Gender-Affirming Psychological Assessment With Youth and Families: A Mixed-Methods Examination

This study aims to discover what parents of gender diverse youth have found helpful as participants in a comprehensive psychological assessment process, and why. Sixteen parents of youth ages 5-16 years who completed a psychological assessment at a pediatric transgender health specialty clinic responded to a survey about the helpfulness of various aspects of the assessment process, including aspects of the assessment considered to be best practice in general (i.e., "nonspecific factors"), and those consistent with recent recommendations for gender-affirming care. Nonspecific factors of the assessment process ranked as most helpful included steps taken by the clinician(s) to develop a strong working relationship with parents (e.g., demonstrating respect or authenticity). In terms of assessment related specifically to gender, parent-identified aspects that were most helpful included the parents perception that the clinician(s) had the child convince them of their gender identity, providing guidance on how to approach school officials about creating a gender-affirming school environment for the child, and encouraging the parent to explore their own views on gender diversity. The findings highlight the importance of the mental health professional in promoting parental acceptance of their child's gender identity, their pivotal role in helping families and youth secure social support and may aid clinicians to revise and improve upon their psychological assessment process of gender dysphoria. Clinical Impact StatementThis study provides information on how mental health professionals can promote parental acceptance of their child's gender identity by describing supportive interviewing and psychological assessment procedures for transgender youth and their families at the point of entry to gender-affirming medical care. Little is known about how best to support transgender youth and their families as they contemplate social and medical transition. Improved knowledge among mental health providers will improve access to quality gender-affirming care for transgender youth and their families.