Family-Based Interventions with Transgender and Gender Expansive Youth: Systematic Review and Best Practice Recommendations

Jean Malpas; Michael J Pellicane; Elizabeth Glaeser

doi:10.1089/trgh.2020.0165

Family-Based Interventions with Transgender and Gender Expansive Youth: Systematic Review and Best Practice Recommendations

Transgend Health. 2022 Feb 14;7(1):7-29. doi: 10.1089/trgh.2020.0165. eCollection 2022 Feb.

Authors

Jean Malpas^{1

2}, Michael J Pellicane^{1

3}, Elizabeth Glaeser^{1

4}

Affiliations

¹ The Gender & Family Project, Ackerman Institute for the Family, New York, New York, USA.
² Private Practice, New York, New York, USA.
³ Department of Psychological Sciences, Kent State University, Kent, Ohio, USA.
⁴ Department of Counseling Psychology, Teachers College Columbia University, New York, New York, USA.

Abstract

Research on transgender and gender expansive (TGE) youth has highlighted the disproportionate and challenging mental health and developmental outcomes faced by these young people. Research also largely suggests that family acceptance of TGE youth's gender identity and expression is crucial to preventing poor psychosocial outcomes in this community. Recently, family-based treatment has become common practice with TGE youth whose families are available for care, but it is unclear whether research provides outcome data for family interventions with TGE youth. This study follows Preferred Systematic Reviews and Meta-Analyses (PRISMA) guidelines to systematically review articles that provide outcome data or clinical recommendations for family-based interventions with TGE youth and their families. No quantitative outcome data for family therapy with TGE youth were found, but numerous articles spanning decades (n=32) provided clinical practice recommendations for family-based interventions with this population. Very few articles provided outcome data for family therapy with sexual minority youth (n=2). Over time, clinical strategies have moved from pathologizing to affirming of TGE youths' gender journey. Common clinical strategies of affirming interventions include (1) providing psychoeducation, (2) allowing space for families to express reactions to their child's gender, (3) emphasizing the protective power of family acceptance, (4) utilizing multiple modalities of support, (5) giving families opportunities for allyship and advocacy, (6) connecting families to TGE community resources, and (7) centering intersectional approaches and concerns. Future research should examine the efficacy of family-based interventions that incorporate these clinical strategies and collect quantitative data to systematically determine their effect on psychosocial outcomes.

Keywords: best practice recommendations; family acceptance; family support; family therapy; gender nonbinary; psychoeducation; systematic review; transgender; youth.

Publication types

Review