Skip to main content
University of Wisconsin–Madison

Transgender, Two-Spirit and Nonbinary Populations

Transgender, two-spirit and nonbinary (TNB) people have increased risk for mental health concerns, including anxiety, trauma-based distress, depression, self-harm and suicidality, and are formally recognized by NIH as a “health disparities population.”

This project is a pilot feasibility trial assessing psychotherapy process and outcomes of e-therapy (telehealth) interventions for TNB clients matched with TNB therapists. The study will collect longitudinal process and outcome data of 15 psychotherapy sessions with 50 TNB clients seeing 10 TNB therapists. Clients will engage in four overall assessments and a short assessment prior to each psychotherapy session.

A primary goal is to center Black, Indigenous and People of Color (BIPOC) clients and therapists. Three community partners will assist with study design, implementation, and dissemination of the results. The three partners include people involved in community organizations who support BIPOC TNB people.

Therapists will be trained to use the Radical Healing Framework and interventions that focus on internalized stigma. Findings from this study could further support expanding insurance coverage for e-therapy services throughout the United States and could be used to train therapists nationwide regarding this innovative mechanism to improve cultural competence.


Stephanie Budge, associate professor of counseling psychology


Elliot Tebbe, assistant professor of nursing