A new intervention designed to guide parents and carers in navigating gender identity and fostering supportive relationships.
Short summary
A new community-based participatory study highlights the importance of family support in improving mental health outcomes for transgender and nonbinary youth. Co-created digital stories reveal how open communication, shared reflection, and inclusive family involvement can reduce isolation, foster empathy, and build stronger connections. The result is a flexible toolkit designed for both professionals and caregivers.
How Family Support Shapes Trans Youth Wellbeing
Transgender and nonbinary youth (TNBY) face higher rates of anxiety, depression, and self-harm compared to their cisgender peers (Wittlin, Kuper, & Olson, 2023). These disparities are largely driven by experiences of minority stress, including social rejection and stigma (Rood et al., 2016; Reed, 2024).
Amid this challenging landscape, family support remains one of the strongest protective factors, through emotional presence, reliability, and active involvement in the young person’s wellbeing (Westwater, Riley, & Peterson, 2019). But what if families want to support their TNBY and simply don’t know how? What approaches can guide the transition from uncertainty and fear to deeper connection and meaningful action?
Family support plays a key role in reducing mental health risks for transgender and nonbinary youth.
A toolkit rooted in real stories and real lives
A recent study by Katz-Wise and colleagues (2024) addresses this question by developing a family-level, practical, and relationship-focused intervention. The Trans Teen and Family Narratives (TTFN) Conversation Toolkit is a free online resource to help families have more open and thoughtful conversations about gender.
At its core are eight digital stories, co-created by TNBY aged 15-21, that explore themes such as identity, tradition, faith, rejection, disability, and chosen family. Each story is paired with a discussion guide and additional resources tailored either for families or for mental health professionals (MHPs).
“Sometimes, it gets really lonely. Meeting you guys kind of makes me feel less alone. Like I have a family out there… and I kind of don’t want it to end.”
— Young participant, digital storytelling workshop
This project was built using a community-based participatory research model. TNBY, caregivers, siblings, and professionals were all involved in designing, reviewing, and refining the toolkit. Their input shaped every phase, from content selection to final usability.
The result is a resource grounded in both evidence and lived experience. Rather than offering prescriptive answers, the toolkit fosters reflection, listening, and trust-building through conversation.
Co-created digital stories help families engage in meaningful conversations about gender identity.
Meeting families where they are
What makes the TTFN Toolkit especially impactful is how it meets families where they are. During focus groups, caregivers often shared how relatable the stories were and how much they wished they had had access to such a resource earlier in their journey.
“You guys just really hit the nail on the head with all of these topics. I would have loved to have seen that video day one.”
— Parent of a trans youth
Siblings also reflected on the need for support in their role, especially when navigating peer conversations or family dynamics. TNBY appreciated the diversity of identities and experiences reflected in the stories, but also called for continued efforts to represent voices often left out, including youth of colour, neurodiverse youth, and those from less accepting environments.
Clinicians in the study highlighted how the toolkit could be used flexibly in sessions or shared with extended family members, especially when direct engagement is difficult.
“When my brother was starting to come out, I was like, ‘This isn’t the way it’s supposed to be,’ just because I had only been exposed to one person having this one experience.”
— Sibling of a trans boy, focus group participant
The toolkit was designed to be non-linear and adaptable, allowing families to use it on their own or as part of a therapeutic process. Rather than prescribing how one should feel or act, the stories model real-life trajectories of complexity, growth, and change. Some begin with pain or confusion and move toward moments of connection. These narratives can serve as a valuable tool to support clinical work, fostering joint reflection between young people, families, and professionals.
Looking ahead
The TTFN Toolkit highlights the potential of narrative-based, co-produced resources to meet the real needs of families with transgender and nonbinary youth. As families, clinicians, and young people continue to use the toolkit, participants in the study have already identified meaningful directions for future development. These include expanding the range of stories to reflect a wider diversity of experiences, such as those of caregivers, siblings, neurodiverse youth, and individuals from communities with limited support or understanding. There is also growing interest in adapting the toolkit for broader applications, including school-based education, community support programmes, and telehealth.
Katz-Wise and colleagues also note the need for further evaluation of the toolkit’s effectiveness in improving communication, fostering acceptance, and reducing minority stress in families. The process of co-developing the intervention itself, through workshops, interviews, and collaborative design, was described as beneficial by many participants. This suggests that participatory methods can serve not only as a means to build better tools, but also as an intervention in their own right.
Future development of the toolkit will focus on greater inclusivity, broader applications, and formal evaluation
Conclusions
The TTFN Toolkit exemplifies how inclusive, evidence-informed interventions can support individual families and the broader systems in which they live. By integrating digital storytelling with structured guidance, the resource creates space for families to explore, reflect, and grow together—whether at home, in therapy, or within extended networks of care.
Methodologically, the project underscores the value of ethical reflexivity, collaborative design, and safeguarding throughout the development of mental health tools. In a context marked by stigma and sociopolitical pressures, these practices offer a model for how research and lived experience can come together to produce tools that are not only useful but transformative.
The TTFN Toolkit bridges research and lived experience to help families support TNBY more effectively.
Where next?
This conference, led by Sabra L. Katz-Wise, PhD, explains how family environments shape the mental health of transgender and nonbinary youth. As Director of the SOGIE Health Equity Research Collaborative and GenderWise Lab, Sabra L. Katz-Wise, PhD, is a leading researcher on LGBTQ+ health and family functioning.
This session will present key findings from the NIH-funded Trans Teen and Family Narratives Project, a longitudinal, community-engaged study exploring how family dynamics impact youth well-being. Attendees will also gain insights into a family-level intervention designed to support families in fostering affirming, healthy relationships.
Use the interactive programme below to gain an overview of the topic, meet the speaker, test your knowledge, and a whole lot more!
NB this blog has been peer-reviewed
References
Katz-Wise, S. L., Godwin, E. G., Medzhitova, Y., Moore, L. B. M., Parsa, N., Hill, A., Oparah, N., Bogart, L. M., Rosal, M. C., Pullen Sansfaçon, A., Ehrensaft, D., Nishman, M. M., & Austin, S. B. (2024). Development of a family-level intervention for families with transgender and/or nonbinary youth: Lessons and recommendations. Journal of Family Psychology. Advance online publication. https://doi.org/10.1037/fam0001262
Reed, E. (2024, May 1). Anti-trans legislative risk assessment map; May 2024 update. Erin in the Morning. https://www.erininthemorning.com/p/anti-trans-legislative-risk-assessment-43a
Rood, B.A., Reisner, S. L., Surace, F. I., Puckett, J. A., Maroney, M. R.,& Pantalone, D. W. (2016). Expecting rejection: Understanding the minority stress experiences of transgender and gender-nonconforming individuals. Transgender Health, 1(1), 151–164. https://doi.org/10.1089/trgh.2016.0012
StoryCenter. (n.d.). Ethical practice. Retrieved October 4, 2023, from https://static1.squarespace.com/static/55368c08e4b0d419e1c011f7/t/579134a05016e13dde264720/1469133984611/Ethics.pdf
Westwater, J. J., Riley, E. A., & Peterson, G. M. (2019). What about the family in youth gender diversity? A literature review. International Journal of Transgenderism, 20(4), 351–370. https://doi.org/10.1080/15532739.2019.1652130
Wittlin, N. M., Kuper, L. E., & Olson, K. R. (2023). Mental health of transgender and gender diverse youth. Annual Review of Clinical Psychology, 19(1), 207–232. https://doi.org/10.1146/annurev-clinpsy-072220-020326
