5 - (IOP 31) A Qualitative Study on Parent-related Determinants to Affirming Mental Health Therapy with Transgender Youth

Background: Parents influence youths’ therapy access, engagement, and effectiveness, through factors, like attitudes about therapy, treatment protocols adherence, and willingness to engage in therapy. For transgender youth, parents play a powerful role in youths’ access to affirming mental health therapy–which supports a patient's gender identity and is linked with enhanced treatment engagement. However, there is little information about how parents influence therapists’ adoption of affirming therapy practices, which may play a pivotal role in transgender youth’s therapy engagement and outcomes.

Objective: Understand how parents influence therapist adoption of affirming practices and offer research-guided recommendations to mitigate barriers.

Methods: This study represents a portion of a larger project evaluating a training to promote Gender-Affirming Psychotherapy (GAP; evidence-informed treatment tailoring approach for working with transgender clients) adoption among mental health therapists. Open-ended questions about determinants to adoption were administered to therapists (N=39) post-training; a subsample (N=16) completed semi-structured interviews on adoption three-month post-training. Interviews on therapist adoption with transgender youth (N=6) treated by trained therapists and their parents (N=3) were conducted seven-months post-training. Survey responses and interview transcripts were analyzed via rapid and traditional content analysis to identify parent-related determinants of affirming practice adoption.

Results: Nineteen parent-related determinants of therapist affirming practice adoption reflected 6 themes: parents’ beliefs about gender or affirming therapy; parents’ emotions; parents’ knowledge about gender or affirming therapy; parents’ therapy participation; family dynamics; and family finances. Of these, 3 were solely barriers (emotions, family dynamics, finances) and 3 were barriers and facilitators (beliefs, knowledge, and participation).

Discussion: We offer six theme-linked recommendations for therapists working with parents to enhance their adoption of affirming practices: expose parents to transgender people and their experiences, train parents in gender affirmation, debunk misinformation, connect parents with support groups, enhance skills in navigating parent-child disagreements (e.g., via training), and provide sliding-scale payment.