“Gender Connections” - A Group Visit Model for Gender Minority and Transgender Youth and their Families

Grant Application

Dana L. Rofey, PhD, Division of Adolescent and Young Adult Medicine, Children’s Hospital of Pittsburgh of UPMC and Western Psychiatric Institute and Clinic

Proposed Innovation

Adolescents and young adults who identify as transgender — or who question the gender assigned to them at birth — face many challenges. They often experience difficulties in their relationships with family members, teachers, and friends; endure prejudice, discrimination, and bullying; and feel anxiety and/or depression with their adolescent development. They are at an increased risk for suicide, substance abuse, and other self-destructive behaviors.

Launched in 2011, the Children’s Hospital of Pittsburgh Gender and Sexual Development Program is one of a select few programs offering gender-related care for youth. Since it was created, the volume of referrals has grown from two patients a month to three or four new patients a week. This project piloted an innovative group model — including visits via video chat technology — aimed at enabling more young people and their families to participate and feel connected to a supportive community.

Improvements

The group visit model was created for both youth and their families, with material and talking points addressing such topics as: What does it mean to be transgender? How do I talk to a PCP, dentist, gynecologist, teacher, or other adult professional? How do I overcome school barriers? How do I recognize and deal with bullying? How do I keep my child healthy and safe?

Through this model, a facilitator introduces the topics while youth and family members drive the conversation through brainstorming, sharing experiences, and identifying goals. The group session format encourages peer contact — patient-to-patient, and parent-to-parent — in a setting where participants feel comfortable and free to discuss difficult topics.

Outcomes

The group visit was designed to relieve isolation by introducing more gender minority and transgender youth and their families to their peers — all of whom are trailblazers in today’s society. The pilot project proved successful with the majority of participating youth showing an improvement in depressive symptoms, peer relationships, and ability to communicate with parents. All participants endorsed the group visit model as being “the most helpful thing I’ve ever participated in.”

This model is now a clinical service through Children’s Hospital of Pittsburgh Adolescent and Young Adult Medicine Clinic. Participants continue to have contact with the two original facilitators (even those now in college) and group attendance is stellar. A manual and treatment plan has been developed for implementation and another version is being adapted for younger youth and their families. It is expected to serve as a national model for transgender care.