Trans and gender diverse young people (TGDYP) face challenges accessing health and mental health services that affirm all aspects of identity. Innovation in the development of appropriate measurement tools to evaluate the affirming nature of these services is crucial for effective care delivery. Unfortunately, measurement tools are rarely created with lived experience expertise. This project addresses this gap by partnering with TGDYP to develop a 'patient-reported outcome measure' and fidelity checklist of ‘whole of self’ affirming care.

The project methodology involves several phases. First, we are undertaking a scoping review of affirming care for different marginalised groups, and qualitative interviews with TGDYP. This will enable us to prioritise perspectives and generate a list of possible items. Second, we will establish a consensus regarding importance of items across TGDYP, family members, and service providers using the Delphi technique. We are embedding lived experience perspectives by having researchers with lived experience and community partners in the project team, working alongside a lived experience advisory group, and employing peer researchers. The input of TGDYP facilitates decision-making based on the needs of community throughout the project.

Preliminary findings underscore critical areas for affirming care, such as cultural responsiveness, cultural humility, disability inclusion, and neuroaffirming approaches. Interview findings and review results will inform the development of draft items for the outcome measure and checklist, which will undergo validation through the Delphi process involving trans youth, their families, and healthcare providers.

Current evaluation methods are insufficient in capturing affirming care comprehensively. Our project aims to create patient-reported outcome measures and fidelity checklists that resonate with the community, ensuring relevance and impact. Integrating lived experiences from development to evaluation ensures methodological rigor and community resonance. Implementing these tools will enable more meaningful evaluations of health and mental health services, fostering ongoing quality improvements to better serve TGDYP.