young adulthood: A meta-analysis","volume":"33","author":"Kroger","year":"2010","journal-title":"J. Adolesc."},{"key":"ref_64","doi-asserted-by":"crossref","first-page":"361","DOI":"10.1016\/j.adolescence.2005.03.008","article-title":"Unpacking commitment and exploration: Preliminary validation of an integrative model of late adolescent identity formation","volume":"29","author":"Luyckx","year":"2006","journal-title":"J. Adolesc."},{"key":"ref_65","unstructured":"Statistics Finland (2022, October 31). Koulutukseen hakeutuminen. Suomen Virallinen Tilasto (SVT): Koulutukseen Hakeutuminen [Verkkojulkaisu] ISSN=1799-4500 Helsinki: Tilastokeskus [Viitattu: 31102022] 2020. Available online: http:\/\/www.stat.fi\/til\/khak\/2017\/index.html."},{"key":"ref_66","doi-asserted-by":"crossref","first-page":"66","DOI":"10.1037\/h0098852","article-title":"Out on the street: A public health and policy Agenda for lesbian, gay, bisexual, and transgender youth who are homeless","volume":"84","author":"Keuroghlian","year":"2014","journal-title":"Am. J. Orthopsychiatry"},{"key":"ref_67","doi-asserted-by":"crossref","first-page":"503","DOI":"10.1016\/j.jadohealth.2018.02.003","article-title":"Chosen Name Use Is Linked to Reduced Depressive Symptoms, Suicidal Ideation, and Suicidal Behavior Among Transgender Youth","volume":"63","author":"Russell","year":"2018","journal-title":"J. Adolesc. Health"}],"container-title":["International Journal of Environmental Research and Public Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1660-4601\/20\/4\/2948\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T18:27:54Z","timestamp":1760120874000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1660-4601\/20\/4\/2948"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,2,8]]},"references-count":67,"journal-issue":{"issue":"4","published-online":{"date-parts":[[2023,2]]}},"alternative-id":["ijerph20042948"],"URL":"https:\/\/doi.org\/10.3390\/ijerph20042948","relation":{},"ISSN":["1660-4601"],"issn-type":[{"value":"1660-4601","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,2,8]]}}}