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Mental Health Symptomatology and Treatment Outcomes of Gender Minority Youth: An Examination of Evidence-Based Practice

Authors:

Abstract

The present study examined the effectiveness and acceptability of a modular youth psychotherapy across cisgender and gender minority youths.
Research Question
Introduction
Participants
§Are existing evidence-based practices
(EBP) as effective and acceptable for
gender minority youth (GMY) as they
are for cisgender youth?
§Relative to their cisgender peers, GMY
experience elevated rates of anxiety1,
depression2, PTSD3, suicidality4, and
other mental health problems5
§These inequities may result from
GMY’s exposure to and internalization
of identity-based stressors6
§Though increasingly accessing mental
health services7, GMY face barriers to
treatment access and engagement8
§Extant EBP are effective in treating
youth’s internalizing and externalizing
symptomatology9, but RCTs have not
accounted for gender identity10
§Evaluating the effectiveness and
acceptability of EBP with GMY will
inform if and how these interventions
should be adapted11
Chorpita et al.,
2013
n
= 111
§
N
= 432 clinically referred youth
§
M
age = 10.6,
SD
= 2.2
§55.1% White, 14.6% Black, 11.6% Latinx,
1.2% Asian, 15.9% multiracial, 1.6% other
n
= 391 cisgender
youth (90.5%)
n
= 41 GMY
(9.5%)
Methods
§Effectiveness: MLM was used to
estimate rates of change in youth’s
affective, anxiety, conduct, and
somatic problems via DSM-oriented
scales of the Youth Self-Report16
§Acceptability: T tests were employed
to compare treatment satisfaction17 and
therapeutic alliance18 across cisgender
youth and GMY
§Gender Identity: YSR #110 (“I wish I
were of the opposite sex”) was used to
identify gender minority status19
Findings Conclusions
The Effectiveness and Acceptability
of Evidence-Based Practices for
Gender Minority Youth
Nathan L. Hollinsaid1,2, John R. Weisz, Ph.D.2, & Maggi A. Price, Ph.D.2
1
Tufts University
, Department of Psychology; 2
Harvard University
, Department of Psychology
§GMY’s affective, anxiety, and somatic
problems improved at rates similar to
those of their cisgender peers
§GMY’s conduct problems improved
more quickly than those of cisgender
youth (
p
< .01), but not after controlling
for initial symptom severity
§GMY reported lower satisfaction than
cisgender youth (
p
= .03)
§Youth-therapist alliance did not vary
across GMY and cisgender youth
Gender minority youth
benefited as much from existing
evidence-based practices as their
cisgender peers, but they reported
lower treatment acceptability.
REFERENCES
For more information or to request references, please visit
https://bit.ly/2CCGYJM or email nathan.hollinsaid@tufts.edu
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§Future RCTs of EBP should collect
gender identity data via inclusive and
validated measures20
§Affirmative training interventions21
for MHPs might reduce barriers to
treatment access and engagement
§Affirmative adaptations to EBP might
improve efficacy and acceptability22
§Adaptations should target minority
stressors and transdiagnostic risk
factors underlying psychopathology23
Weisz, Santucci,
et al., 2018
n
= 175
Weisz, Ugueto,
et al., 2018
n
= 73
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Results
YSR Affective Problems
YSR T-scores
Natural Log (Months Since Baseline + 1)
YSR Anxiety Problems
YSR T-scores
Natural Log (Months Since Baseline + 1)
YSR Conduct Problems
YSR Somatic Problems
YSR T-scores
YSR T-scores
Natural Log (Months Since Baseline + 1)
Natural Log (Months Since Baseline + 1)
Weisz et al.,
2019
n
= 73
§Pooled across 4 RCTs of EBP12-15:
Cisgender Youth GMY
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