The gender affirmative lifespan approach (GALA): A framework for competent clinical care with nonbinary clients

Abstract

Background: The limited research on nonbinary individuals suggests that this community experiences significant health disparities. Compared to binary transgender individuals, research suggests that nonbinary individuals are at elevated risk for discrimination and negative mental health outcomes, including depression, anxiety, traumatic stress, and suicidality. Even mental health providers who work with binary transgender individuals often lack knowledge of and training to work competently with nonbinary individuals.

Methods: The authors of this conceptual article present the Gender Affirmative Lifespan Approach (GALA), a psychotherapy framework based in health disparities theory and research, which asserts that therapeutic interventions combating internalized oppression have the potential to improve mental health symptomatology resulting in improved overall health and well-being for gender diverse clients. GALA’s therapeutic interventions are designed to promote positive gender identity development through five core components: (1) building resiliency; (2) developing gender literacy; (3) moving beyond the binary; 4) promoting positive sexuality; and (5) facilitating empowering connections to medical interventions (if desired).

Results: The core components of the GALA model are individualized to each client’s unique needs, while taking into consideration age and acknowledging developmental shifts in, or fluidity of, gender across the lifespan. This model represents an inclusive, trans-affirmative approach to competent clinical care with nonbinary individuals.

Discussion: Application of the GALA model with nonbinary clients is discussed, including one clinical case vignette.     

A Review of “Dreams: A portal to the source”

By Edward C. Whitmont and Sylvia Brinton Perera. London and New York: Routledge, 1989.     

Comparison of barriers self-efficacy and perceived behavioral control for explaining physical activity across 1 year among adolescent girls.

The absence of longitudinal data about correlates of physical activity during adolescence has hindered the identification of key mediator variables that can be targeted by interventions. Building on the authors' previous report of a cross-sectional analysis, this study compared barriers self-efficacy and perceived behavioral control as predictors of change in 2 levels of physical activity across a 1-year period among a sample of Black and White adolescent girls (N=1,038). Self-efficacy did not predict change in either moderate or vigorous physical activity. In contrast, perceived behavioral control exhibited a longitudinal, independent relationship with change in vigorous physical activity. The authors concluded that perceived behavioral control is an independent predictor of change in vigorous physical activity levels across a 1-year period among a sample of Black and White adolescent girls and warrants study as a potential mediator variable in interventions designed to increase or maintain physical activity.     

Utrecht Gender Dysphoria Scale - Gender Spectrum (UGDS-GS): Construct validity among transgender,nonbinary, and LGBQ samples

Abstract

Background: Researchers combined both versions of the original Utrecht Gender Dysphoria Scale (UGDS) to create a single gender spectrum version (UGDS-GS) which measures dissatisfaction with gender identity and expression over time as well as comfort with affirmed gender identity.

Aim: This study examined the construct validity of the newly revised, UGDS-GS.

Method: Tests of measurement invariance were conducted in stages to assess measurement invariance of the UGDS-GS across three groups: cisgender, binary transgender, and nonbinary/genderqueer.

Results: Findings indicate that the UGDS-GS functions acceptably in all three gender groups (configural and metric invariance). Also, across binary transgender and nonbinary/genderqueer groups, the measure functions very similarly with all four types of invariance. Item level findings highlight the specificity of the measure to distinguish experiences of binary transgender and nonbinary/genderqueer persons differently from cisgender LGBQ individuals.

Conclusions: The UGDS-GS demonstrates a large degree of invariance across binary transgender, nonbinary/genderqueer, and cisgender LGBQ subgroups; and therefore, findings indicate this revision to be a substantial improvement. This 18-item self-report, Likert-type scale measure is a) inclusive of all gender identities and expressions (e.g., transfeminine spectrum, transmasculine spectrum, genderqueer, nonbinary, cisgender); b) appropriate for use longitudinally from adolescence to adulthood; and c) administered at any point in the social or medical transition process, if applicable, or in community-based research focused on gender dysphoria that examines cisgender and transgender persons.     

Explanation and verbalization in a computer-assisted search task

Three experiments examine the effects of two different forms of explanation on assisted performance on a complex search task. The task involves determining which of a set of factories is responsible for polluting a river by testing the river for the presence or absence of various pollutants. All subjects receive computer suggestions as to which pollutants they should test for. In addition, some subjects receive an explanation of the principle according to which the advice program works. Two forms of explanation are compared. Experiment 1 shows that subjects who are allowed to ask “why” each computer recommendation is made perform significantly better than those who are provided with a block text of explanation at the start of each trial. Experiment 2 shows that the latter type of explanation is not completely ineffective, however. Subjects who are required to verbalize following the single explanation perform significantly better than do subjects who are required to verbalize but who have not received any form of explanation. Finally, Experiment 3 shows that subjects who receive the multiple “why” explanations or the explanation/verbalization combination maintain a superior performance level on subsequent unaided trials.