Trans and gender diverse young people's attitudes towards game-based digital mental health interventions: A qualitative investigation

Abstract

BackgroundTrans and gender diverse (TGD) young people are at high risk for mental health difficulties. Previous research has shown that three in four TGD young people have been diagnosed with an anxiety disorder and/or depression and almost one in two have attempted suicide. TGD young people experience barriers to traditional mental health services, commonly faced with inexperienced providers and discrimination. Video and computer games, as well as online spaces, are sources of resilience for TGD young people. Digital mental health interventions are a feasible, but understudied, approach to consider for this population.MethodsN = 14 TGD young people aged 11–18 years were recruited to take part in focus groups as part of a multistage project. The focus groups were transcribed verbatim and analysed using a general inductive thematic analysis approach. This paper reports on their attitudes towards digital games and game-based digital mental health interventions.DiscussionAspects of game-based digital mental health interventions should be inclusive of diverse genders and sexuality, moderated appropriately and include content such as storylines and characters who are of diverse sexualities and/or gender. Participants were of the opinion that games should be preventative rather than treatment-focused; however, considering the high rate of mental health difficulties in this population, interventions should ideally address symptoms along the continuum from sub-clinical to clinical.

Effectiveness, Acceptability, and Feasibility of Digital Health Interventions for LGBTIQ+ Young People: Systematic Review

“…While minority subpopulations are typically numerically small, and some argue that developing tailored interventions for such groups may be unnecessary [ 106 ], there is also evidence to suggest that minority groups appreciate tailoring of interventions. For example, in a recent study examining the attitudes of transgender and gender-diverse young people toward mental health gaming interventions, participants noted that TGD representation and inclusion of meaningful, specific tailored content was favorable [ 31 ].…”

“…LGBTIQ+ young people are adept and frequent users of digital technologies [ 33 , 46 , 47 ]; however, research indicates that technology use can present several challenges. Evidence suggests that the internet (including social media and online communities in particular) can be harmful in this population (as well as young people more broadly) [ 31 ] due to the potential for toxic interactions and exposure to distressing content [ 48 ], such as the normalization of self-harm and suicidal behaviors [ 49 ]. However, an array of benefits associated with technology use has also been documented in LGBTIQ+ young people.…”

“…The concept of digital delivery of interventions is generally acceptable to this group, and this is particularly true when they are specifically targeted with LGBTIQ+ themes [ 32 ]. Many existing digital health interventions are not specifically applicable to LGBTIQ+ people [ 51 ]; however, untailored interventions may exacerbate feelings of alienation [ 31 , 52 , 53 ]. Given these factors, the development and evaluation of targeted digital health interventions for LGBTIQ+ young people may represent an opportunity to improve the delivery of health care to this group, should the benefits outweigh the known challenges associated with digital health care delivery discussed above.…”

The Role of the Avatar in Gaming for Trans and Gender Diverse Young People

“…Importantly, there is a current initiative, SPARX-T, to develop an online intervention tailored specifically to the needs of TGD youth in preventing depression (Perry et al, in preparation) [ 39 ]. TGD young people assert that game-based digital mental health interventions need to be trans-affirmative and gender inclusive in content to be appealing [ 40 ]. The findings of this study can further inform serious game design given TGD young people are likely to be users of e-mental health interventions.…”

Experiences and Perceptions of Trans and Gender Non-Binary People Regarding Their Psychosocial Support Needs: A Systematic Review of the Qualitative Research Evidence

“…Each study could score ‘high’ ‘medium’ or ‘low’ depending on specific criteria. A total of sixteen studies achieved ‘high’ scores [ 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 ]. Medium scores were achieved by two studies [ 43 , 44 ].…”