Test–Retest Reliability and Sensitivity of a Brief Clinical Monitoring Measure for Transgender and Gender Diverse Adults: The Trans Collaborations Clinical Check-In (TC\u3csup\u3e3\u3c/sup\u3e)

The current study aimed to examine the test–retest reliability and sensitivity of the Trans Collaborations Clinical Check-In (TC3) in a 3-month period with four assessment points at baseline, 1, 2, and 3 months to examine its utility as a clinical progress monitoring measure. This study builds on the initial validation study conducted by Holt et al. (2019). The sample of 32 transgender and gender diverse (TGD) participants were chosen who met screening for at least modest depression and anxiety, and did not have other significant risk factors (e.g., mania, self-harm). Participants completed a battery of measures that assessed mood, well-being, and gender-related constructs at each of the time points in addition to demographic questionnaires. Overall, the TC3 exhibited excellent test–retest reliability. While there was no systematic change in scores, there was some random variation of scores around the mean; and large, within-person correlations between time points. The TC3 also demonstrated convergence with many of the gender-related constructs, and to a lesser degree demonstrated criterion validity with mental health constructs. Further longitudinal study with larger samples in addition to study within intervention frameworks are necessary next steps to understand the utility of the TC3 for assessing systematic change over time. Overall, the current study highlights the initial utility of the TC3 to measure aspects of gender-related well-being across time, such as during health or behavioral health services. Public Significance Statement -- The overall findings of the study suggest that the Trans Collaborations Clinical Check-In (TC3) is a valid and reliable tool for use with transgender and gender diverse (TGD) people in clinical settings, which addresses the dearth of validated, brief TGD-specific assessments that are routine essentials for providing evidence-based care

The Rise of Transgender and Gender Diverse Representation in the Media: Impacts on the Population

In recent years, the transgender and gender diverse (TGD) population has gained a stronger voice in the media. Although these voices are being heard, there are limits on the types of TGD representation displayed in media. The current study interviewed 27 TGD individuals. These interviews exposed how participants view the rise of TGD media representation. The main themes that emerged were TGD awareness and TGD identity discovery and role modeling. Clearly, there is a disconnect between transnormativity in the media and transnormativity in reality

Psychometric Evaluation of the Transgender Congruence Scale

Introduction Despite increased attention to transgender and gender diverse (TGD) issues in psychological literature during the past decade, gaps remain for psychometric validation of TGD-specific measures. Kozee et al. (Psychology of Women Quarterly 36(2):179–196, 2012) addressed such gaps by creating the Transgender Congruence Scale (TCS), measuring gender acceptance and feelings of gender congruence between internal and external attributes across a broad range of gender identities. The current study extended Kozee and colleagues’ work by further examining the psychometric properties of the TCS. Methods Between October and November of 2017, 210 transmasculine, transfeminine, and gender diverse adults between ages 19 and 73 completed online surveys containing demographic, gender identity-specific, and well-being measures including the TCS. Results Results of confirmatory factor analysis replicated the original two-factor model (Appearance Congruence and Gender Identity Acceptance), with the elimination of two poorly loading items, resulting in a 10-item reduced model (TCS-10). Higher scores on TCS-10 were associated with positive scores on gender-related well-being, congruence, and pride, positive affect, and life satisfaction, as well as lower scores on gender-related dysphoria, non-affirmation, internalized transphobia, and marginalization. There were modest but significant associations between Gender Identity Congruence and both depression and negative affect. Conclusions Despite limitations of sample size and diversity of identities, the study reaffirmed the utility of the TCS as an overall construct of gender identity congruence with a 10-item reduced structure related to other established TGD constructs. Policy Implications Though socio-political climate is the ultimate domain for alleviating TGD stigma and discrimination, factors such as gender congruence are essential areas of focus to foster resiliency

Identifying and addressing barriers to treatment for child sexual abuse survivors and their non-offending caregivers

Mental health treatment is a critical part of an effective and compassionate response to the disclosure of child sexual abuse (CSA). Given the vast negative consequences for children and families following CSA, engagement in treatment can benefit youth and their non-offending caregivers. Yet, these families face unique barriers to treatment initiation, adherence, and effectiveness. The identification of these barriers allows clinicians, researchers, and policy makers to increase treatment utilization, engagement, and value. The current review and its recommendations derive from the existing literature combined with knowledge gained from a clinical research team with more than 20 years of experience offering a treatment program for CSA survivors and their non-offending family members. The review organizes barriers around factors related to individual characteristics of children and caregivers, perceptions and beliefs commonly held following CSA, and challenging family interactions in the context of individual and group treatment for CSA. Finally, barriers related to systemic and societal factors are examined given the importance of understanding the legal and cultural context in which families seek and engage in treatment. Recommendations for further research, suggestions for clinicians, and considerations for policy change to decrease the identified treatment barriers for families impacted by CSA are provided

Transgender and Gender Diverse Clients’ Experiences in Therapy: Responses to Sociopolitical Events and Helpful and Unhelpful Experiences

We examined transgender and gender-diverse (TGD) people’s reports of their therapy experiences over the course of a year. We explored how participants’ therapists integrated discussions about current events, as well as their more general perspectives on helpful and unhelpful experiences. A total of 107 participants provided data on these questions at least once over 12 months of surveys (M age = 33.79; 70.1% White), reflecting on their current therapy experiences. Through thematic analysis of qualitative data, the following themes were constructed regarding discussing sociopolitical events: (a) facilitating coping via bearing witness to clients’ internal experiences and implementing other therapeutic interventions; (b) moving beyond the individual by integrating identity, systems, or contexts; (c) feeling disconnected and misunderstood. We grouped participants’ helpful experiences into the following themes: (1) availability, connection, and therapeutic approaches facilitate positive experiences; (2) the necessity of knowledge, education, and affirmation of TGD identities; (3) helpful therapy means seeing the world in which clients live. We grouped participants’ unhelpful experiences into the following themes: (1) logistical issues can interfere with therapy; (2) lack of depth and disconnection results in subpar therapy; (3) insufficient understandings of TGD identities results in potentially harmful practices. These findings deepen understandings of how to integrate discussions about current events into therapy and provide competent and affirming care to TGD clients

Resilient Transgender and Gender Diverse Youth: The Protective Role of Sibling Relationships and Family Environment on Well-Being

Sibling relationships are often overlooked in family contexts and can serve as protective relationships for youth, leading to more positive outcomes (Feinberg et al., 2013). Further, supportive family environments are associated with better academic outcomes, greater self-esteem, and lower internalizing symptoms (e.g., depression, anxiety; Milevsky & Levitt, 2005; Walsh, 2012; Widmer & Weiss, 2000; Wojciak et al., 2013). However, there is limited knowledge regarding the impacts of sibling and family relationships for transgender and gender diverse youth (TGDY) specifically. TGDY families are unique in that they must manage complex relational and social structures within and outside of their families while supporting their transgender youth. While ecological influences have been widely accepted related to impacts on youth and family development generally (Bronfenbrenner, 2005) and have been applied to TGDY more broadly (e.g., Craig et al., 2015; Singh et al., 2011), further in-depth examination of the reciprocal influence of TGDY, sibling, and family environments is needed. As family support has been demonstrated to buffer negative outcomes and increase family resiliency (Katz-Wise et al., 2018), and siblings being important sources of support (Hilton & Szymanski, 2011) for TGDY, further investigation regarding impacts of TGDY family resiliency is of utmost importance. While some studies to date have examined sibling relationships for TGD-youth specifically (e.g., D’Augelli et al., 2008; Wheeler et al., 2019), there is a need to integrate the perspectives of TGDY, siblings, and caregivers to further understand associations with family resiliency. Relatedly, there is a need to consider the social environment surrounding these family systems to contextualize influences on TGDY and sibling relationships. The proposed research addresses the methodological limitations of previous research with TGDY and siblings in addition to providing salient avenues for more nuanced understanding of how sibling relationships, family dynamics, and socioenvironmental context relate to TGDY well-being and resiliency. This study provides the necessary background to highlight the need for future programmatic research and potential intervention frameworks

“A victim/survivor needs agency”: Sexual assault survivors’ perceptions of university mandatory reporting policies

In institutions of higher education, mandatory reporting policies require certain employees to report students’ sexual assault disclosures to university officials, even if the student does not want to report. It is commonly assumed that these policies will benefit survivors, but there is a paucity of research to substantiate this assumption. The current study examined college sexual assault survivors’ perceptions of mandatory reporting policies, including three specific policy approaches (Universal, Selective, Student-Directed). Interviews were conducted with 40 college sexual assault survivors and thematic analysis was used to analyze these data. Results found that the mandatory reporting policy approaches that survivors prefer, which limit the number of mandatory reporters and offer more autonomy and flexibility, do not align with the policy approaches most frequently implemented within institutions of higher education (i.e., Universal). Survivors anticipated more harms resulting from mandatory reporting than benefits (e.g., pushing survivors into disclosures before they are ready, increasing stress and anxiety, discouraging help-seeking from trusted sources of support on campus). Survivors lacked substantive knowledge of their university’s mandatory reporting policy. Findings suggest that policy makers at institutional, state, and federal levels should consider survivors’ perspectives when crafting such policies and institutions should increase educational efforts about mandatory reporting

Identifying and addressing barriers to treatment for child sexual abuse survivors and their non-offending caregivers

Mental health treatment is a critical part of an effective and compassionate response to the disclosure of child sexual abuse (CSA). Given the vast negative consequences for children and families following CSA, engagement in treatment can benefit youth and their non-offending caregivers. Yet, these families face unique barriers to treatment initiation, adherence, and effectiveness. The identification of these barriers allows clinicians, researchers, and policy makers to increase treatment utilization, engagement, and value. The current review and its recommendations derive from the existing literature combined with knowledge gained from a clinical research team with more than 20 years of experience offering a treatment program for CSA survivors and their non-offending family members. The review organizes barriers around factors related to individual characteristics of children and caregivers, perceptions and beliefs commonly held following CSA, and challenging family interactions in the context of individual and group treatment for CSA. Finally, barriers related to systemic and societal factors are examined given the importance of understanding the legal and cultural context in which families seek and engage in treatment. Recommendations for further research, suggestions for clinicians, and considerations for policy change to decrease the identified treatment barriers for families impacted by CSA are provided