(PS6-20) Enhancing Competency in Gender-Affirming Mental Health Approaches for Youth: Evaluating the Impact of Intensive Training for Behavioral Health Providers

Abstract Text: Behavioral health providers (BHP) play a critical role in delivering gender-affirming care, yet many lack formal training in this area. Many BHP in community outpatient settings receive varying levels of diversity and inclusion training, shaped by differing accreditation requirements across graduate programs. While some programs mandate dedicated coursework, others rely on workshops or other trainings, leading to inconsistencies in training content. A critical gap exists in specialized training for gender diverse individuals, including transgender, non-binary, and gender nonconforming populations—who are at increased risk for mental health concerns. Additionally, policies surrounding gender-affirming care in the U.S. remain inconsistent, creating barriers to access and forcing many youth and families to relocate in search of appropriate services. Providers often seek post-graduate training that primarily focuses on symptomatology rather than gender minority stress, with limited consultative support. As such, this study examined the effectiveness of a six-month intensive training program aimed at increasing outpatient BHS’ knowledge, skills, and confidence in working with gender-diverse youth.

Ten BHP from a pediatric academic medical center participated (100% identified as cisgender, 90% White/European-American), all of which had more than 6 years of behavioral health training experiences, including their graduate school training. The training utilized multiple forms of learning including didactics, vignettes, independent education, live observation of psychosocial evaluations within a gender clinic, and individual and group consultation for current gender diverse patients.

A set of questions was created by the trainer to assess providers' knowledge, skills, and case conceptualization abilities related to gender-affirming care. These questions were administered before and after the training to measure self-reported changes in knowledge, including requirements for services like hormone therapy, service limits, and legal responsibilities. Providers also self-reported their awareness and ability to provide gender-affirming approaches to mental health care and had the chance to practice identifying clinical steps for case conceptualization.

Pre-training assessments revealed that 80% of providers had minimal experience with gender-diverse youth, and 60% self-identified low competency in assessing gender dysphoria and co-occurring diagnoses. Post-training, 80% reported increased clinical experience, 100% self-identified greater competence in applying WPATH Standards of Care, and significant improvements were found across multiple self-reported measures, including therapeutic confidence and intersectional identity application (all p < .01). Knowledge-based assessments showed an increase in correct knowledge- based responses from pre to post. Qualitative data indicated a shift from general conceptualizations to more specific, socioecological interventions. These findings suggest that structured, intensive training significantly enhances provider competency in gender-affirming care, highlighting the need for expanded educational efforts in clinical settings.