Social media offers 'a sense of safety and community' for transgender, nonbinary kids

Key takeaways:

• Although social media has been shown to harm mental health, it may offer a protective effect in transgender and nonbinary youth.
• PCPs should discuss the content and context of social media with young patients.

Social media appeared to be associated with fewer mental health issues among transgender and nonbinary youth, according to study findings published in JAMA Network Open.

Therefore, directing transgender and gender nonbinary (TGNB) youth to reduce social media use could backfire for those “who are intentional about creating safe spaces on social media that may not exist in their offline world,” Sarah M. Coyne, PhD, a professor at Brigham Young University, and colleagues wrote.

Mental health among youth is a “critical public health issue,” with TGNB children and adolescents at an even greater risk, the researchers noted. Currently, an estimated 25% to 32% of TGNB kids attempt suicide.

Concerns remain regarding the impact of social media use on mental health among children and adolescents. To limit these risks, the U.S. surgeon general issued an advisory urging for more actions to ensure safer social media use. However, previous research has indicated that social media could be a protective factor rather than a risk for the mental health of TGNB children and adolescents.

“I broadly researched the impact of social media on mental health during adolescence. I felt that we were not representing the transgender/nonbinary experience as well as we could,” Coyne told Healio.

So, Coyne and colleagues conducted a cross-sectional study to evaluate the connections between mental health and social media use among cisgender, gender nonbinary and transgender youths. They included 1,231 people aged 10 to 17 years who took an online survey between May and August 2021, 54.8% of whom identified as cisgender women, 38.9% of whom identified as cisgender men and 6.3% of whom identified as TNGB or “other.”

Coyne and colleagues reported that gender identity was linked to children’s and adolescents’ experiences of social media in ways that they wrote could have distinct mental health implications.

“Not all adolescents respond to social media in the same way,” Coyne said. “Social media appears to be very important for TGNB youth. When used actively, it provides a sense of safety and community and is related to better mental health.”

The researchers found that gender identity moderated both the direction and strength of several associations between mental health and social media practices: taking intentional breaks (eg, depression: B = 1.03; 95% CI, 0.14-1.92), active social media use (eg, emotional problems: B = 1.82; 95% CI, 0.16-3.49) and cleaning and/or curating social media feeds (eg, depression: B = 0.91; 95% CI, 1.98 to 0.09).

These findings, they concluded, indicate that research regarding the impact social media has on young people should focus on gender identity.

Coyne said that social media “is hardly ever even mentioned” in primary care, but now physicians can expand those conversations.

“Instead of asking about screen time, which is what typically happens, I would love it if clinicians would discuss both the content and context of social media with their patients, with an understanding that TGNB youth might be having quite different experiences than cis youth,” she said.