PURPOSE: Family acceptance is a crucial protective factor for transgender and gender diverse (TGD) youth well-being. Few studies examine how families react to gender transitions by youth. This study aimed to examine whether families react differently when youth report different gender identities or when youth report gender-nonconforming expressions. METHODS: Data from 92 TGD youth from a community-based sample participated in up to 4 waves of surveys, 9 months apart (2012-2015). Three gender identity trajectories were identified: (1) youth who consistently identified as TGD (consistent TGD)
(2) youth who were initially cisgender (CIS) but later identified as TGD (CIS→TGD)
and (3) youth who identified as TGD but later identified as CIS (TGD→CIS). Patterns of family acceptance over time were analyzed using hierarchical linear modeling, including within-person (time-varying) and between-person associations. RESULTS: Youth who reported consistent TGD identities reported less family acceptance at baseline, and stable and low family acceptance across time
youth who initially identified as CIS and later as TGD reported a pattern of decreasing family acceptance (b = -0.41, p = .004). Current gender nonconformity (but not gender nonconformity in childhood) was associated with lower family acceptance (between-person level: b = -0.22, p = .005
within-person level: b = -0.12, p = .058). DISCUSSION: In a community-based sample of gender-diverse youth, family acceptance corresponds to gender identity and current gender expression (rather than gender expression earlier in childhood). Interventions should help families of TGD youth, particularly of those whose gender expression is nonconforming, understand gender-diverse identities.