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Analyses revealed complex bidirectional family relationships, highlighting 5 contextual factors influencing these relationships school, community, workplace, religion, and extended family. TGD youths' identity development was inextricably linked to how caregivers respond to, adjust to, and learn from their children, and how caregivers interact with one another. Findings illustrate how caregiver acceptance and family cohesion may be linked and how youth and caregivers identified shared contextual factors impacting the family system. Thi