Date of Award

January 2024

Document Type

Open Access Thesis

Degree Name

Doctor of Nursing Practice (DNP)


Yale University School of Nursing

First Advisor

Christine Rodriguez


Transgender youth (TGY) are at an increased risk for depression, anxiety, and suicidality; delaying transition can worsen this. Nationally, gender programs have waitlists beyond a year. In conservative states, providers are fewer in number, and legislation may prohibit services. Thus, gender programs rely on mental health and primary care providers to assist youth who express a strong desire to be a gender other than that assigned at birth, and who endure protracted wait times to start treatment. This DNP project developed and implemented an evidence-based, gender-affirming peer support group to improve patient experience and mental health outcomes by providing information to transgender youth awaiting gender-affirming hormone therapy during protracted wait times to treatment initiation. This clinical improvement project included a group of ten TGY, ages 13-17. Eight informational virtual meetings were held twice monthly for four months. Clinical assessments included pre- implementation and implementation PHQ-9 and GAD-7 measures and a group satisfaction survey. Descriptive statistics reported and summarized data obtained from intake interviews, behavioral health measures, and the survey. Results suggest that providing relevant information in an intimate peer group setting of transgender youth awaiting treatment can help mitigate symptoms of depression and anxiety while fostering a sense of community and belonging. By providing information in an easy-to-access, communal format during a protracted gap in care, a support group can be a lifeline for TGY. In states or regions where gender-affirming care is restricted or criminalized, virtual groups can offer welcoming, safe, life-affirming, and protective mental healthcare.


This is an Open Access Thesis.

Open Access

This Article is Open Access