TransMind

Transgender and gender diverse (TGD) individuals experience an incongruence between their natal sex and gender identity that can cause deep discomfort known as gender dysphoria (GD). In recent years, the number of individuals who identify as TGD has increased markedly, particularly among younger age groups. This has led to a growing demand for specialized transgender healthcare and long waiting times (>3 years). Prolonged waiting for transgender care is associated with psychosocial distress, poorer health, and increased healthcare consumption. Moreover, it can exacerbate mental health problems such as depression, anxiety, and suicidality, which are prevalent in this population. Given that many TGD individuals do not feel comfortable or “at home” in their body, the vulnerability to mental problems may stem from impaired body awareness and interoceptive ability, which is essential for emotion regulation. Mindfulness-based interventions (MBIs) have been shown to improve mental health, promote interoceptive ability, and enhance emotional resilience, and could thus be a valuable (early) intervention option for people with GD. 

This mixed-methods pilot study will explore the effects of a group-based MBI on body and emotional awareness in TGD individuals by collecting both quantitative measures and qualitative experiences on an adapted gender-inclusive MBI program. 

In this pilot study, we will offer an 8-week MBI entitled Mindfulness-Based Cognitive Therapy for Life (MBCT-L), adapted in language for use in an adult gender-diverse population and co-facilitated by a trainer with lived experience. Participants will be recruited through TGD social networks. A combination of qualitative and quantitative data will be acquired to explore the effects of mindfulness training. Participants will be interviewed before and after the training to collect qualitative data on their experience with the training protocol, the group-based format and effects on body/interoceptive awareness and emotion regulation (co-primary outcomes), well-being, rumination, perceived stress, positive and negative affect, alexithymia, self-compassion and mindfulness skills. 

We will offer an 8-week mindfulness program (MBCT-L) that was developed by the University of Oxford Mindfulness Centre. It will be adapted in language for use in a gender-diverse population (18 - 50 years of age). Two trainers will teach the program, including one person with lived experience and one clinician. The training program follows a standardized protocol based on mindfulness-based cognitive therapy (MBCT) but applicable for use in a non-clinical population. The training program consists of 8 weekly 2-hour group sessions and one silent day. The program includes mindfulness exercises, elements from cognitive therapy, psychoeducation, and gentle physical exercises. In between sessions, participants are encouraged to practice at home for approximately 30 minutes/day. 

The risks and discomforts associated with participation in this study are estimated as low. The main burden for participants consists of repeated non-invasive assessments. Benefits for participants include the opportunity to participate, free of charge, in a mindfulness program adapted for the TGD population. An indirect benefit of this pilot study is the potential to inform and provide a base for a larger study aimed at improving transgender care during the waiting period.