The Double Identity Crisis in Transgender Adolescent Development

Introduction

The literature on transgender youth has primarily focused on neuroscientific and biological, etiological factors (Ghiasi et al., 2024; Levin et al., 2022), violence and victimization (Lombardi et al., 2002; Norris & Orchowski, 2022), gender identity models (Boskey, 2014; Doyle, 2022; Katz-Wise et al., 2017; Pleak, 2009; Spencer et al., 2021), hormonal treatment (Chen et al., 2023; Graham, 2023), transgender sports and athletics (Oberlin, 2023), gender dysphoria  (Steensma et al., 2013), and the prevalence of suicidality (Austin et al., 2022). The unique and complex process of concurrently negotiating personal and gender identity in adolescence is rarely researched. This dual identity understanding is coined by the author as the “double identity crisis”.  

The concept evolved from working with young transgender adults about a year after the onset of the COVID-19 pandemic. Newer to treating this population, the author began to speculate about the developmental demands on transgender adolescents.  The author was particularly interested in how identity development is addressed in this group of individuals, who may already be feeling ostracized by their families and peers.

The “double identity crisis” finds its roots in Marcia’s (1966) theory of identity status. His original theory has received considerable support as noted in a large-scale systematic review by Maehler and Hernandez-Torrano (2025).

Marcia (1966) described adolescents as being faced with the challenge of identifying oneself independent from one’s primary caregivers. Adolescents respond with one of four choices: diffusion, moratorium, foreclosure, or achievement. How adolescents negotiate identity depends on one’s level of exploration and commitment.  Whatever path an adolescent chooses may become consequential to the following stages of life span development. Take for example, a middle-aged client who foreclosed to being the “party guy” in high school and remained emotionally arrested for most of his adult life; devolving into an alienated and depressed individual who became dependent on alcohol.

Marcia’s Theory Applied to Transgender Teens

Marcia (1966) described identity diffused adolescents those who do not engage in identity exploration and do not commit to an identity. He believed that diffusion was more common amongst younger adolescents, representing the most immature level of identity formation. Relative to the transgender adolescent, awareness of gender incongruence may not have occurred. A South Korean investigation by Oh, et al. (2023) found that the age of first awareness was 10.6 years with a standard deviation of 5.1 years . One could speculate that it may have been subconsciously repressed due to a lack of emotional or developmental readiness to begin exploration in addition to cultural, religious, peer, or family pressure.

Marcia (1966) described identity foreclosure as a way of avoiding the identity crisis by foreclosing to the demands of caregivers and peers. Any exploration is limited. A commitment is made to the identity imposed on them by others. For transgender adolescents, this might refer to having growing awareness of gender incongruence, but foreclosing due to being raised in a more conservative family, cultural, or religious system. This may be due to hearing family, friends, and community members speak derogatively about the LGBTQ community.  

Marcia (1966) described identity moratorium in terms of exploring or experimenting with identity but ultimately deferring to perceived or implied demands of the caregiver or caregivers, and friends. A transgender teen, with a more definitive awareness of gender identity, may begin exploring what it feels like to live in one’s affirmed gender (i.e. experimenting with clothing), but succumbs, or commits to one’s assigned gender due to the words, attitudes, and pressure from family, friends, religious affiliations, and the community. 

Marcia (1966) described identity achievement as an adolescent showing full exploration and commitment to an identity that best suits oneself. Transgender teens who reach a level of achievement have explored, integrated, and committed to living in the gender that feels right to them.

Four Groups with 16 Combinations

The “double identity crisis” presumes that personal and gender identity co-occur as separate but co-equal processes that can influence one another.  Exploring and committing to “who I am” is just as important as exploring and committing to “what gender I am”. However, depending on the level of gender dysphoria, exploration of gender identity might take precedence.

 What follows is a basic description of each of the four sets of groupings.

Group 1

Group 1 matches personal identity diffusion with four forms of gender identity crises.  The result is diffusion-diffusion, diffusion-foreclosure, diffusion-moratorium, and diffusion-achievement.

Group 2

Group 2 matches personal identity foreclosure with the gender identity crises of diffusion, foreclosure, mortarium, and achievement. This group comprises the combinations of foreclosure-diffusion, foreclosure-foreclosure, foreclosure-moratorium, and foreclosure-achievement.

Group 3

Group 3 matches personal identity moratorium with the gender identity crises of diffusion, foreclosure, moratorium, and achievement.  This group consists of moratorium-diffusion, moratorium-foreclosure, moratorium-moratorium, and moratorium-achievement.

Group 4

Group 4 matches personal identity achievement with gender identity crises of diffusion, foreclosure, moratorium, and achievement. This group comprises the combinations of achievement-diffusion, achievement-foreclosure, achievement-moratorium, and achievement-achievement.

Developmental and Psychological Considerations

How transgender teens negotiate the “double identity crisis” can weigh heavily on their mental health as they transition to young adulthood (Wanta, et al. 2019).  In the healthiest case of double achievement, individuals who after thoroughly exploring and finding acceptance toward both their personal and gender identity, set themselves up for a successful transition. They have the confidence, drive, interpersonal savvy, emotional maturity, balance, and resilience to transition and achieve whether at work, college, a trade, or the military. They are primed to form the intimate relations needed to work through one of the more significant developmental tasks (Erikson, 1950) of young adulthood.

For the other 15 combinations, minor to significant longer-term consequences may follow into early adulthood.  The most negatively impacted groups are those in the double-diffused, diffused-foreclosed, foreclosed-diffused, and double-foreclosed categories. This is due to the lack of exploration into who one really is and what gender makes most sense to them.  These individuals may enter young adulthood experiencing higher levels of psychological distress, lack of self-direction, and less than sufficient relational intimacy. This may partly explain the higher percentage of drop-out rates among transgender college students compared to cisgender peers (Liss, et al., 2024).  They become further compromised when criticized for not moving forward with their lives, dropping out of college, failing to launch, and characterized as lazy, immature, or choosing to live like a teen.

Case Examples

The following case examples have been included to illuminate the model and how it translates to treatment. The cases were specifically chosen because they show how the double identity crisis operates and affects the development of teens and young adults before being addressed in treatment; moving from different combinations of unresolved identity status to forms of double achievement. These cases show how the double identity crisis may not become resolved until well into adulthood.

G: A Case of Diffusion-Diffusion

Consider the case of “G”, a transgender male in his mid-20s. G was raised in a devoutly religious home with controlling parents. G was a quiet, unassuming kid who was discouraged from having a voice and pursuing his individual interests. He was socialized femininely and forced into activities which he never felt comfortable.  As an adolescent, G felt a growing sense of confusion within himself; “a boy trapped in a girl’s body” which he did not express to anyone. He was particularly fearful of his parents finding out and disowning him.

G never explored who he was as most decisions were made for him. G quietly succumbed to his parents’ demands.  G dated males, participated in soccer, and applied to college because that was expected, despite wanting to pursue a career in the trades. Social relations were kept to a minimum. G did not listen to music that his parents did not permit.

G showed a diffusion-diffusion response to the double identity crisis by suppressing any exploration and/or commitment to personal and gender identity.  Into young adulthood, he struggled with anxiety and depression and felt like a “passenger in life”. Interpersonal relationships were few. Most often, G kept to his room missing the opportunity to engage in college life. In private, G began a tentative exploration by dressing in men’s clothing and working manual labor jobs.

G was asked to identify which combination of the double identity crisis fit most. G suggested moratorium/moratorium which after further processing admitted was more like diffusion-diffusion; though now on a trajectory of exploration and commitment.  The earliest part of therapy focused on developing a voice, making decisions, socializing, and setting boundaries with his parents.  This set the stage for personal identity development. G realized that he was funny and enjoyed dark humor and began visiting comedy clubs. He realized that he was more than crafty. He began woodworking. He began listening to the techno music he enjoyed and found himself dancing freely around his house. He took a break from church as he never felt this was part of his true identity.

Therapy helped G progress through the gender stage of the double identity crisis. He became assertive and developed a sense of empowerment. His relationships blossomed. G began exploring life as a man which led to joining support groups, starting hormonal treatment, and changing his name.  Eventually, G let his parents know that he was hormonally in transition.  The relationship remained delicate, but in process. At this point in his development, G entered a mode of moratorium/achievement-achievement.

Y: A Case of Diffusion-Achievement

Y, an early 20s transgender male, came to treatment due to anxiety and depression.  He was introverted and had trouble making friends throughout his life. Y had some adolescent interests in graphic design which he never explored. Y spent much of his time playing video games but did not identify himself as “a gamer”. Y lacked self-direction. He was primarily home-bound after high school, neither working nor taking classes.

Despite Y’s lack of personal identity development, he explored his gender identity to the point of achievement. Y affirmed his gender as “trans-masculine” since the beginning of high school. He read and went on forums discussing gender identity.  Through education and exploration, Y realized he was not comfortable living as a woman. He came out to the family and changed his name. His family was supportive.  He became active in the transgender community, completed top surgery, and began taking testosterone.

The diffusion-achievement dilemma created problems for Y’s entry into adulthood.  Despite being settled in his gender, Y never explored who he was, or how he envisioned the future. Thus, Y remained unmotivated, depressive, socially withdrawn, and less than productive even while identifying confidently as man. Y was instructed to select which of the 16 combinations best fit them.  Y chose diffusion-achievement.  Therapy focused on developing his personal identity which included having a voice and becoming a proactive participant in life. This included a focus on differentiating when he was acting in his more confident adult self with those around him, or regressing into his reactive or withdrawn adolescent self; particularly in relation to his parents and partners.   After a year of treatment, Y was working and enrolled in school. Though still generally anxious, the anxiety became less debilitating and his depression alleviated. Y achieved an evolving personal identity to match his gender identity achievement.

Concluding Remarks

Personal and gender identity formation can either be deferred, explored, or accepted  to produce our healthiest transgender youth.  Treatment needs to address both aspects of the double identity crisis uniquely encountered by this cohort. Achieving gender identity alone is not sufficient as it may not fully address one’s personal identity development; though it can help promote it by alleviating gender dysphoria.

From the perspective of the “double identity crisis”, an over emphasis on gender affirmed care can become detrimental when gender-achieved adolescents have foreclosed the development of their personal identities to their gender identity development. This may be due to believing that gender achievement will solve all their psychological distress.  This individual might compromise the personal identity by taking on aspects of the transgender community, some of which may not speak to who they really are but achieve a sense of belonging. This is not any different than the adolescent who bases his, her, or their identity solely around the sport team, or the cannabis using crowd.

Stated differently, short-sighted therapists who overly emphasize gender identity to the neglect of personal identity development might be doing this population a disservice. This is not to suggest a minimization of gender affirming care; in fact, becoming more comfortable in one’s gender identity may alleviate the dysphoria needed to pursue one’s personal identity development as previously noted. The reminder pertains to the treatment of both aspects of identity development to maximize growth of the person-as-a-whole.

Likewise, personal identity development in absence of gender identity development is just as problematic. It cannot overcompensate for a diffused or foreclosed gender identity, or a gender identity that remains in moratorium and evokes pervasive feelings of gender dysphoria. In conclusion, those who do not resolve the “double identity crisis” experience isolation, low self-esteem, a lack of self-direction, shame, anxiety, and depression that affects their long-term development.  Those who can find achievement of their personal and gender identities are most suited for relational success and emotional well-being.