Improving Mental Health Among Transgender Adolescents: Implementing Mindful Self-Compassion for Teens
4 months ago 4 months agoYouthREX Research Summaries ask Just Six Questions of research publications on key youth issues. These summaries get at what the youth sector needs to know in two pages or less!
1. What is the research about?
Transgender youth often face mental health challenges at an alarmingly higher rate than their cisgender (non-transgender) peers.
The Minority Stress Theory describes how minority groups experience different stressors — distal (external) and proximal (internal or relating to one’s subjective perceptions) – that can contribute to poor mental health. Gender dysphoria – experienced as the mismatch between one’s identified gender and the gender that one was assigned at birth – causes transgender youth to experience these stressors in their day-to-day lives; for example, being misgendered or not being able to access safe bathrooms (distal), or experiencing internalized transphobia (proximal). The daily discrimination and violence faced by transgender youth can result in depression and suicidal ideation, which can be predicted for youth who experience an unmet need for acceptance and belonging (referred to as thwarted belongingness) and the feeling that they are a burden to others (referred to as perceived burdensomeness).
Researchers explored self-compassion as an identifiable personal resource that can help to buffer the stressors that transgender youth face, focusing on Mindful Self Compassion for Teens, an eight-week program that has reported increased benefits in resilience and decreased anxiety, depression, and stress, but that has not yet been studied with transgender youth. This research looked at how the program could improve psychological outcomes for transgender youth.
2. Where did the research take place?
The research took place in the United States.
3. Who is this research about?
This research is about youth, 13-17-years-old, who identify as transgender or gender expansive (identifying with a gender different than the sex assigned at birth and not identifying with binary constructions of gender). Because roughly half of transgender youth will experience depression, and around half of those youth will experience symptoms of suicidal ideation, targeting participants for this research was vital to understanding how transgender youth experience mental health and wellbeing.
“I’d say the biggest issue that trans people have, particularly transgender teenagers… is self-compassion. It feels like they have no self-compassion because it feels impossible to love yourself whenever it feels like you’re not even yourself. But I’d say that this class really does kind of help with that. It helps you kind of find yourself and it helps you grow along with yourself” (p. 292).
4. How was this research done?
Participants were recruited from Canada and the United States through social media and through flyers that were also shared with advocacy organizations, community psychologists, and therapists.
The Mindful Self-Compassion for Teens program was delivered over eight sessions on Zoom. Although COVID-19 restrictions forced program delivery to take place online, researchers were interested in understanding how participants would experience this program in an online setting. Participants were divided into three cohorts. Each session of the program had a different theme relating to self-compassion and exploring avenues to introducing self-compassion into the participants’ everyday lives.
A mixed methods design enabled researchers to use more than one approach to data collection:
- an online pre-intervention survey (administered before participants engaged in the program);
- an online post-intervention survey (administered after participants engaged in the program);
- online recorded semi-structured post-intervention interviews (performed one-on-one for participants to share their feedback); and
- an online three-month follow-up survey.
The pre- and post-intervention surveys and the three-month follow-up survey included six questionnaires; each used a different scale to measure psychosocial outcomes such as depression, anxiety, life satisfaction, self-compassion, interpersonal needs, and resilience.
Data collected from the 26 youth who participated in all three surveys were reviewed and analyzed.
5. What are the key findings?
As a result of participation in the Mindful Self-Compassion for Teens program:
- self-compassion among participants increased;
- experiences of depression, anxiety, and perceived burdensomeness decreased;
- thwarted belongingness decreased (primarily in the months that followed the program); and
- resilience increased.
Four overarching themes describing participant experiences emerged:
i) Virtual safe space: The creation of a safe space was vital to participants feeling comfortable and reassured; they experienced a sense of togetherness through their connections to one another and to supportive instructors. The virtual setting increased feelings of a safe space, as participants had access to comfort items from their daily lives and could choose platform features to participate in whatever ways were most comfortable (i.e., turning off the camera, using the chat function, etc.).
ii) Connection to body: Part of the program asks participants to connect to their body through body scans, appreciation for one’s body, supportive touches, and mindful walking. However, given that some transgender youth experience body dysmorphia, instructors opted out of introducing the body scan and opted into practices that encouraged body kindness and awareness. Some participants shared that bringing awareness to the body helped promote feelings of calmness and others felt that using supportive touch during stressful moments helped to process difficult feelings.
iii) Personal growth: Participants shared that they developed a new coping strategy that involved talking to themselves like a good friend would, which helped them to recognize and accept their emotional states. Others shared that their perspective on themselves and their lives had changed, with increased feelings of self-worth, belonging, and life satisfaction. The introduction of the Japanese art of kintsugi helped participants acknowledge their self-worth by recognizing that their flaws are made beautiful by the challenges they experience.
iv) Meeting specific needs of transgender youth: Participants suggested changes to tailor the program to transgender youth, including ensuring:
- at least one transgender instructor for representation, relatability, and role modeling;
- weekly session introductions, as identities and pronouns can fluctuate from week to week;
- participation from trans elders;
- instructors connect with participants individually before the program to discuss potential challenges or triggers;
- clear online protocols from the first session regarding expectations of appearing on camera and the use of other platform features.
Overall, participants felt able to share valuable experiences with other transgender youth, felt connected to instructors in a way that fostered empowerment and understanding, and felt the program created a space where transgender youth can get to know themselves better.
6. Why does it matter for youth work?
As self-compassion encourages self-acceptance, emotional regulation, and connection to others in the context of painful experiences, increasing self-compassion can be an effective approach to addressing the mental health concerns that transgender youth experience. Transgender youth are largely underrepresented in research, however, particularly mental health research, and more focus and dedication are needed to develop effective mental health programming for transgender youth to combat the violence, discrimination, and stressors that they face in their day to day lives.
Although self-compassion approaches can be used to support individual trans youth, violence, discrimination, and stressors are systemic in nature and transcend generalized intervention methods. Ensuring a focus on shifting the systemic forces of oppression for diverse young people will help to promote broader conversations about the mental health of transgender youth and support the creation of environments that are inclusive, safe, and affirming.
Bluth, K., Lathern, C., Clepper-Faith, M., Larson, L. M., Ogunbamowo, D. O., & Pflum, S. (2023). Improving mental health among transgender adolescents: Implementing mindful self-compassion for teens. Journal of Adolescent Research, 38(2), 271-302.
Categorised in: Research Summary