Scholars have documented that considerable health disparities exist between transgender persons and the general population. A growing research base suggests that the family environment of trans individuals—i.e., the social climate within one’s family—can have a significant influence on the population’s health and wellbeing. Despite the substantiated relationship between the family environment of transgender people and their health, there are three identifiable gaps in the literature that warrant further research. First, no known quantitative studies have considered trans family environments beyond those that are accepting and rejecting, or how such family environments might be differently related to the population’s mental and physical health. Second, though scholars are increasingly recognizing the existence of gender heterogeneity within the trans population, it remains unknown if the health and family environment vary for trans persons of different gender identities. A third gap exists within the nascent literature on individuals with nonbinary gender identities in which there is an absence of studies examining the experiences of their family members.

The three papers that comprise this mixed-methods dissertation respond to the aforementioned gaps in the literature. The first two studies analyze quantitative survey data collected from transgender adults (N=873); study three analyzes qualitative interview data collected from the parents of adult children with nonbinary gender identities (N=14). Study one examines family environment heterogeneity and tests its association with mental and physical health. Study two assesses variation in mental health, physical health, and family environment as a function of having a binary vs. a nonbinary gender identity. Study three uncovers how parents of nonbinary adult children make sense of their child’s gender and the developmental processes that occur in doing so. Taken together, findings from this dissertation offer important implications for healthcare providers, clinicians, and intervention efforts aimed at improving the health of transgender populations.