PROJECT SUMMARY Gender minority young adults (GMYA; 18-25 years old), who have a gender that is different than their assigned sex at birth, have 3-4 times greater risk of depression and anxiety than those whose gender is congruent with their assigned sex at birth (i.e., cisgender). The accumulation of gender minority stress (GM stress), stress due to stigma related to one’s gender identity and/or expression is one proposed cause of this disparity. GM stress can become internalized, and feelings of shame and repetitive thoughts (rumination) can make mental health worse. Despite the known associations between GM stress, mental health, shame and rumination, few interventions exist to address GM stress in GMYA. Self-compassion, treating oneself with kindness instead of self-criticism in painful or difficult times, has been identified as a useful strategy to alleviate GM stress among GM people, and is a trait that can be strengthened. Mindful self-compassion (MSC), an 8-week intervention, combining mindfulness and self-compassion skills is one way to increase self-compassion. However, MSC has not yet been tested with GYMA and it is not known whether gender dysphoria (distress due to body not matching identity) could make it difficult to fully engage with body-based practices. My long-term research goal is to improve the mental health and wellbeing of GMYA by identifying, and intervening on, modifiable risk and protective factors using community-engaged, trauma-informed interventions. The current project builds upon my prior cross-sectional research on GMYA’ mental health by exploring the feasibility of an existing intervention with a new population. The objective for this proposal is to obtain training and certification as an MSC teacher as well as additional skills in trauma-informed mindfulness and embodied practice, intervention science (implementation, evaluation, and adaptation), advanced data analysis, and community engaged research. With guidance from my mentors, I will pursue the following specific aims: 1) evaluate the feasibility of an 8-week MSC intervention and data collection plan (pre-, post-, 3-month follow-up) with 5 consecutive groups of GMYA, 2) evaluate the usability of MSC intervention activities by GMYA and determine whether MSC activities need to be tailored for GMYA, and 3) explore GMYA’s pre- and post- intervention and 3-month follow-up data to examine whether shame, rumination, self-compassion, depression, and anxiety are sensitive to change. The goals of this project are consistent with NCCIH’s interest in mind-body interventions to help reduce stress, anxiety, and depression among sexual and gender minority populations (NOT-MD-22-012), objectives to advance science on health promotion, resilience, and symptom management (Obj. 3), and commitment to research with diverse populations and a diverse scientific workforce (Obj. 4). Under the guidance of expert mentors in the population, methods, approaches, and with a strong history of research funding- the proposed project will provide me with the necessary skills to independently conduct rigorous complementary and integrative health research to improve mental health and wellbeing among GMYA.

Project Narrative Gender minority young adults (GMYA) experience unique stress related to their gender identity and/or expression, which may be amplified be amplified by current events like the ongoing COVID-19 pandemic and political actions to restrict the rights of GMYA, that can contribute to worse depression and anxiety compared to their cisgender counterparts. Evidence suggests increasing self-compassion among GM people could decrease depression and anxiety by reducing shame and rumination, but the full mindful self-compassion (MSC) intervention has yet to be tested among GMYA. If feasible and acceptable, MSC could be evaluated in a larger clinical trial for its ability to reduce the impact of gender minority stress on GMYA mental health.