An AFFIRMative cognitive behavioral intervention for transgender youth: Preliminary effectiveness.

Austin, Ashley; Craig, Shelley L.; D'Souza, Sandra

doi:10.1037/pro0000154

Cited by 76 publications

(78 citation statements)

References 44 publications

(62 reference statements)

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“…The sad irony is that transgender children are most commonly hospitalized for psychological reasons, and therefore their dysphoria is only worsened when these events occur. One small study looks at affirmational care -where the children are completely accepted in their gender identity -and despite the small sample size of eight participants, they found significantly decreased depression scores, and there were indications that other positive mental health outcomes might be significant in larger studies [5], which supports what I am putting forward here.…”

supporting

confidence: 59%

A Nurse and Parent’s Perspective on the Medical/Nursing Approach to Transgender Youth

Burke-Aaronson¹

2018

NCP

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I am a registered nurse in the maternal/child/obstetrical area. I have often encountered families who are non-traditional, such as two mothers, or two fathers plus a surrogate, however I have not yet had the pleasure of caring for childbearing families where one or more of the parents were transgender. However, I knew there were reports of transmit (men who were assigned female at birth) who carried and gave birth to their own children, and in some cases even breastfed their infants. I am now an assistant professor teaching women's health/obstetrics and have been careful to include LGBTQ and other alternative family arrangements in my teaching material. I even began to work with a team of professors to include LGBTQ and sexual health across our nursing school curriculum. This is especially pertinent as we are located in San Francisco, which has a large community of LGBTQ individuals.Four years ago, after I had begun this work, my child who assigned female at birth told me that he was not a girl. He was nine. I had begun to see signs of this in the year prior as he began to receive education around puberty and realized the reality that he could not accept these particular changes in his body. He socially transitioned immediately (short hair, masculine clothing, pronoun and name change). We were fortunate in that we were part of a medical system that had a gender reassignment services, and more importantly a youth gender program. Unfortunately, it was not a comprehensive youth gender clinic with all services in one location, which was the case with the adult gender services in this system. We started seeing a therapist who assessed

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supporting

confidence: 59%

A Nurse and Parent’s Perspective on the Medical/Nursing Approach to Transgender Youth

Burke-Aaronson¹

2018

NCP

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“…The TIS may have utility in clinical settings to assess internalized transphobia as a minority stress process, potentially informing interventions to alleviate internalized transphobia and promote health and well-being. 47 For example, individual psychotherapy may reduce shame 67 and group therapy or access to community resources may decrease alienation, 68,69 which would be expected to have a positive impact on symptoms of depression and anxiety. 15,44 The TIS could be re-administered at follow-up to evaluate progress in alleviating shame, increasing self-acceptance and pride, and fostering a sense of comfort and belonging among other transgender individuals.…”

Section: Clinical Utilitymentioning

confidence: 99%

The Transgender Identity Survey: A Measure of Internalized Transphobia

et al. 2020

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Purpose: We describe the development of a measure of internalized transphobia, defined as discomfort with one's transgender identity as a result of internalizing society's normative gender expectations. Methods: An item pool was created based on responses from a small clinical sample (N = 12) to an open-ended questionnaire. Expert judges reviewed the items, resulting in a 60-item instrument for empirical testing. We conducted exploratory factor analysis (EFA) by using a community sample of 430 transgender individuals (aged 18-72, mean [M] = 37.4, standard deviation [SD] = 12.0), and confirmatory factor analysis (CFA) by using an online sample of 903 transgender individuals (aged 18-66, M = 31.6, SD = 11.1). Construct validity was examined by using correlations with instruments assessing related constructs administered to the online sample. Results: EFA resulted in a 52-item instrument with four subscales: Pride, Passing, Alienation, and Shame. CFA, after removal of half of the items, retained the four-factor structure. The final 26-item scale showed excellent internal consistency (0.90) and test-retest reliability (0.93). The factors showed a pattern of association with crossgender identity, gender ideology, outness, felt stigma, self-esteem, and psychological distress consistent with moderate-to-good construct validity. Conclusion: Internalized transphobia can be conceptualized as four interrelated dimensions: pride in transgender identity (reverse scored), investment in passing as a cisgender person, alienation from other transgender people, and shame. The Transgender Identity Survey reliably assesses this construct, useful in research to understand the impact of minority stress on transgender people's health. It can also be used in clinical practice to assess internalized transphobia at intake and follow-up.

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“…However, the e-therapy field is rapidly evolving and the developers of AFFIRM (a group-based CBT intervention for LGBT+ young people, cited in both reviews) [34] have highlighted their intentions to expand their program. In particular, it is hoped that in the future AFFIRM can be delivered in an online format [35]. We identified another e-therapy intervention in the field of LGBT+ mental health called TODAY.…”

Section: Comparisons To Prior Researchmentioning

confidence: 99%

How LGBT+ Young People Use the Internet in Relation to Their Mental Health and Envisage the Use of e-Therapy: Exploratory Study

Lucassen¹,

Samra²,

Iacovides³

et al. 2020

Preprint

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BACKGROUND: Lesbian, gay, bisexual, and transgender (LGBT) youth and other young people diverse in terms of their sexuality and gender (LGBT+) are at an elevated risk of mental health problems such as depression. Factors such as isolation and stigma mean that accessing mental health services can be particularly challenging for LGBT+ young people, and previous studies have highlighted that many prefer to access psychological support on the Web. Research from New Zealand has demonstrated promising effectiveness and acceptability for an LGBT+ focused, serious game-based, computerized cognitive behavioral therapy program, Rainbow Smart, Positive, Active, Realistic, X-factor thoughts (SPARX). However, there has been limited research conducted in the area of electronic therapy (e-therapy) for LGBT+ people. OBJECTIVE: This study aimed to explore how and why LGBT+ young people use the internet to support their mental health. This study also sought to explore LGBT+ young people's and professionals' views about e-therapies, drawing on the example of Rainbow SPARX. METHODS: A total of 3 focus groups and 5 semistructured interviews were conducted with 21 LGBT+ young people (aged 15-22 years) and 6 professionals (4 health and social care practitioners and 2 National Health Service commissioners) in England and Wales. A general inductive approach was used to analyze data. RESULTS: LGBT+ youth participants considered that the use of the internet was ubiquitous, and it was valuable for support and information. However, they also thought that internet use could be problematic, and they highlighted certain internet safety and personal security considerations. They drew on a range of gaming experiences and expectations to inform their feedback about Rainbow SPARX. Their responses focused on the need for this e-therapy program to be updated and refined. LGBT+ young people experienced challenges related to stigma and mistreatment, and they suggested that strategies addressing their common challenges should be included in e-therapy content. Professional study participants also emphasized the need to update and refine Rainbow SPARX. Moreover, professionals highlighted some of the issues associated with e-therapies needing to demonstrate effectiveness and challenges associated with health service commissioning processes. CONCLUSIONS: LGBT+ young people use the internet to obtain support and access information, including information related to their mental health. They are interested in LGBT-specific e-therapies; however, these must be in a contemporary format, engaging, and adequately acknowledge the experiences of LGBT+ young people.

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An AFFIRMative cognitive behavioral intervention for transgender youth: Preliminary effectiveness.

Cited by 76 publications

References 44 publications

A Nurse and Parent’s Perspective on the Medical/Nursing Approach to Transgender Youth

A Nurse and Parent’s Perspective on the Medical/Nursing Approach to Transgender Youth

The Transgender Identity Survey: A Measure of Internalized Transphobia

How LGBT+ Young People Use the Internet in Relation to Their Mental Health and Envisage the Use of e-Therapy: Exploratory Study

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