Trans Care: An Online Intervention to Reduce Symptoms of Gender Dysphoria

Primary outcomes

1. Change in Depression, Anxiety, and Stress Scale (DASS-21) Score

   Time frame: before and after intervention (participants will have up to 1 month to complete intervention), 3 month follow up

   DASS-21 is a composite measurement used to assess symptoms of depression, anxiety, and stress in community settings. The 21-item survey is comprised of three subscales for Depression, Anxiety, and Stress. Responses are provided on a 4-point Likert scale, Where 0 = Did not apply to me, 1 = applied to me some degree, or some of the time, 2 = applied to me a considerable degree or good part of time, and 3 = applied to me very much or most of the time. Total possible range of scores is from 0 to 63, with higher scores indicating higher levels of symptoms.

2. Change in Gender Congruence and Life Satisfaction Scale (GCLS) Score

   Time frame: before and after intervention (participants will have up to 1 month to complete intervention), 3 month follow up

   GCLS measures gender congruence and life satisfaction in a 38-item self assessment, for a total possible range of scores from 38-190 where higher values indicate greater gender congruence, greater gender-related well-being, and greater life satisfaction.

3. Change in Modified Gender Minority Stress and Resilience measure (M-GMSRM) Score

   Time frame: before and after intervention (participants will have up to 1 month to complete intervention), 3 month follow up

   Total scores are calculated for each scale based on summed values assigned to possible response options. The first 8 items are scored 0 for "never," 1 for "yes, before age 18," 2 for "yes, after age 18," and 3 for "yes, in the past year." Scores from these items are then summed where a higher score indicates more frequent and recent experiences of gender related prejudice. All other items are scored from 0 - 4 according to responses ranging from strongly disagree to strongly agree. Items within each subscale (i.e., non-affirmation of identity, internalized transphobia, and negative expectations for the future) are summed with high scores indicating greater distress.

4. Change in Trans and Nonbinary Coping Measure (TNCM) Score

   Time frame: before and after intervention (participants will have up to 1 month to complete intervention), 3 month follow up

   TNCM assesses the unique ways of coping with gender-related stress. The measure includes six subscales (Social Support/Connection (5 items); Social Activism (4 items); Hope (5 items); Strategic Gender Expression (5 items); Behavioral Avoidance (5 items); Identity Nondisclosure (4 items). Responses to items are recorded on a 5-point scale from 1 (I do not do this) to 5 (I almost always do this). Scale items are summed to create subscale scores. A higher score indicates greater frequency of use of that coping strategy.

5. Alcohol Use Disorder Identification Test

   Time frame: before and after intervention (participants will have up to 1 month to complete intervention), 3 month follow up

   This is scored from 0-4 where higher scores are indicative of increased dependence on alcohol.

6. Number of Days in the Past Week You Consumed Alcohol

   Time frame: before and after intervention (participants will have up to 1 month to complete intervention), 3 month follow up

   7 = 7 days, 6 = 6 days, 5 = 5 days, 4 = 4 days, 3 = 3 days, 2 = 2 days, 1 = 1 day, 0 =no days

7. Quantity of Alcohol Use

   Time frame: before and after intervention (participants will have up to 1 month to complete intervention), 3 month follow up

   How many alcoholic drinks, on average, have you had per day during the pastweek? An alcoholic drink is defined as 1 beer, 1 glass of wine, 1 shot of alcohol, or 1mixed drink.

   Response options:

   5 = 12+ drinks, 4 = 8-11 drinks, 3 = 5-7 drinks, 2 = 3-4 drinks, 1 = 1-2 drinks, 0 =none

8. Change in Multidimensional Gender Dysphoria Measure Scores

   Time frame: before and after intervention (participants will have up to 1 month to complete intervention), 3 month follow up

   The Multidimensional Gender Dysphoria Measure is a 25-item survey each scored from 1 (strongly disagree) to 6 (strongly agree) for a total possible range of scores of 5-30 in each of 5 domains: Body Gender Dysphoria, Social Gender Dysphoria, Variability of Gender Dysphoria, Relief from Gender Dysphoria, and Internalized Gender Normativity. Higher scores indicate greater gender dysphoria distress.