Future Directions in Mental Health Treatment with Stigmatized Youth

Abstract

Acknowledgements. The authors thank Mr. Shuai ("Eddy") Jiang for his help adding references and formatting this manuscript and Dr. Jonathan S. Jay for his thoughtful review and recommendations.

Structural transphobia is associated with psychological distress and suicidality in a large national sample of transgender adults

“…To date, these inequities have been largely attributed to stigma at the individual level, such as exposure to transphobia via interpersonal interactions and/or internalizations of these experiences [ 21 , 23 , 25 ]. Despite substantial evidence that structural stigma in the form of discriminatory laws/polices and prejudicial societal attitudes also shapes mental health among multiple stigmatized groups [ 35 , 37 , 39 , 41 , 67 ], as well as increasing calls to incorporate contextual factors into suicide research [ 68 – 71 ], scholars have rarely conceptualized or rigorously measured structural transphobia by accounting for both transphobic laws/policies and attitudes across US states. Further, research has not yet comprehensively assessed structural transphobia’s associations with multiple dimensions of suicidality (e.g., thoughts, plans, attempts) and/or psychological distress among a large national sample of transgender adults.…”

“…Critically, addressing structural transphobia and its mental health consequences requires multilevel intervention strategies, including efforts to transform transphobic laws/policies and attitudes at the state level, train mental health providers in the provision of gender-affirming care (e.g., increasing their knowledge of supportive resources, particularly for transgender adults living in highly stigmatizing contexts), and adapt existing mental health interventions to explicitly attend to structural stigma exposure [ 67 ]. For example, research demonstrates that reducing transphobic attitudes may increase individuals’ support for transgender rights [ 73 ].…”

Gender Dysphoria: Optimizing Healthcare for Transgender and Gender Diverse Youth with a Multidisciplinary Approach

“… 62 To reduce stigmatizing health-care experiences for TGD youth, innovative and sustainable strategies (eg, web-based learning collaboratives) are needed to disseminate culturally responsive, gender-affirming care training to licensed community providers who work outside of gender specialty clinics. 63 Pediatric providers in health-care settings can implement changes in clinical practices and collaborate with health-care administration to implement policy changes that shift system-wide practices (eg, offering options to include chosen name, gender identity in electronic medical records).…”

Treatment personalization can promote mental health equity by addressing stigma.

“…In order to address substantial mental health and mental health care inequities, treatment personalization efforts should address stigma. To do so, it is necessary to develop, test, and scale up new or existing interventions that address client's stigma-related experiences (see Price & Hollinsaid, 2022 for detailed recommendations) and reduce clinician bias (Dovidio & Casados, 2019).…”