Development and Feasibility Trial of Online Peer Support for Parents of Gender Diverse Youth

摘要 性别多元化青年（GDY）是指那些在性别认同和性别分配之间存在不一致的人， 出生与顺性别（非性别多样性）相比，这一人群面临着显着的心理健康不平等 青年，包括抑郁症和自杀意念的增加率。研究表明，父母的肯定， 或者父母支持孩子的性别认同，可以减少这些健康不平等，但没有证据表明- 基于策略，以帮助父母肯定他们的GDY。对父母来说，肯定是一个挑战， 文献表明，外部经验，如连通性和歧视，以及内部经验， 恐惧和耻辱等经历可能会影响这些挑战。此外，现有支持也有局限性， 为父母建立的制度，包括地理因素，因为大多数聚会团体或机会都在城市 中心，和社会压力，因为许多父母感到不堪重负，在大集团设置。在线支持 计划有可能克服这些障碍，并允许1：1的家长同行指导，这有 在其他儿科患者人群中显示出成功，以及对GDY及其家庭的潜力。然而，在这方面， 有必要增加家长参与的研究，以了解父母因素与 肯定。需要这些数据来制定可接受和可行的有效在线支持计划 帮助父母确认GDY。本研究的中心假设是，一个在线的1：1父母同伴支持 该计划将导致增加父母的肯定和改善健康结果的GDY。K23项目将： 1)调查了美国不同地理和种族的GDY父母的横截面， 了解与肯定相关的因素，2）设计一个知情的在线支持干预措施 为GDY的父母提供1：1的父母同伴指导，以及3）试点测试在线支持干预， 可行性和可接受性。实现这些目标，除了职业发展计划，包括 课程，研讨会和领导力发展，将允许申请人在全国范围内的学术成长 代表性调查、研究者参与的干预开发、临床试验和研究计划 领导，并将进一步推动申请人向独立过渡。这些目标还将提供 进行未来R 01随机对照试验以评价利益相关者有效性的必要数据- 设计了在线1：1家长同伴指导干预，以提高家长对GDY的肯定，最终帮助 改善这一弱势群体的健康公平性。

ABSTRACT Gender diverse youth (GDY) are those with incongruence between their gender identity and sex assigned at birth. This population faces significant mental health inequities compared to cisgender (not gender diverse) youth, including increased rates of depression and suicidal ideation. Research suggests that parent affirmation, or parents supporting their child’s gender identity, can reduce these health inequities, but there are no evidence- based strategies to help parents affirm their GDY. Being affirming can be challenging for parents, and current literature indicates that both external experiences, like connectedness and discrimination, and internal experiences, like fear and stigma, may shape these challenges. Further, there are limitations to existing support systems for parents including geographical considerations, as most groups or opportunities to meet are in urban centers, and social pressure, as many parents feel overwhelmed in large group settings. Online support programs have the potential to overcome these barriers and allow for 1:1 parent peer mentoring, which has shown success in other pediatric patient populations as well as potential for GDY and their families. However, there is a need for increased stakeholder-engaged research to understand parent factors associated with being affirming. Such data are needed to develop acceptable and feasible online support programs that are effective at aiding parents to affirm GDY. The central hypothesis of this research is that an online 1:1 parent peer support program will lead to increased parent affirmation and improved health outcomes for GDY. This K23 project will: 1) survey a geographically and racially diverse cross-section of parents of GDY in the United States to better understand factors associated with being affirming, 2) design a stakeholder-informed online support intervention featuring 1:1 parent peer mentoring for parents of GDY, and 3) pilot test the online support intervention for feasibility and acceptability. Conduct of these aims, in addition to a career development plan inclusive of coursework, workshops, and leadership development, will allow for the applicant’s academic growth in nationally representative surveys, stakeholder-engaged intervention development, clinical trials, and research program leadership, and will further advance the applicant’s transition to independence. These aims also will provide the necessary data to conduct a future R01 randomized control trial to evaluate the effectiveness of the stakeholder- designed online 1:1 parent peer mentoring intervention to improve parent affirmation of GDY, ultimately helping to improve health equity for this vulnerable population.