Department of Psychology, Harvard University.
Department of Psychology, University of California, Los Angeles.
J Consult Clin Psychol. 2020 Dec;88(12):1053-1064. doi: 10.1037/ccp0000597.
Gender minority youth (i.e., children/adolescents whose gender identity and/or expression is inconsistent with their birth-assigned sex) experience elevated rates of emotional and behavioral problems relative to cisgender youth (who identify with their birth-assigned sex), which are not intrinsic to gender identity but attributable to unique minority stressors. Although empirically supported treatments have proven effective in treating these mental health concerns generally, randomized controlled trials have not examined effects for gender minority youth.
To address this gap, we pooled data from clinically referred youth (N = 432; M(SD)age = 10.6(2.2); 55.1% White) assigned to empirically supported treatment conditions across four previous randomized controlled trials of modular psychotherapy. A proxy indicator of gender identity (i.e., youth's wish to be the opposite sex) was used to classify gender minority (n = 64) and cisgender (n = 368) youth. Youth- and caregiver-reported pretreatment internalizing and externalizing problems, treatment effectiveness on these domains, and treatment acceptability were compared across groups.
Gender minority youth reported more severe pretreatment internalizing and externalizing problems compared to cisgender youth; in contrast, their caregivers reported less severe problems. Although treatment was equally effective for both groups on most outcomes, gender minority youth's caregiver-reported externalizing problems improved more slowly and less reliably, and their self-reported internalizing problems were more likely to remain clinically elevated. Furthermore, gender minority youth reported lower treatment satisfaction.
While findings suggest that empirically supported treatments may effectively address many mental health problems for gender minority youth, they also underscore the need for treatment enhancements that improve acceptability and outcomes. (PsycInfo Database Record (c) 2020 APA, all rights reserved).
性别少数群体青年（即，其性别认同和/或表达与出生时分配的性别不一致的儿童/青少年）经历的情绪和行为问题的发生率高于顺性别青年（认同其出生时分配的性别的人），这些问题不是性别认同所固有的，而是归因于独特的少数群体压力源。尽管经验支持的治疗方法已被证明对治疗这些心理健康问题通常有效，但随机对照试验并未研究性别少数群体青年的效果。
为了解决这一差距，我们汇总了来自临床转介青年的数据（N=432；M（SD）年龄=10.6（2.2）；55.1%为白人），他们被分配到四项先前关于模块心理治疗的随机对照试验中的经验支持的治疗条件。使用性别认同的代理指标（即，青年希望成为异性）来对性别少数群体（n=64）和顺性别群体（n=368）青年进行分类。比较了不同组别的青年和照顾者报告的治疗前内化和外化问题、这些领域的治疗效果以及治疗的可接受性。
与顺性别青年相比，性别少数群体青年报告了更严重的治疗前内化和外化问题；相反，他们的照顾者报告了较轻的问题。尽管治疗对大多数结果对两组都同样有效，但性别少数群体青年的照顾者报告的外化问题改善得更慢、更不可靠，他们的自我报告的内化问题更有可能保持临床升高。此外，性别少数群体青年报告的治疗满意度较低。
虽然研究结果表明，经验支持的治疗方法可能有效地解决性别少数群体青年的许多心理健康问题，但也强调了需要改进治疗方法，以提高可接受性和治疗效果。
