(PS6-4) It Made Me Feel More Empowered: Sex and Relationship Education in Therapy with Trans and Gender Diverse Adolescents

Abstract Text: Healthy relationship development is critical for adolescents’ social-emotional wellbeing, and rapidly shifting social structures and peer relationships can be challenging to navigate concurrently with adolescent identity development (Kenny et al., 2013; Roach, 2018). This can be particularly complex for transgender and gender diverse (TGD) youth given the nature of these developmental tasks alongside navigating safety, access to affirming spaces, and limited availability of queer-inclusive education in a shifting political landscape (Levitt & Ippolito, 2014; Xing et al., 2015). The positive psychosocial impacts of comprehensive sex education and the relevance of discussing relationships in therapy with adolescents situate mental health providers well to address some of the gaps in knowledge and access to resources that youth, particularly TGD youth, face. However, there is extremely limited research on the experiences of TGD adolescents navigating sexuality and relationship development, and even less research on how to engage TGD adolescents in these discussions in a supportive, affirming, and evidence-based way. This study aimed to fill some of these gaps by characterizing TGD adolescents’ experiences navigating sexuality and relationships and understanding the perspectives of both TGD adolescents and affirming mental health providers on discussing these topics in therapy.
Semi-structured qualitative interviews were conducted with TGD adolescents ages 15-18 (n = 14) and affirming mental health providers (n = 20) aiming to understand TGD adolescents’ experiences navigating sexuality and relationships and all participants’ perspectives on engaging in sexuality- and relationship-focused conversations in therapy. Data were analyzed using reflexive thematic analysis to better understand participants’ perspectives. Four overarching themes were identified: Cisnormativity and Transphobia as Drivers of Fear and Inequity, Community Connectedness as Protective, Power Imbalance and Empowerment in Therapy, and One-Size-Fits-None. Findings were then used to form several recommendations for clinical practice which will be presented.
Findings provide a deeper understanding of TGD adolescents’ experiences and perceptions of the utility of receiving support from mental health providers in navigating sexuality and relationship development. Further, they provide insight into the experiences and perspectives of affirming mental health providers and by integrating these perspectives, allow for consideration of applications to clinical practice, research, and policy which will be presented. These results highlight the critical need for comprehensive sex and relationship education and its implications for all youth and the importance of applying research to inform affirming therapy practices.