An Interdisciplinary Model for Meeting the Mental Health Needs of Transgender Adolescents and Young Adults: The Mount Sinai Adolescent Health Center Approach

Abstract

Transgender and gender nonconforming (TGNC) adolescents and young adults face significant mental health disparities, including increased rates of suicidality, depression, and self-harm. These disparities are multidetermined and stem, in part, from the emotional consequences of family rejection, peer and community victimization, social isolation, and discrimination and transphobia in both daily settings (e.g., school) and society as a whole. In order to meet the mental health needs of TGNC youth, we must intervene in multiple levels of youths’ lives and provide gender-affirming evidence-based therapies. In this paper, we describe an integrated model of meeting the mental health needs of TGNC youth, with the ultimate goal of reducing mental health disparities. We provide guidance for macro-level interventions, including efforts to implement social change; mezzo-level interventions, including structuring a health care setting to be gender-affirming; and micro-level interventions, including gender-affirming dialectical behavior therapy, cognitive behavioral therapy, family therapy and support group interventions. Throughout, we highlight our descriptions of interventions with case examples in order to provide additional practical guidance.