Mental health practitioners' perspectives on supporting transgender and gender diverse youth: A scoping review.

Background: Gender diverse (GD) youth face unique stressors that result in disproportionate mental health challenges compared to their peers. Although mental healthcare is a crucial resource for addressing these challenges, GD youth often report negative experiences, leading to avoidance of services and worsening distress. Understanding mental health practitioners (MHPs) perspectives of supporting GD youth is important for improving their capacity to deliver appropriate, supportive care. Aim: The aim of this review is to scope and consolidate evidence on the perspectives of MHPs in their work with GD youth. Methods: PsycINFO, Scopus, PubMed, Proquest dissertations and theses, and Google Scholar were searched between March-April 2024 for English language primary research of any study design, including peer-reviewed articles and theses/dissertations. Thematic synthesis was used to consolidate the findings of 23 included studies. Results: Six interrelated themes were constructed: (i) perceived lack of availability and utility of GD education and training; (ii) limited knowledge and preparedness for practice; (iii) navigating uncertainty and adapting therapeutic approaches; (iv) the need for multilevel care addressing individual, relational, and systemic needs; (v) providing safety and affirmation, and challenging deficit narratives; and (vi) emotional, ethical, and value-based challenges in supporting GD youth. Conclusions: There is a need for GD training and evidence-based guidelines for MHPs for working with GD youth and their families. Some MHPs provided safety and acceptance to GD youth, while others experienced conflicted personal and professional values. MHPs may benefit from critical reflection and clinical supervision to navigate challenges associated with their role supporting GD youth.