A Gender-Affirming Stigma Intervention to Improve Substance Misuse and HIV Risk Among Transgender Adults

What this Trial Is About

Researchers are evaluating a new mutual-help program called the TLC Program designed specifically for transgender adults who use substances or have recently been in recovery. This program is based on Acceptance and Commitment Therapy (ACT), a counseling approach that uses mindfulness to help people connect with their values and improve mental health. The TLC Program was developed collaboratively by transgender and gender diverse community members, mental health providers, and researchers to address stigma and substance misuse among transgender populations who face high rates of HIV and social challenges. The study compares two groups: one receiving treatment-as-usual (TAU) following established guidelines for alcohol, drug use, and HIV prevention, and another receiving TAU plus the TLC Program. The TLC Program is a peer-led, telehealth group intervention delivered via videoconferencing over 12 weeks. Sessions last about 1.5 hours and cover ACT core concepts with a focus on gender affirmation, internalized stigma, and substance use reduction. Additional sessions explain stigma's impact on health and promote self-care goals related to substance use and healthcare engagement. Participants will be involved in assessments at baseline, after 12 weeks, and at 24-week follow-up. These include questionnaires measuring internalized transphobia, healthcare empowerment, psychological flexibility, substance use, and HIV risk. Weekly patient-reported outcomes will also be collected. Researchers will monitor intervention acceptability, appropriateness, and feasibility. The study aims to understand whether the TLC Program can reduce stigma and improve health behaviors among transgender adults facing substance use challenges.

The Trans-Led Care Study