Gender-affirming multidisciplinary care for transgender and non-binary children and adolescents

Warwick, Rebecca; Shumer, Daniel E.

doi:10.1080/02739615.2021.2004146

Cited by 2 publications

(2 citation statements)

References 80 publications

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“…For TGNB youth with trauma, experiencing greater barriers to accessing mental health services poses an additional risk for worse mental health outcomes (e.g., Warwick & Shumer, 2023). While most trauma-focused interventions require at least some verbal processing and engagement, for youth with communication challenges associated with comorbid anxiety, modifications and accommodations are much needed to support their capacity to engage in trauma-focused treatment.…”

Section: Theoretical and Research Basis For Treatmentmentioning

confidence: 99%

Narrative Exposure Therapy for Treating Post-Traumatic Stress Among Transgender Youth of Color With Selective Mutism

Casas

Conn

2023

Clinical Case Studies

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Rates of post-traumatic stress (PTS) are greater among transgender and non-binary (TGNB) youth compared to their cisgender peers. This disparity has been linked to increased experiences of trauma among TGNB youth, including greater exposure to child abuse, discrimination, hate crimes, and familial and peer bullying and rejection. Few studies to date have examined the use of trauma-focused interventions with TGNB youth. Narrative Exposure Therapy (NET) has been identified as a potentially impactful treatment for PTS for communities who experience oppression and human rights violations given its social justice-oriented “testimonial” approach and focus on meaning-making around traumatic experiences. While narrative-based approaches are often considered “best practice” for trauma interventions, youth may present with comorbid conditions that present barriers or often preclude them from receiving trauma treatment, such as selective mutism (SM). In this case series, we describe the use of NET for treating PTS symptoms in two transgender youth with comorbid SM, as well as adaptations to support their engagement and progress in treatment. Treatment progress was observed in reduction of PTS symptoms, increase in self-reported resilience and positive well-being, and full remission of SM, with treatment gains observed 6-months post-discharge. From these cases, we identified that (1) NET is a brief treatment that can address PTS and SM symptoms among TGNB youth; (2) NET is able to be adapted to enhance engagement in a narrative-based, trauma-focused therapy for youth with PTS and SM; and (3) NET can also increase self-perceived resilience and a sense of positive well-being for TGNB youth.

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Section: Theoretical and Research Basis For Treatmentmentioning

confidence: 99%

Narrative Exposure Therapy for Treating Post-Traumatic Stress Among Transgender Youth of Color With Selective Mutism

Casas

Conn

2023

Clinical Case Studies

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“…8 Many TGD individuals rely on tailored multidisciplinary support while navigating their gender journey. 9 Prior studies have highlighted the role of gender-affirming care (GAC) on positive psychosocial outcomes in tandem to improving quality of life, reaffirming the need for both continued and increased access to this type of care. 10 Although failure to receive GAC has proven to be detrimental, many barriers to pursuing care continue to burden the TGD community, including anxiety due to fear of discrimination, lack of insurance coverage, increased out of pocket cost, and proximity to quality care.…”

Section: Introductionmentioning

confidence: 99%

Patient and parent perspectives on the utility of telemedicine for initial surgical gender care consultations: A cross-sectional survey

et al. 2023

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Introduction The COVID-19 pandemic has expanded the use of telemedicine to patient populations that were previously constrained to in-person visits. Few studies have investigated the role that telemedicine plays in shaping the care of these patient populations. This project explores the impact of telemedicine for one such population: patients and parents of gender-diverse individuals seeking gender-affirming surgery. Methods A 10-question survey using previously validated questions was completed by 34 patients and 9 parents of patients (aged 15–31) who received virtual care at the Center for Gender Surgery at Boston Children's Hospital between March 2020 and April 2021. The survey was divided into two parts. The first section collected demographic information. The second assessed participant perspectives on remote surgical gender care through a series of Likert-type and open-ended questions. Results A total of 100% of the respondents felt that their telemedicine visit was convenient; 60% (18) of the patients and 87% (7) of the parents stated that they look forward to future use of this modality. Free responses highlighted common perspectives on remote surgical gender care, including the increased accessibility of gender-affirming care through telehealth, the limitations of telehealth for addressing physical and relational aspects of gender care, patients’ desire for autonomy and privacy during telehealth visits, and parents’ desire to be involved throughout their children's gender journey. Conclusion These results demonstrate the unique ability of telemedicine, if implemented thoughtfully, to enhance outcomes for patients seeking surgical gender affirmation.

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Gender-affirming multidisciplinary care for transgender and non-binary children and adolescents

Cited by 2 publications

References 80 publications

Narrative Exposure Therapy for Treating Post-Traumatic Stress Among Transgender Youth of Color With Selective Mutism

Narrative Exposure Therapy for Treating Post-Traumatic Stress Among Transgender Youth of Color With Selective Mutism

Patient and parent perspectives on the utility of telemedicine for initial surgical gender care consultations: A cross-sectional survey

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