Background: Transgender, nonbinary, and gender diverse (TNG) youth often describe exploring identities andcommunities online Studies of cisgender youth connect increased digital technology use with loneliness anddecreased body image Digital technology use in adolescent school experiences has increased over time, andsuddenly youth across the U S are in completely digital school environments due to the COVID-19 pandemic With educational systems employing and encouraging these tools, it is critical to understand the technologyuse of TNG youth and how this affects their health Objective: To compare features of digital technology use of cisgender and TNG youth, as well as interactions of this use with well-being Methods: Using Qualtrics panels, we surveyed a nationally representative sample of adolescents (ages 13-18) and their parents about digitaltechnology use Youth assessment included the Adolescent Digital Technology Interactions and Importance(ADTI) scale, with subscales assessing the purpose of technology use, and the short Problematic and RiskyInternet Use Screening Scale (PRIUSS-3) Health-related measures included validated instruments assessing body image, parental support, loneliness, well-being, fear of missing out (FOMO), and parent social media use We compared ADTI scores between gender groups with analysis of covariance Generalized estimatingequation (GEE) analysis was conducted to compare the proportions of subjects at risk for problematic internetuse (PRIUSS-3 &gt;3) All comparisons were adjusted for age and parent social media use Pearson's correlationanalyses evaluated the correlations between parent support, body image, loneliness, well-being, and FOMOvs ADTI and PRIUSS-3 scores Results: Among 4575 adolescent-parent pairs, there were 53 (1 16%) TNG youth TNG youth showed higher probabilities of problematic internet use than cisgender peers (0 91 vs 0 69,p=0 004) TNG youth had signicantly higher scores for use of technology to explore identity/go outside one'soffline environment (ADTI 2) compared to cisgender youth (mean 18 45 vs 15 76, p = 0 0085) Parental supportcorrelated positively with ADTI 2 scores for TNG youth (0 05), though correlated negatively with ADTI 2 scoresfor cisgender youth (-0 22, p=0 043) In a pattern different from cisgender peers, problematic internet usescores for TNG youth correlated positively with body image (0 26 vs -0 17, p = 0 0025) and well-being (0 33 vs -0 08, p = 0 0019) Conclusion(s): TNG youth are at increased risk for problematic internet use compared tocisgender peers, though motivations for digital technology use may differ TNG youth are more likely to usedigital technology to explore identity and go outside one's offline environment Correlation of digital usemeasures with positive body image and well-being also suggests that this population may uniquely benetfrom digital experiences, which may challenge current denitions of problematic internet use in thispopulation Future research, screening and intervention efforts should address both positive and problematicdigital technology use among TNG youth Demographics of Cisgender and TNG Youth Participants Comparison of Correlation Coefficients of ParentSupport, Body Image, Loneliness, Well-being, and Fear of Missing Out versus Digital Technology Interactionsand Problematic Internet Use Outcomes for Transgender/Nonbinary and Cisgender Youth
Digital media use differs between transgender and cisgenderyouth