3 - (IOP 30) Design and Methodological Recommendations for Implementation Research to Enhance Mental Health Equity Among Transgender Youth

Background: The mental health of transgender youth in the United States is being adversely affected by an increase in transphobic rhetoric and restrictive legislation. These include bans on school sports participation and denial of gender-affirming care. Such conditions exacerbate the mental health risks for this already vulnerable population, highlighting a critical need for dissemination and implementation (D&I) research addressing
multilevel transphobia.

Methods: This literature review synthesizes studies on the impact of multilevel transphobia on the mental health of transgender youth, alongside the benefits of gender-affirming services. Drawing on this literature base and cutting-edge health equity studies, we provide concrete guidance for implementation researchers committed to enhancing mental health services for this group.

Results: Research method recommendations span two primary areas of implementation research: (1) developing, testing, and scaling effective services; and (2) addressing systemic barriers, particularly in policy and access to care. Across these domains, we provide guidance and exemplar studies for using recommended methods: community-engaged research, transdisciplinary partnerships, policy dissemination research, and
online intervention research. The review details methodological approaches and exemplar studies that demonstrate the utility of implementation science in overcoming both structural and practical barriers to care for transgender youth.

Conclusions: To advance mental health equity for transgender youth, it is imperative to utilize implementation science for developing and scaling promising and effective mental health interventions. Our review calls for rigorous research aimed at overcoming policy barriers and enhancing service delivery through community-engagement and innovative solutions like online interventions. These research designs and methods can be generalized to address other health inequities.