87. Using Standardized Patient Encounters To Build Interdisciplinary Pediatric Learners’ Gender-Affirming Clinical Self-Efficacy And Skills In Caring For Transgender Youth

Abstract

one, we conducted "lifeline interviews," inviting youth to visually depict their life histories along a timeline, displaying significant events in chronological order. At the end of the interview, we asked participants to take photos that corresponded to prompts about internal and external resources (e.g. "Take a photo that represents your personal strengths" or "Take a photo that represents a safe space for you.") In Phase two, participants returned with their photos, which were used to guide the second interview. All interviews were audio recorded, transcribed verbatim, coded, and analyzed using inductive thematic analysis. Results: Participants described five themes related to internal resilience: 1) Gaining strength through enduring and surviving hardships (e.g. "Going through those tough trials really gave me the strength to carry on with my life and really pursue happiness"); 2) Self-acceptance and self-affirmation (e.g. "I've gone through phases when I severely disliked who I was and being in the body that I was in. So, loving myself was the best support I could've given myself"); 3) Learning how to handle discriminatory situations, either by standing up for oneself (e.g. "I will do me and if they have a problem with it, there's the door"), or by avoiding conflict; 4) Cognitive behavioral techniques, including future orientation, mindfulness, and externalizing/reframing problems ("I have to be conscious of the way that I think about things, because otherwise I easily become really upset about things that there's no evidence for"); and 5) Positive psychology practices, including helping others, practicing gratitude, hope and optimism, and positive thinking ("If I was feeling really overwhelmed or depressed or anything, I would just make a list of things that made me happy"). Conclusions: Trans and non-binary adolescent participants reported the use of multiple individual resilience strategies to manage minority stress in their lives. These resilience strategies can help inform the development of strength-based community, clinical, and schoolbased interventions serving trans and non-binary adolescents, in order to improve their mental health outcomes.