Fifty-five transgender youth described their gender development and expression, parents' reactions to their gender nonconformity, and initial and current mothers' and fathers' reactions to their transgender identity. All of the youth reported feeling different from others in early childhood. Forty-three of the participants' mothers and 26 of their fathers knew about their identities. The youth reported that 54% of their mothers and 63% of their fathers initially reacted negatively, and 50% of the mothers and 44% of their fathers reacted negatively at the time of the interviews, an average of 3 years later. The more gender nonconforming the youth, the more likely they reported that they were verbally and physically abused by their mothers and fathers. Implications of these findings for social service professionals are discussed.

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The family empowerment program (FEP) is a multi-systemic family therapy program that partners multi-stressed families with an interdisciplinary resource team while remaining attached to a "traditional" mental health clinic. The rationale for this model is that far too often, families presenting at community mental health centers struggle with multiple psychosocial forces, for example problems with housing, domestic violence, child care, entitlements, racism, substance abuse, and foster care, as well as chronic medical and psychiatric illnesses, that exacerbate symptoms and impact traditional service delivery and access to effective treatment. Thus, families often experience fragmented care and are involved with multiple systems with contradictory and competing agendas. As a result, services frequently fail to harness the family's inherent strengths. The FEP partners the family with a unified team that includes representatives from Entitlements Services, Family Support and Parent Advocacy, and Clinical Staff from the agency's Outpatient Mental Health Clinic practicing from a strength-based family therapy perspective. The goal of the FEP is to support the family in achieving their goals. This is accomplished through co-construction of a service plan that addresses the family's needs in an efficient and coherent manner-emphasizing family strengths and competencies and supporting family self-sufficiency.

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