(PS9-59) Preliminary Findings from an Affirming Cognitive-behavioral Therapy Protocol: A Clinical Trial in Partnership with Transgender and Gender Diverse Communities

Mental health disparities faced by transgender and gender diverse (TGD) individuals, including higher rates of depression, anxiety, and suicidality, and the ability of affirming psychotherapy to ameliorate these disparities, underscore the need for evidence-based mental health interventions tailored to the needs of these communities. Hope and colleagues (2022) published adaptations of care developed in partnership with TGD community members to offer guidance on providing affirming services for TGD clients. However, the pairing of these adaptations with evidence-based protocols has yet to be evaluated. The present study is the first to assess the application of these adaptations of care to a well-established cognitive-behavioral therapy (CBT) protocol for depression and anxiety through a clinical trial.

The current study analyzed data collected from 24 TGD adults between the ages of 19-68 years (M = 27.38, SD = 12.69) who participated in the clinical trial. Participants were randomly assigned to either immediate treatment (n = 17), in which they completed a 12-session weekly CBT protocol, or a waitlist control group (n = 7) in which they were asked to delay treatment for 12 weeks before beginning the protocol. During the waitlist condition, therapists completed check-ins with the participants biweekly. All participants completed measures related to their mental health and wellbeing at various timepoints (i.e., every 4 weeks during waitlist and treatment and 3 months post-treatment). The present study analyzed preliminary data related to anxiety, depression, and life satisfaction from 20 participants who have completed measures throughout 12 weeks of participation.

Quantitative analyses demonstrate significant improvements in life satisfaction among the treatment group compared to the waitlist control [F (1, 20) = .010, p < .001]. Repeated measures ANOVA show non-significant differences between the treatment and control groups on changes of anxiety and depression measures. However, only the treatment condition showed significant changes in symptoms of depression [t(15) = 5.77, p < .001] and anxiety [t(15) = 3.78, p < .001] from baseline to end-of-treatment, whereas change in the control condition was non-significant. Among all who completed treatment, there were significant differences in anxiety [t(20) = 3.37, p < .01], depression [t(19) = 5.46, p < .001], and life satisfaction [t(20) = -2.24, p < .05] scores from baseline to end-of-treatment.

The findings from the present study suggest that applying the adaptations of care to a CBT protocol for TGD adults is effective in improving life satisfaction and provide preliminary evidence that the adapted protocol is effective in reducing symptoms of anxiety and depression. Additionally, these preliminary analyses provide insight into the unique aspects of conducting a clinical trial with TGD communities, which will be discussed further.