Narrative Exposure Therapy to Reduce Posttraumatic Stress Symptoms Among Transgender and Gender Diverse Adolescents and Young Adults: A Pilot Study

Transgender and gender diverse (TGD) adolescents and young adults experience disproportionately higher rates of trauma compared to their cisgender peers. Beyond adverse childhood experiences, TGD youth are also exposed to gender-based traumatic experiences, including interpersonal rejection, bullying, and physical attacks, resulting in greater symptoms of posttraumatic stress. Few tailored interventions have been developed and evaluated with TGD youth to address this crucial mental health need within our current sociopolitical context, including increasing bans on care for TGD young people. This pilot study examined the use of narrative exposure therapy (NET) to reduce posttraumatic stress symptoms and increase self-perceived resiliency and positive well-being in TGD adolescents and young adults. A community sample of 41 racially and ethnically diverse TGD youth (Mage = 17.15 +/- 2.38) completed NET after screening at a Los Angeles-based medical clinic. Participants attended on average 12 sessions of NET (+/- 5.96). Participants reported multiple traumatic events, with 85.4% reporting six or more different trauma types, including events related to gender-based discrimination. Findings show a statistically significant reduction in posttraumatic stress symptoms, as well as an increase in resiliency and positive well-being at discharge from treatment. Qualitative feedback from participants also highlighted their positive experiences with NET. This pilot study provides initial support for the use of NET to reduce posttraumatic stress symptoms for TGD adolescents and young adults. The implications for future studies utilizing NET with TGD youth are discussed further.