Abstract: A Randomized Controlled Trial of Youth Mentoring for Transgender Youth: Complier Averaged Causal Effects (Society for Social Work and Research 31st Annual Conference)

Schedule:

Friday, January 22, 2027

Golden Gate 6 (Hilton San Francisco Union Square)

* noted as presenting author

Jennifer Jester, Associate Research Scientist, University of Michigan-Ann Arbor, ann arbor, MI

Lorey Wheeler, Professor, University of Nebraska, Lincoln, NE

Joseph Gardella, PhD, Assistant Research Scientist, University of Michigan-Ann Arbor, MI

Jillian Scheer, Assistant Professor, University of Rhode Island

Sloane Cornelius, Graduate Student Researcher, University of Nebraska, Lincoln

Skyler Hopfauf, Project Manager, University of Michigan-Ann Arbor, ann arbor, MI

Will Jackson, Project Coordinator, University of Michigan-Ann Arbor, Ann Arbor, MI

Deb Hope, Professor, University of Nebraska, Lincoln

Susan Swearer, Professor, University of Nebraska, Lincoln

Background and purpose. The current political and social climate is increasingly hostile toward transgender and gender diverse youth (TGDY), with 29 states enacting laws that restrict rights and access to care. These conditions, alongside other stressors, contribute to elevated anxiety and depression, increased internalized transphobia, and diminished hope for the future. To address these challenges, we conducted a randomized trial with a waitlist control to evaluate a brief mentorship program designed to reduce mental health distress and internalized transphobia while increasing hope among TGDY. Although intent-to-treat (ITT) analyses are the gold standard for randomized trials, they may underestimate treatment effects when noncompliance occurs. To better estimate program impact, we used Complier Average Causal Effects (CACE) modeling, which isolates effects among participants who meaningfully engage with the intervention.

Methods. A pilot RCT examined the preliminary efficacy of a group-based mentoring and skill-building intervention among 57 TGDY aged 14–18. Participants completed surveys assessing mental health, social-emotional competence, and positive identity at baseline, post-intervention, and three-month follow-up. Twenty-four participants were assigned to a waitlist control and 33 to the intervention. Of those in the intervention, seven (21%) attended two or fewer sessions (inadequate dose), while the remainder attended at least four sessions (adequate dose). We reanalyzed outcomes most likely to be affected by mentoring using CACE modeling. Bayesian methods were used due to the small sample size, implemented in R (noncompliance framework based on Imbens and Rubin, 1997). Given the pilot nature of the study, 90% credible intervals were used.

Results. At post-test, CACE estimates indicated improvements among compliers for depression (-6.02, -0.53), anxiety (-4.56, -0.19), and internalized transphobia (-1.00, -8.35,), as credible intervals did not include zero. Hope for the future (-0.28, 0.30) was unchanged. At three-month follow-up, effects were no longer sustained.

Conclusions and implications. Even brief, affirming mentorship interventions can produce meaningful short-term improvements in mental health and internalized stigma among TGDY. However, the lack of sustained effects highlights the broader structural conditions shaping youth well-being. In a context of ongoing political hostility and systemic marginalization, short-term interventions alone may be insufficient to produce lasting change. From a social work and social justice perspective, these findings underscore both the promise and the limits of individual- and relational-level approaches. While mentorship can function as a critical protective factor, durable improvements in mental health likely require sustained, multi-level supports that address structural drivers of minority stress. Expanding access to longer-term, culturally responsive, and affirming interventions is essential to promoting enduring well-being and positive identity development among TGDY.