A patient-centered model of mental health care for trauma and minority stress in transgender and gender diverse people

A bottom-up network analysis

Bibliographic Data

ID13088864
AuthorsAnna C Salomaa (0000-0003-4033-4083, VA Boston Healthcare System, corresponding author), Danielle S Berke (0000-0003-2754-0683, Hunter College), Kelly Harper (0000-0003-4504-6232), Sarah E Valentine (0000-0002-4856-9269, Boston Medical Center), Sarah Valentine (0000-0002-3786-3833), Colleen A Sloan (0000-0002-6591-7309, VA Boston Healthcare System), Zig Hinds (0000-0001-9980-2502, VA Boston Healthcare System), Lisa Gyuro (VA Boston Healthcare System), Cara Herbitter (0000-0002-5019-0442, VA Boston Healthcare System), William T Bryant (0000-0003-0957-5938, Ralph H. Johnson VA Medical Center), Jillian C Shipherd (0000-0001-6742-7912, VA Boston Healthcare System), Nicholas A Livingston (0000-0001-5671-3200, VA Boston Healthcare System)
Year2024
Volume12
Issue4
Pages578-588
Publication date2024-02-08
Peer ReviewedYes
Open AccessYes
TypeARTICLE
VenuePsychology of Sexual Orientation and Gender Diversity (JOURNAL)
Journal identifiersISSN: 2329-0382 • E-ISSN: 2329-0390
PublisherAmerican Psychological Association (PUBLISHER • US)
DOI10.1037/sgd0000705
PMID38765785
OpenAlexW4391643253
LanguageEN
References cited13

Transgender and gender diverse (TGD) individuals are disproportionately exposed to traumatic and high-impact minority stressors which can produce an array of transdiagnostic symptoms. Some clinical presentations align well with established evidence-based treatments, but others may require patient-centered modifications or combined approaches to address treatment needs. In this study, we employed a novel, bottom-up approach to derive insights into preferred intervention strategies for a broad range of trauma- and TGD-minority stress-related expressions of clinical distress. Participants (18 TGD individuals, 16 providers) completed a q-sort task by first sorting cards featuring traumatic experiences and/or minority stressors and transdiagnostic psychiatric symptoms into groups based on perceived similarity. Next, participants sorted interventions they believed to be most relevant for addressing these concerns/symptoms. We overlayed networks of stressors and symptoms with intervention networks to evaluate preferred intervention strategies. TGD networks revealed transdiagnostic clustering of intervention strategies and uniquely positioned the expectancy of future harm as a traumatic stressor. Provider networks were more granular in structure; both groups surprisingly emphasized the role of self-defense as intervention. While both networks had high overlap, their discrepancies highlight patient perspectives that practical, material, and structural changes should occur alongside traditional clinical interventions

Distress · Intervention (counseling · Mental health · Minority stress · Psychiatry · Psychological intervention · Sexual minority · Sexual orientation · Stressor · Transgender · Traumatic stress · Clinical Psychology · LGBTQ Health, Identity, and Policy · Mental Health Research Topics · Psychology · Psychotherapy Techniques and Applications · Social Psychology

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