A Pilot Test of a Text Message-Based Transgender and Nonbinary Affirmative Cognitive-Behavioral Intervention for Anxiety and Depression

摘要

Transgender and nonbinary (TNB) people report experiencing elevated rates of discrimination and psychological distress (James et al., 2016). Transgender-affirming interventions are recommended to address psychological distress (e.g., anxiety, depression) reported by TNB individuals (Craig & Austin, 2016). TNB people in rural areas report barriers (e.g., lack of financial resources, long commutes) to accessing affirmative and/or quality treatment (Knutson, Koch, Arthur, Mitchell, & Martyr, 2017). Electronically delivered interventions, if found to be effective, could be used to reduce barriers and increase the accessibility of affirmative care to TNB people, especially people in remote areas and during pandemics such as the 2019 novel coronavirus (COVID-19). The current study presents pilot feasibility data examining a 6-month transgender-affirmative intervention based on short message service (SMS). Participants (N=14) were 18 years old or older and identified as transgender and/or nonbinary. Anxiety, depression, and social support were assessed at pre- and posttreatment and at 3-month follow up. Anxiety, t(13)=2.95, p = .01, d=0.40, and depression, t(13)=2.76, p < .05, d=0.73, decreased significantly from pre- to postintervention. Anxiety, t(13)=3.26. p = .01, d=0.65, further decreased from preintervention to follow-up, and social support, t(13)=-2.45, p < .05, d=0.29, increased from preintervention to follow-up. The intervention demonstrated good feasibility and acceptability, based on participant feedback. We discuss the implications of our results for technology-based TNB-affirmative care for individuals, as well as future directions for research.