"There's hope and there's a future for all of us": Co-design of a group cognitive behavioral therapy (CBT) intervention for trans young people (TAG TEAM).

Background: Trans youth experience gender minority stress, which contributes to poor mental health outcomes. Previous studies have demonstrated that group cognitive behavioral therapy (CBT) interventions are effective in improving mental health and well-being in LGBTQ+ youth experiencing minority stress more broadly. At the same time, there is growing recognition of the importance of co-designing novel mental health interventions to improve their acceptability and relevance. Currently, there is a need for group CBT interventions that have been co-designed with trans youth to ensure such programs are tailored to their needs. Aim: To develop a novel group CBT intervention for trans young people using co-design. Methods: We conducted a co-design study with trans youth recruited from the Royal Children's Hospital Gender Service in Victoria, Australia. Applying a participatory research approach, we held three online co-design workshops where participants designed the intervention's structure, format, objectives and content. We recorded and transcribed the workshops and thematically analyzed the transcripts to develop the intervention. Results: Eight trans young people aged 15-21 years participated in the study. Participants made recommendations for the intervention centering around: (1) trans community connection, positivity, and hope, and (2) accommodating diverse experiences, perspectives, and needs. TAG TEAM (Trans Adolescent Group ThErapy for Alleviating Minority stress) was developed on the basis of these recommendations, consisting of six two-hour sessions conducted weekly and facilitated by a psychologist and trans peer facilitator. Discussion: The use of co-design to develop the TAG TEAM intervention is likely to improve its applicability to trans young people and their needs, which in turn increases its potential to improve their mental health.