A Clinical Program for Transgender and Gender-Diverse Neurodiverse/Autistic Adolescents Developed through Community-Based Participatory Design

John F. Strang*, Megan Knauss, Anna van der Miesen, Jenifer K. McGuire, Lauren Kenworthy, Reid Caplan, Andrew Freeman, Eleonora Sadikova, Zosia Zaks, Noor Pervez, Anouk Balleur, D. W. Rowlands, Ely Sibarium, Laura Willing, Marissa A. McCool, Randall D. Ehrbar, Shannon E. Wyss, Harriette Wimms, Joshua Tobing, John ThomasJulie Austen, Elyse Pine, April D. Griffin, Aron Janssen, Veronica Gomez-Lobo, Abigail Brandt, Colleen Morgan, Haley Meagher, Dena Gohari, Laura Kirby, Laura Russell, Meredith D. Powers, Laura G. Anthony

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

30 Scopus citations


Objective: A series of studies report elevated rates of autism and autistic characteristics among gender-diverse youth seeking gender services. Although youth with the co-occurrence present with complex care needs, existing studies have focused on co-occurrence rates. Further, clinical commentaries have emphasized provider-centered interpretations of clinical needs rather than key stakeholder-driven clinical approaches. This study aimed to employ community-based participatory research methodologies to develop a key stakeholder-driven clinical group program. Method: Autistic/neurodiverse gender-diverse (A/ND-GD) youth (N = 31), parents of A/ND-GD youth (N = 46), A/ND-GD self-advocates (N = 10), and expert clinical providers (N = 10) participated in a multi-stage community-based participatory procedure. Needs assessment data were collected repeatedly over time from A/ND-GD youth and their parents as the youth interacted with one another through ongoing clinical groups, the curriculum of which was developed progressively through the iterative needs assessments. Results: Separate adolescent and parent needs assessments revealed key priorities for youth (e.g., the importance of connecting with other A/ND-GD youth and the benefit of experiencing a range of gender-diverse role models to make gender exploration and/or gender affirmation more concrete) and parents (e.g., the need for A/ND-related supports for their children as well as provision of an A/ND-friendly environment that fosters exploration of a range of gender expressions/options). Integration and translation of youth and parent priorities resulted in 11 novel clinical techniques for this population. Conclusions: With generally high acceptability ratings for each component of the group program, this study presents a community-driven clinical model to support broad care needs and preferences of A/ND-GD adolescents.

Original languageEnglish (US)
Pages (from-to)730-745
Number of pages16
JournalJournal of Clinical Child and Adolescent Psychology
Issue number6
StatePublished - 2021

ASJC Scopus subject areas

  • Clinical Psychology
  • Developmental and Educational Psychology


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