Objective:The Child Behavior Checklist (CBCL) is a widely used instrument to screen for emotional and behavioral problems in children and adolescents. This study examined the impact that the choice of scoring template (male/female) had on scale scores in transgender and gender nonconforming (TGNC) youth as well as scores in the clinical range. Method: The analytic sample consisted of 108 participants (including 55 TGNC children ages 6 -11 years and 53 TGNC adolescents ages 12-18 years). Paired samples t tests, McNemar's test for dependent samples, and Cohen's d av effect sizes were used for comparisons. Results: While statistically significant differences were found for several syndrome and broad band scale scores, there were largely trivial differences when comparing female versus male templates. Further, the number of scores in the clinical range when comparing male versus female templates were not statistically significantly different. For example, parent/guardian report of transgender boys (12-18 years) showed significant differences between scores based on a male versus female template on 9 of 11 scales; however, only the somatic problems, rule-breaking behavior, and internalizing subscales showed a difference in the number of clinical range scores (albeit not statistically significant). Conclusions: Choice in template does not seem to significantly impact whether a score will be clinically significant or not in this community-based sample. More research that is inclusive of nonbinary youth, with clinical samples, and with larger sample sizes is needed to build upon this preliminary work. Implications for Impact StatementThis study suggests that using the male versus female template for the Child Behavior Checklist does not result in significantly different numbers of scores that fall in the clinical range in this community-based sample of transgender children and adolescents.

There is limited information about caregiver and provider perspectives regarding the design of a mobile health solution to facilitate the transition from the neonatal intensive care unit (NICU) to home. Focus groups were conducted with English- or Spanish-speaking families enrolled in an urban high-risk infant follow-up clinic and with their care providers. We generated salient themes using an inductive thematic analysis. Twenty-two participants completed the study. Among caregivers, the infant’s median gestational age (IQR) was 29 (23, 34) weeks and 63% were Hispanic. Among the providers, 55% had practiced for more than 10 years and 18% were bilingual. Key stakeholder (family and provider) priorities for designing a mobile health solution were organized into eight domains, i.e., implementation ideas around user interface and timing, providing path planning and information, increasing support, improving engagement with providers and services, mitigating barriers to care after discharge and strengthening parenting role and confidence. The results from this study suggest that families and healthcare providers prioritize path planning, information and support as the pillars for designing an effective NICU-to-home transition mobile health application. Implications for product development include family empowerment, being a credible source of information and creating a resource for caregiver support and mental health.

Background While there is growing research considering the experiences of transgender youth whose identities align with the gender binary, especially among young trans women, there are significantly fewer studies that accurately capture data about nonbinary youth, and even fewer studies capturing the experiences of transgender and gender diverse (TGD) youth of color. The purpose of this research was to assess the prevalence of sexual health behaviors, mental health challenges, substance use, and healthcare utilization among Black/African American, Latinx, Asian/Pacific Islander, indigenous and multi-racial/ethnic TGD youth, who have been largely underrepresented in research. Methods A total of 108 TGD youth ages 16–24 were recruited into the Trans Youth of Color Study (TRUTH). Each participant completed a 90-min survey administered by a research assistant with more sensitive information collected using ACASI. In addition to a completing a survey administered by research staff, participants also participated in specimen collection, which included urine sampling to assess recent substance use without a prescription, self-collected rectal/frontal and throat swabs to test for gonorrhea and chlamydia, and a blood draw to test for recent use of drugs, gonorrhea and chlamydia, and syphilis. The sample was recruited at public venues, community outreach and referral, through social media outreach, and via participant referral. Cross-sectional analyses were from a single study visit. Results Compared to rates among their cisgender peers, participants reported experiencing adverse social and structural determinants of health—e.g. food insecurity (61%), housing instability (30%), and limited access to healthcare (26% had no place to go for healthcare)—and elevated rates of illicit drug use (19–85%), mental health problems (e.g. 60% self-reported depression), and involvement in sexual risk-related behaviors (e.g. among those reporting penetrative sex 57–67% reported sex without a condom). Conclusions This study adds descriptions of both mental and sexual health outcomes of a non-clinical sample of TGD youth to the literature, particularly among young transgender men and gender nonbinary youth, who have frequently been excluded from previous studies of sexual health. The findings document experiences and behaviors among TGD youth that contribute to mental and sexual health concerns, including rates of substance use, and healthcare utilization.

Background Growing research on transgender youth is accounting for the variety of ways in which young people define their genders and sexualities. Because of this growing representation, more research is needed to understand how intersectional identities and stigma affect risk for HIV acquisition along the HIV care continuum and engagement in mental and physical health care. Little is known about accessibility to HIV-related prevention services of nonbinary and transmasculine youth, and further understanding of the impacts on transfeminine people—those who have historically faced the highest prevalence of HIV positivity—is crucial. Objective The overarching aims of the Trans Youth of Color Study are to conduct longitudinal research with a cohort of transgender minority youth (TGMY), explore factors that aid in the prevention of new HIV infection and transmission, and reduce HIV- and AIDS-related disparities by focusing on successful engagement in care. Findings from this research will be used to inform the development of new interventions designed to engage TGMY in the HIV prevention and care continua. Methods Longitudinal research (baseline and follow-up assessments every 6 months for 3 waves of data collection) followed a cohort (N=108) of transgender youth of color recruited in Los Angeles, California, United States. Participants were recruited using multiple community-informed strategies, such as from local venues, social media, and participant referral. In addition to self-report surveys, urine was collected to assess recent use of illicit drugs, and blood, rectal, and throat swabs were collected to test for current sexually transmitted infection and HIV infection. Additional blood and plasma samples (10 mL for 4 aliquots and 1 pellet) were collected and stored for future research. Results Participants in the Trans Youth of Color Study were recruited between May 25, 2018, and December 7, 2018. Baseline and longitudinal data are being analyzed as of August 2022. Conclusions The findings from this research will inform adaptations to existing evidence-based HIV prevention interventions and help to guide new interventions designed to engage TGMY, especially those who are Black, Indigenous, or people of color, in the HIV prevention and care continua. International Registered Report Identifier (IRRID) DERR1-10.2196/39207