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

The current project aims to improve the well-being of trans and nonbinary (TNB) individuals through an online intervention (Trans Care) targeting the reduction of symptoms of gender dysphoria. The Trans Care intervention will involve the creation of an online intervention comprised of eight modules intended to reduce symptoms of gender dysphoria, increase active coping, and improve the well-being of TNB individuals. Aim 1 is a feasibility and acceptability study of the proposed intervention and will enroll 100 TNB participants to provide feedback to inform a follow-up randomized controlled trial.

Study Overview

• Status: Not yet recruiting
• Conditions: Gender Dysphoria
• Intervention / Treatment: Other: Trans Care Web App

Detailed Description

The overall purpose of this project is to create a free intervention that can be disseminated widely throughout TNB communities to improve well-being in an easy, accessible way. Development and execution of the Trans Care intervention involves two primary aims:

• Aim 1) Feasibility and acceptability analysis (FAA) [represented by this study record]
• Aim 2) A pilot randomized controlled trial (RCT) of Trans Care's efficacy [to be registered to a separate study record]

Aim 1 involves qualitative and quantitative feedback regarding the content of the Trans Care intervention modules, impact on TNB participants well-being, and feasibility and acceptability of Trans Care intervention. Results from the FAA study will then be analyzed and presented to our community partners who will help us develop modifications to Trans Care to increase its efficacy and ease of use.

Aim 1 Hypotheses:

• The investigators expect that qualitative responses from participants in the FAA study overall will reflect that the Trans Care intervention was feasible and helpful. Any proposed changes from participants' qualitative responses will be incorporated into the final Trans Care intervention presented in the RCT.
• The investigators expect that participants in the FAA study will endorse high scores three scale assessment of feasibility and acceptability.

Aim 1 Endpoints:

The primary endpoint of the study is to determine if the Trans Care intervention is feasible and helpful to TNB individuals for improving their coping strategies. This will be determined through qualitative prompts and a quantitative measure of feasibility and acceptability.

• Study Type: Interventional
• Enrollment (Estimated): 100
• Phase: Not Applicable

Contacts and Locations

• Study Contact: Name: Louis Lindley, MA; Phone Number: 972-922-5786; Email: llindley2@wisc.edu

Study Locations

• United States
  • Wisconsin
    • Madison, Wisconsin, United States, 53705
      • University of Wisconsin

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Adult; Older Adult
• Accepts Healthy Volunteers: Yes

Description

Inclusion Criteria:

• Identify as transgender, transsexual, nonbinary, and/or have a transgender history.
• Experience gender dysphoria.
• Time available to commit to completing a 4-5-hour online intervention and 1-2 hours to complete follow up surveys

Exclusion Criteria:

• under 18 years old
• individual does not identify as transgender, transsexual, nonbinary, and/or have a transgender history
• does not experience gender dysphoria
• is unable to commit to the time requirements of the study
• does not have access to an internet compatible device

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Supportive Care
• Allocation: N/A
• Interventional Model: Single Group Assignment
• Masking: None (Open Label)

Number of Arms

1

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: Trans and Nonbinary Adults	Other: Trans Care Web App; an educational and interactive website designed to improve coping strategies of TNB individuals

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Acceptability of Intervention Measure (AIM) Score	The AIM is a 4-item measure of intervention acceptability, each item is rated on a 1-5 scale, with 1 = not at all acceptable and 5 = very acceptable. Total mean scores range from 1 - 5, higher scores indicate higher acceptability.	post intervention (intervention can take up to 5 hours to complete, participant has up to 1 month to complete it)
Intervention Appropriateness Measure (IAM) Score	IAM is a 4-item measure of intervention appropriateness, each item is rated on a 1-5 scale, with 1 = not at all acceptable and 5 = very acceptable. A total mean score ranges from 1 - 5, higher scores indicate higher appropriateness.	post intervention (intervention can take up to 5 hours to complete, participant has up to 1 month to complete it)
Feasibility of Intervention Measure (FIM) Score	FIM is a 4-item measure of intervention feasibility, each item is rated on a 1-5 scale, with 1 = not at all acceptable and 5 = very acceptable, with a total mean score ranging from 1 to 5, higher scores indicate higher feasibility.	post intervention (intervention can take up to 5 hours to complete, participant has up to 1 month to complete it)
Summary of Qualitative Prompts	Participants will be given four prompts to qualitatively assess their experience with the intervention. What you liked most? What would you change? What was most helpful? and What was least helpful? Thematic analysis will be conducted to analyze participants' responses to determine predominant changes suggested by participants	post intervention (intervention can take up to 5 hours to complete, participant has up to 1 month to complete it)
Trans Care Intervention Specific Feasibility and Acceptability Score	This measure is score from 0 to 4 in each of 5 domains: overall assessment, helpfulness, instructions, videos, and activities. Higher scores indicate higher feasibility and acceptability.	post intervention (intervention can take up to 5 hours to complete, participant has up to 1 month to complete it)
Digital Working Alliance Inventory (D-WAI) Score	The D-WAI is scored from 7-point Likert-type scale from 1 (strongly disagree) to 7 (strongly agree), for a total range of scores from 7-42 where higher scores indicate higher perceived app effectiveness.	post intervention (intervention can take up to 5 hours to complete, participant has up to 1 month to complete it)

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Depression, Anxiety, and Stress Scale (DASS-21) Score	DASS-21 is scored from 0-3 in each of 3 domains: depression, anxiety, and stress. Higher scores mean increased depression, anxiety, and stress.	baseline and post intervention (intervention can take up to 5 hours to complete, participant has up to 1 month to complete it)
Gender Congruence and Life Satisfaction Scale (GCLS) Score	GCLS asks participants to think about how they have felt over the last 6 months. Responses are scored on a 5-point Likert scale (always = 1; never = 5). A higher scores mean greater gender congruence, greater gender-related well-being, and greater life satisfaction.	baseline and post intervention (intervention can take up to 5 hours to complete, participant has up to 1 month to complete it)
Modified Gender Minority Stress and Resilience Measure (M-GMSRM) Score	M-GMSRM is scored from 0-100 where higher scores indicate higher stress.	baseline and post intervention (intervention can take up to 5 hours to complete, participant has up to 1 month to complete it)
Trans and Nonbinary Coping Measure (TNCM) Score	TNCM is scored from 0-5 where higher scores indicate greater frequency of utilization of coping strategy in each of 6 domains: Social Support / Connection, Social Activism, Hope, Strategic Gender Expression, Behavioral Avoidance, Identity Non-Disclosure.	baseline and post intervention (intervention can take up to 5 hours to complete, participant has up to 1 month to complete it)
Brief Cope Score	The Brief Cope survey is scored from 1-4 in each of 3 domains: problem-focused coping, emotion-focused coping, and avoidant-coping. Higher scores indicate increased coping mechanisms.	baseline and post intervention (intervention can take up to 5 hours to complete, participant has up to 1 month to complete it)
Alcohol Use Disorder Identification Test	This is scored from 0-40 where higher scores are indicative of increased dependence on alcohol.	baseline and post intervention (intervention can take up to 5 hours to complete, participant has up to 1 month to complete it)
Number of Days in the Past Week You Consumed Alcohol	7 = 7 days, 6 = 6 days, 5 = 5 days, 4 = 4 days, 3 = 3 days, 2 = 2 days, 1 = 1 day, 0 = no days	baseline and post intervention (intervention can take up to 5 hours to complete, participant has up to 1 month to complete it)
Quantity of Alcohol Use	How many alcoholic drinks, on average, have you had per day during the past week? An alcoholic drink is defined as 1 beer, 1 glass of wine, 1 shot of alcohol, or 1 mixed drink. Response options: 5 = 12+ drinks, 4 = 8-11 drinks, 3 = 5-7 drinks, 2 = 3-4 drinks, 1 = 1-2 drinks, 0 = none	baseline and post intervention (intervention can take up to 5 hours to complete, participant has up to 1 month to complete it)

Collaborators and Investigators

• Sponsor: University of Wisconsin, Madison
• Investigators: Principal Investigator: Stephanie Budge, PhD, LP, University of Wisconsin, Madison

Study record dates

Study Major Dates

• Study Start (Estimated): April 1, 2024
• Primary Completion (Estimated): May 1, 2024
• Study Completion (Estimated): May 1, 2024

Study Registration Dates

• First Submitted: May 22, 2023
• First Submitted That Met QC Criteria: May 22, 2023
• First Posted (Actual): June 1, 2023

Study Record Updates

• Last Update Posted (Actual): March 5, 2024
• Last Update Submitted That Met QC Criteria: March 1, 2024
• Last Verified: March 1, 2024

More Information

Terms related to this study

• Keywords: coping; online intervention; trans and nonbinary; gender minority stress
• Additional Relevant MeSH Terms: Mental Disorders; Mood Disorders; Sexual Dysfunctions, Psychological; Depressive Disorder; Gender Dysphoria; Depressive Disorder, Major
• Other Study ID Numbers: 2023-0644: FAA; A171600 (Other Identifier: UW Madison); UW Baldwin Endowment (Other Identifier: UW Madison); Protocol Version 11/7/2023 (Other Identifier: UW Madison)

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: NO

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No