The Effectiveness and Acceptability of Evidence-Based Practices for Gender Minority Youth

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  1. John Weisz

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Description: Introduction: Gender minority (GM) youth report elevated rates of anxiety, depression, self-harm, suicidality, and other mental health concerns relative to cisgender youth. However, they are less likely to seek mental health care, a byproduct of treatment inaccessibility, discrimination, and non-affirming providers. Researchers have begun to tailor interventions to GM youth, yet little is known about the benefits of existing evidence-based practices (EBPs), as RCTs thereof have failed to account for gender identity. The present study evaluated the effectiveness of MATCH, a modular EBP, to determine if gender identity predicted treatment outcomes. Methods: Pooled across four RCTs, participants included N = 443 clinically referred school-age youth (ages 7-15; M = 10.6, SD = 2.2) treated by therapists trained in MATCH. Youth-reported mental health symptomatology was assessed via DSM-oriented scales of the Youth Self-Report (YSR). As the RCTs did not collect gender identity data, GM status was identified from YSR Item #110 (“I wish I were of the opposite sex”). Multilevel modeling was employed to assess for different trajectories of change in YSR T scores between n = 402 cisgender and n = 41 GM youth. Results: Across treatment, GM youth reported higher average mental health concerns than their cisgender peers. Both cisgender and GM youth showed significant improvement across DSM-oriented scales (i.e., affective, anxiety, conduct, and somatic problems) over treatment, and rates of change did not vary between subsamples. Discussion: GM youth experienced elevated symptomatology relative to cisgender youth, a disparity that may arise from exposure to stigma-related stressors. As GM youth’s symptoms improved at rates similar to those of cisgender youth, the potential benefits of EBPs necessitate addressing identity-based disparities in access to mental health services and discrimination therein.

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