Date of Award


Document Type



College of Nursing

Degree Name

Doctor of Nursing Practice (DNP)


Background: Transgender and nonbinary (TGNB) youth make up almost two percent of the student population in the United States (Johns et al., 2019). They face usual challenges of adolescence, including identity, relationships with parents and peers, and body image, but also must navigate stigma, discrimination, and difficulties accessing necessary resources and information (Tankersley et al., 2021). Particularly, the sex education TGNB youth receive is often inadequate in relevant content for navigating puberty, sex, and relationships (Haley et al., 2019; Pampati et al., 2020). Youth may be left feeling ill-prepared for intimacy, puberty, or coming out, and be more likely to have negative sexual experiences (Haley et al., 2019; Riggs & Bartholomaeus, 2018)

Methods: As part of the series of studies conducted by Seattle University, the University of Washington, and Seattle Children’s Hospital, focus groups were facilitated with individuals associated with health service and advocacy organizations working with TGNB youth. Three focus groups with a total of 19 participants were transcribed and analyzed with thematic analysis.

Discussion: Input from participants in the focus groups mirrored many aspects of already identified recommendations. The content was integrated into a toolkit including mental health and crisis resources, expanded PrEP resources, peer connection, mental health resources and videos of adult perspectives in the TGNB and LGBTQ community. The issues identified by both TGNB youth and participants of the focus groups address issues from sexual health, mental health, relationships, and prevention of violence to gender stereotypes and toxic masculinity all of which influence overall health. Health care providers have an opportunity and obligation to address these issues as part of a holistic approach to minimize disparities.