Effect of a Brief Social Contact Video on Transphobia and Depression-Related Stigma Among Adolescents
Authors: Doron Amsalem, Justin Halloran, Brent Penque, Jillian Celentano, Andrés Martin
Journal: JAMA Network Open (2022)

<h3>Importance</h3> Transphobia and stigma remain barriers to seeking mental health care for gender-diverse adolescents. <h3>Objective</h3> To examine the utility of brief social contact–based video interventions of transgender protagonists with depression to reduce transphobia and depression-related stigma and increase treatment-seeking intentions among adolescents in the general population. <h3>Design, Setting, and Participants</h3> During August 2021, a total of 1437 participants were recruited and randomly assigned to 1 of 4 video-based conditions in a 2:2:1:1 ratio: (1) transgender adolescent girls, (2) transgender adolescent boys, (3) cisgender adolescent girls, or (4) cisgender adolescent boys. <h3>Interventions</h3> In each of the approximately 110-second videos, an empowered presenter shared their personal story about coping with depression and reaching out for help. <h3>Main Outcomes and Measures</h3> The primary outcome was the score on the Attitudes Toward Transgender Men and Women (ATTMW) scale. Secondary outcomes were (1) a "gender thermometer" rating for warmth in transgender perception, (2) the Depression Stigma Scale (DSS) score, and (3) the General Health-Seeking Questionnaire (GHSQ) score. <h3>Results</h3> Of the 1437 randomized participants, 1098 (76%) completed the postintervention assessment and passed all the validity tests (mean [SD] age, 16.9 [1.2] years; 481 [44%] male; 640 [58%] White). A significant change in attitudes toward transgender youth was found within the intervention group only (mean [SD] ATTMW scores: intervention group, 34.6 [23.1] at baseline to 32.8 [24.2] after intervention;<i>P</i> &lt; .001; control group, 33.5 [23.4] at baseline to 32.4 [24.1] after intervention;<i>P</i>= .01). The mean (SD) total DSS scores decreased significantly across study groups (intervention: 1.3 [3.3]; control: 1.7 [3.3];<i>P</i> &lt; .001). A significant increase in intention to seek help from a parent was found in the intervention (mean [SD] GHSQ score, 0.2 [1.1]) and control (mean [SD] GHSQ score, 0.3 [1.2]) groups (<i>P</i> &lt; .001), as was a decrease in those not wanting to seek help from anyone (mean [SD] GHSQ score: intervention, 0.2 [1.6],<i>P</i> = .009; control, 0.3 [1.2],<i>P</i> &lt; .001) Secondary analyses revealed significant differences in baseline ATTMW scores and intervention effects between transgender and gender-diverse and cisgender participants and between lesbian, gay, bisexual, or queer (LGBQ) and straight participants (F = 36.7,<i>P</i> &lt; .001) and heterosexual participants (F = 37.0,<i>P</i> &lt; .001). A significant difference was also found in mean (SD) transgender warmth scores from baseline to after intervention between groups (2.6° [13.1°] in the intervention group vs 0.4° [8.3°] in the control group;<i>P</i> &lt; .001). <h3>Conclusions and Relevance</h3> In this randomized clinical trial, brief social contact–based videos proved efficacious in reducing transphobia and depression-related stigma and in increasing treatment-seeking intentions among adolescents in the general population. By personifying, individualizing, and providing face and voice to the experience of transgender youth, other adolescents, especially those who are cisgender and/or of a heterosexual orientation, can gain empathetic insights into the lives of their often marginalized and stigmatized fellow youth. <h3>Trial Registration</h3> ClinicalTrials.gov Identifier:NCT04969003