Toplumsal destek ve cinsiyet kimliğinin doğrulanması burada kritik bir rol oynamaktadır. Toplumsal cinsiyet kimliği ve bu popülasyondaki ifadelerde çeşitlilik konusunda giderek artan bir farkındalık söz konusu olsa da, biyopsikososyal gelişimin cinsiyet ikilisinin ötesinde ve geçişin ötesinde kapsamlı bir anlayışı eksiktir.[187]
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