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Working with Transgender and Gender Diverse Youth: Navigating the Current Political Climate, Clinical Practice Guidelines, and Ethical Considerations

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1.  In a recent study, what percentage of youth who initiated gender-affirming medical treatment re-identified with their birth sex upon follow-up? 47% 24% 4% 1%

2.  How does anti-trans legislation impact the mental health of transgender and gender-diverse youth? Anti-trans legislation contributes to increased mental health symptoms, increased physical health symptoms, increased non-disclosure of identity, and reduced access to healthcare. Anti-trans legislation results in increased social supports as schools and communities rally around trans youth. Anti-trans legislation results in improved mental health as a result of reduced access to gender-affirming treatment. Anti-trans legislation does not have any correlation to the mental health of TGD youth.

3.  How does Minority Stress Theory conceptualize the development of mental health problems in trans and gender-diverse individuals? Distal stress factors, such as negative expectations, have both a direct and indirect effect on mental health outcomes, with the indirect effect being mediated by proximal stress factors such as low self-esteem. Proximal stress factors, such as depression, have both a direct and indirect effect on mental health outcomes, with the indirect effect being mediated by distal stress factors such as suicidal ideation. Distal stress factors, such as discrimination, have both a direct and indirect effect on mental health outcomes, with the indirect effect being mediated by proximal stress factors such as internalized transphobia. Proximal stress factors, such as internalized transphobia, have both a direct and indirect effect on mental health outcomes, with the indirect effect being mediated by distal stress factors such as discrimination.

4.  Which of the following are protective factors against emotional distress in trans and gender-diverse youth? gender-affirming treatment, trans legislation, mental health treatment mental health treatment, peer support, family support gender-affirming treatment, peer support, family support diagnosis of gender dysphoria, peer support, family support

5.  Which statement best summarizes research findings on gender-affirming treatment for trans and gender-diverse adolescents? Studies primarily find that various gender-affirming interventions for adolescents result in improved psychological outcomes and treatment satisfaction. Studies primarily find that only puberty blockers, but not hormones or surgery, result in improved psychological outcomes and treatment satisfaction. Studies primarily find that gender-affirming interventions for adolescents result in improved psychological outcomes but reduced treatment satisfaction. Studies primarily find that gender-affirming interventions for adolescents result in treatment satisfaction but reduced psychological outcomes.

6.  Which of the following presentations is commonly seen in trans and gender diverse youth, and is important for providers to receive training in? paraphilia autism and neurodiversity psychosis none of the above

7.  Which of the following is NOT a way in which families and schools should support trans and gender-diverse youth? create loosely enforced anti-bullying measures provide opportunities to explore medical transition options if indicated Use the youth’s name and pronouns correctly support the youth in connecting with LGBT community

8.  Which of the following interventions would be unethical to implement when working with trans and gender-diverse youth? Acceptance and Commitment Therapy Trans-Affirmative Narrative Therapy surgical interventions reparative therapy

9.  Which of the following is an ethical argument related to withholding gender-affirming medical intervention from trans and gender-diverse adolescents? withholding treatment is ethical because adolescents cannot consent to medical intervention. withholding treatment is not a neutral action and can cause harm to the adolescent. withholding treatment always benefits adolescents as it is in compliance with the ethical principle of non-maleficence. none of the above.

10.  Which of the following non-medical interventions can be provided to support transition in youth? hormones and surgery puberty blockers and tucking binding and tucking drag and ballroom

11.  Which of the following is NOT an intervention provided to families of trans and gender-diverse youth? pathologizing psychoeducation giving families opportunities for advocacy allowing space for families to express their emotions about their child’s gender

12.  What type of informed consent is typically recommended prior to initiating gender-affirming medical treatment for adolescents? adolescent assent only parental consent and adolescent assent parental consent only none of the above

13.  What is one way schools can help trans and gender-diverse students cope with minority stress? encourage students to connect with all staff and peers no matter their personal views publicly identify the trans and gender-diverse students so that staff and peers can better support them encourage internalized transphobia help students make connections with trusted staff and peers

14.  What are puberty blockers and are their effects reversible or irreversible? medications that delay endogenous puberty; their effects are irreversible medications that delay endogenous puberty; their effects are reversible medications that provide supplemental hormones such as testosterone and estrogen; their effects are irreversible medications that are provided to children several years before they start puberty to delay the pubertal process; their effects are reversible

15.  Which of the following statements about youth coming out as trans/gender diverse is most accurate? coming out is nearly always associated with an improvement in mental health. coming out is nearly always associated with worsened mental health. the impact of coming out on mental health is dependent on level of social support. none of the above.