# Development of a Training Intervention to Improve Mental Health Treatment for Gender Minority Youth: Administrative Supplement

> **NIH NIH K23** · BOSTON COLLEGE · 2024 · $77,500

## Abstract

PROJECT ABSTRACT
Transgender youth are 2-3 times more likely to be diagnosed with depression or anxiety and 6 times more
likely to attempt suicide relative to cisgender youth. These mental health inequities are exacerbated by mental
healthcare barriers, such as discrimination. Negative mental healthcare experiences are associated with lower
treatment engagement for transgender youth, including high dropout and low satisfaction. Conversely, mental
healthcare that is gender-affirming - that which addresses the needs and experiences of transgender people -
is associated with strong treatment engagement and better outcomes, relative to non-affirming treatments.
Despite the positive impacts of gender-affirming mental healthcare, it is rarely provided. To address this void in
mental healthcare, we developed and pilot-tested Gender-Affirming Psychotherapy (GAP), an
intervention consisting of research-informed principles and skills that augment mental health
treatment to address transgender youth’s needs. Examples of intervention skills include: using affirmed
names, using preferred pronouns, and avoiding invasive questions. In a pilot trial situated in a medium-sized
mental health clinic (K23MH124670), GAP demonstrated strong acceptability, feasibility, and appropriateness.
A 10-hour implementation package (i.e., combination of strategies) encompassed within a self-paced online
training, was also delivered across 2 months. The package included 5 discrete implementation strategies: (1)
didactics, (2) patient stories, (3) practice, (4) incentives, and (5) an organizational support message. It
demonstrated acceptability and feasibility, and was effective in improving provider attitudes, knowledge,
self-efficacy (implementation mechanisms) and GAP adoption (implementation outcome). As the next step in
efficiently and pragmatically promoting mental health equity for transgender youth, we will conduct a trial to
optimize an implementation package to increase GAP adoption in large healthcare systems in places
with varying transphobia levels. In Aim 1, we will validate the conceptual model of GAP implementation and
effectiveness for large healthcare systems, using data from n=726 providers and n=1071 transgender patients
from two large healthcare systems. In Aim 2, we will identify an optimized GAP implementation package, which
will be the package with the fewest costs relative to implementation success. Finally, in Aim 3, we will explore
structural transphobia as a moderator of GAP implementation and effectiveness to determine whether GAP
implementation and/or intervention needs differ in high (vs. low) structural transphobia regions.

## Key facts

- **NIH application ID:** 11055688
- **Project number:** 3K23MH124670-03S1
- **Recipient organization:** BOSTON COLLEGE
- **Principal Investigator:** Maggi Price
- **Activity code:** K23 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2024
- **Award amount:** $77,500
- **Award type:** 3
- **Project period:** 2021-09-01 → 2025-08-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/11055688

## Citation

> US National Institutes of Health, RePORTER application 11055688, Development of a Training Intervention to Improve Mental Health Treatment for Gender Minority Youth: Administrative Supplement (3K23MH124670-03S1). Retrieved via AI Analytics 2026-06-01 from https://api.ai-analytics.org/grant/nih/11055688. Licensed CC0.

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