Therapy Experiences of Transgender and Gender Diverse Adolescents and Their Caregivers

Abstract

Transgender and gender diverse (TGD) adolescents and their caregivers have highlighted the dearth of providers trained in gender-affirming practices as a critical treatment barrier, yet little is known about their specific experiences in mental health therapy. The present study sought to elucidate these experiences. Qualitative description was employed to analyze data from 105 clinical interviews completed with TGD adolescents (n=49; ages 11-20) and/or their caregivers (n=65; ages 36-84) seeking medical gender transition services at a pediatric gender program in the U.S. Participants highlighted satisfactory experiences with therapists they perceived as gender-affirming and who actively involved caregivers in therapy. Several participants reported unhelpful experiences with therapists viewed as non-affirming. In a few cases, caregivers were alienated from therapy when therapists told them to affirm their adolescent's gender in highly directive ways. Findings underscore the need to train therapists in gender-affirming practices and highlight the importance of thoughtfully engaging caregivers in therapy.

Engaging adolescents in family therapy: The role of English slang and digital communication norms in therapeutic settings

“…Integrating English slang and digital communication norms into family therapy requires therapists to demonstrate cultural sensitivity and inclusivity in their language and communication practices. Therapists must recognize and respect the diverse cultural backgrounds, identities, and communication styles of adolescent clients and their families to ensure that therapy is accessible, relevant, and affirming (Price et al, 2022).…”

Employing dissemination and implementation science to promote mental health equity for transgender youth

“…32 This study adds to research elucidating the many difficulties transgender youth and their families face when they engage in mental health services (e.g., untrained providers) and their need for more tailored supports. 33,34 Taken together, it is possible that existing mental health treatments, including EBPs, are not by themselves sufficient for addressing the needs of transgender youth.…”

Transgender-Specific Adolescent Mental Health Provider Availability is Substantially Lower in States with More Restrictive Policies

“…According to one of the largest surveys of lesbian, gay, bisexual, transgender, and queer (LGBTQ) adolescents in the US, 50% of transgender respondents wanted but did not receive mental healthcare in the past year (Green et al, 2020). Moreover, among transgender adolescents utilizing mental healthcare, negative experiences (e.g., misgendering) are common (Price, Bokhour et al, 2022). One critical factor contributing to these adversities is the paucity of transgender-specific ("trans-specific") mental health providers in the US-i.e., providers who specialize in working with transgender clients (Abreu et al, 2020;Gridley et al, 2016;Vance et al, 2015;Whitman & Han, 2017).…”