JMIR Publications

Background:

Previous research found that transgender and gender nonbinary (TNB) individuals rely more on online environments for receiving support in handling gender transition. As the outness process can be difficult to handle, psychological interventions targeting coping abilities are required.

Objective:

The current study outlines the preregistered protocol for the randomized controlled trial (RCT) entitled Resilient Identity, which integrates previous theoretical resilience frameworks. The purpose is to develop resilience and other related skills, particularly self-compassion in young transgender and nonbinary (TNB) adults.

Methods:

The paper focuses on a 3-arm design (Metaverse, online asynchronous platform, and waitlist) consisting of 7 sessions of a theme-based support group. Following randomization of the expected sample into the three conditions (45 participants per group), four assessments will be conducted: baseline, mid- and post-program, and three-month follow-up. Participants (aged 18-35) in the active conditions will be exposed to five scenario-based social contexts depicting microaggressions in corresponding Metaverse rooms and will engage in corresponding problem-solving tasks and self-compassion exercises. A mixed-methods approach will be utilized, with linear mixed-effects models employed to analyze outcomes across 12 primary variables.

Results:

The study protocol was finalized and preregistered in April 2025. The trial’s pilot phase was conducted between May and August 2025. The main RCT was initially planned to begin in September 2025 but was postponed until the end of 2026 due to delays in recruitment and implementation. The planned trans-affirmative setting will allow TNB young adults to explore gender expression in a secure, peer-mentoring and support format that promotes authenticity. Results are expected to show that participants in the Metaverse condition will have higher resilience scores than those in the other conditions. These improvements are also expected to generalize to related outcomes, such as self-compassion, self-efficacy, facilitative coping, and assertiveness, supported by the environment’s immersive features.

Conclusions:

The Resilient Identity support groups propose a low-intensity intervention model aimed at strengthening resilient attitudes in response to social threats among TNB individuals in Romania. Data from this trial will assess the efficacy of the scenario-based approach in preventing the escalation of psychological difficulties among this vulnerable population in a high-structural-stigma setting.

Clinicaltrial:

ClinicalTrials.gov NCT06959992; https://clinicaltrials.gov/study/NCT06959992