Studying the power of self-compassion intervention for transgender teens
Knowing the power of self-compassion, Karen Bluth, PhD, focuses her research on the relationship between mindfulness, self-compassion, and mental health in adolescents. Her most recent study, “Improving Mental Health Among Transgender Adolescents: Implementing Mindful Self-Compassion for Teens,” was published in Journal of Adolescent Research in December 2021. Bluth is a Faculty Fellow at UNC Frank Porter Graham Child Development Institute (FPG) and research assistant professor in the department of psychiatry at the UNC School of Medicine.
The recent study was designed to investigate the feasibility, acceptability, and preliminary outcomes of an online self-compassion intervention for adolescents who self-identified as transgender or gender expansive, with the goal of improving their mental health. After five years of wishing to do this research and not obtaining funding for it, Bluth decided to pursue the research regardless, which meant that she and her team worked without pay.
“Trans teens struggle so much with mental health, with rates of depression four times higher compared to their cisgender (i.e., non-transgender) peers while 51% of transgender teens experience suicidal ideation and 32% attempt suicide,” says Bluth. “These kids are suffering and knowing that I have something that can alleviate their suffering and not be able to implement it because the money wasn’t available … I just said, ‘I have to do this.’”
She and her team recruited study participants through social media platforms such as Facebook, Twitter, and Instagram, including Facebook groups that were specifically for parents of transgender adolescents and organizations for LGBTQIA+ populations. Flyers providing information for the study were also sent to academic researchers, community psychologists and therapists, LGBTQ advocacy organizations, and three local pediatric and adolescent gender clinics for gender diverse youth. Since the study was conducted online, participants also needed access to a computer or an internet-enabled mobile device.
The empirically-based self-compassion program, Mindful Self-Compassion for Teens, was taught by two trained instructors in eight 1.5 hour sessions on Zoom. Surveys were administered before the program began, after it was completed, and three months after it ended. Researchers collected qualitative data through end-of-program interviews and open-ended questions on the postsurvey. Results indicated that all but one psychosocial measure significantly improved from pre- to post-intervention, which then significantly improved at the three-month follow-up while most other improvements were maintained at follow-up.
Forty-one participants completed the pre-intervention survey, 29 participants completed the post-intervention survey, and 28 completed the 3-month follow-up survey. Twenty-six participants provided data at all three time points, and those 26 were used in the analyses.
The results suggest that self-compassion interventions can be incorporated into therapy programs to support and improve mental health for transgender adolescents.
The qualitative data enabled researchers to posit why and how psychosocial outcomes improved. The creation of a safe space where participants felt comfortable sharing their experiences, and at times being vulnerable to the group, was likely an instrumental factor in achieving positive outcomes. Encouraging the participants to be kind to their body was helpful for many who have been accustomed to rejecting and dismissing their body. Participants shared that the program helped them get to know themselves better and provided them space where the process of identity development could unfold.
This research study is especially timely in light of legislation being introduced in states throughout the country that limits discussion of LGBTQIA+ identities and, in the case of Texas, has allowed the investigation of parents who provide gender-affirming treatments to their transgender children. Bluth says that negative messages like this—telling trans youth and adults that there is something wrong with them—are a large cause of the high rates of depression among trans individuals. “When trans people are told that they don’t fit in and they're not valued or valuable, they take this in and develop internalized transphobia,” says Bluth. “Suicide rates have skyrocketed among teens in general in the last decade and it’s even worse for trans youth.”
Bluth wants to ensure that teens—both transgender and cisgender—their caregivers, and families learn that the study shows that mindful self-compassion is a tool that can lead to
a significant decrease in anxiety and depression, factors that are associated with suicidal thoughts. “We assume that the teenage years are usually a period of life that's very difficult and that adolescents are going to suffer through it,” adds Bluth. “But it doesn't have to be that hard; we have tools that can help alleviate a lot of the suffering and we know that these tools work.”
Resources for teens and their families include classes, both online and in person, at the Center for Mindful Self-Compassion. Bluth has authored a number of books, including The Self-Compassionate Teen: Mindfulness and Compassion Skills to Conquer Your Critical Inner Voice and has recently published an audio book, Self-Compassion for Girls: A Guide for Parents, Teachers and Coaches.