A Waitlist Intervention for Transgender Young People and Psychosocial Outcomes.

Background: Recent referrals of transgender young people to specialist gender services worldwide have risen exponentially, resulting in wait times of 1-2 years. To manage this demand, we introduced an innovative First Assessment Single-Session Triage (FASST) clinic that provides information and support to young people and their families and triages them onto a secondary waitlist for subsequent multidisciplinary care. Although FASST has been shown to substantially reduce initial wait times, its clinical impact is unknown.

Methods: FASST was evaluated by analysis of clinical surveys and qualitative interviews. A total of 142 patients were surveyed before and after FASST, and comparison was made to a historical control group of 120 patients who did not receive FASST. In-depth interviews were also held with FASST attendees ( = 14) to explore experiences of FASST, and inductive content analysis was performed.

Results: After FASST, there were improvements in depression (standardized mean difference [SMD] = -0.24; 95% confidence interval [CI]: -0.36 to -0.11; < .001), anxiety (SMD = -0.14; 95% CI: -0.26 to -0.02; = .025) and quality of life (SMD = .39; 95% CI: 0.23 to 0.56; < .001). Compared with historical controls, those attending FASST showed reduced depression (SMD = -0.24; 95% CI: -0.50 to 0.01; = .065) and anxiety (SMD = -0.31; 95% CI: -0.57 to -0.05; = .021). FASST attendees qualitatively described an increased sense of agency, which was related to improved outlook, validation, sense of self, and confidence.

Conclusions: Given burgeoning waitlists of pediatric gender services worldwide, this study suggests FASST may prove a useful model of care elsewhere.