Defining and measuring ‘whole-of-self’ affirming care to evaluate a multidisciplinary patient-centred and sustainable model of care for trans young people experiencing intersectional disadvantage

Young people who are trans and gender diverse (YTGD) experience disproportionate structural and interpersonal stigma, leading to high levels of psychological distress. This is further exacerbated for YTGD from historically disadvantaged groups, (e.g., culturally and linguistically diverse, neurodiverse). Despite the high need for metal health care, YTGD face serious delays in seeking help and services are not designed to meet their needs.
In 2022, a multidisciplinary, person-centred, specialised gender service for YTGD aged 12-25 was established within an existing youth mental health service (Orygen). The service was co-designed with people with lived experience, and 70% of team members have lived experience. The service provides care to YTGD from: 1) five headspace Centres (integrated primary care services) in culturally diverse northwestern suburbs of Melbourne; and 2) the Victorian statewide waitlist of Australia’s first paediatric gender clinic at the Royal Children's Hospital.
This study aims to evaluate the effectiveness of the service by measuring the degree to which it meets the needs of YTDG from historically disadvantaged groups. For services to be effective, YTDG need to be able to safely share all parts of their identity (e.g., gender, culture, neurodiversity). For this to happen, services must provide ‘whole-of-self’ affirming care. We will use a co-design approach informed by implementation science with qualitative and quantitative methods to: 1) obtain consensus on what constitutes ‘whole-of-self affirming care’ and develop a novel patient-reported experience measure and fidelity checklist; and 2) evaluate the implementation and effectiveness of Orygen’s service.
This study will address critical knowledge gaps (how to measure ‘whole-of-self’ affirming care) and develop the translational tools to evaluate and scale up the world’s first specialised gender service operating within existing youth primary mental health services.