The impact of a marriage checkup with transgender couples

Randomized controlled trial of the Marriage Checkup: Stress outcomes

Several couple interventions targeting relationship distress also show beneficial effects on individual mental health. Yet, strikingly few studies report effects on perceived stress. This study examined the effects of a brief couple intervention, the Marriage Checkup (MC), on perceived stress. We randomly assigned 231 couples to receive two MCs (Weeks 7 and 51) or to a waitlist control. Survey data were collected at seven time points over 2 years and analyzed using multilevel models. We found no significant between-group treatment effects on average stress at any time point. However, women, but not men, in the intervention group experienced decreased stress after the second MC (d = -0.23) and more women in the intervention group (26.5%) compared with the control group (14.9%) experienced reliable improvements in stress after the second MC. Overall, the MC did not result in main effects on stress but caused temporary reliable change in terms of stress relief for women.

A randomized controlled trial of a 5-year marriage checkup booster session for a subsample of responder couples

This study examined maintenance and booster effects of a brief couple intervention, the Marriage Checkup (MC), across 5 years. A subsample of 63 couples who benefitted from two previous MCs (responder couples), were randomly assigned to a third MC or control. Before randomization (at 4-years-9-months), the responder sample had maintained small to medium effects on two measures of relationship functioning. After randomization, we found no significant between-group effects. Yet, within-group analyses revealed that while control couples showed flat trajectories in all outcomes after the 4-year-9-months baseline, couples receiving a third MC (at Year 5) reported small to medium improvements in three measures of relationship functioning and maintained follow-up effect in one measure. Findings indicate that couples who initially improved from the MC can maintain some of their improvements over long periods. The potential of boosting such improvements with recurrent MCs is a relevant target for further investigation in larger samples.

Factors that drive mental health disparities and promote well-being in transgender and nonbinary people

Transgender (or trans) is an umbrella term for individuals who experience their gender differently from what is associated with the sex they were assigned at birth. Individuals who are nonbinary experience their gender outside binary conceptions of gender. Although research has predominantly focused on negative mental health outcomes for transgender and non-binary (TNB) individuals, an emergent literature has begun to explore protective and health-promoting factors and dimensions of psychological well-being. In this Review, we discuss the sociocultural context for TNB people, beginning with a brief history of TNB identity before highlighting frameworks for understanding the higher prevalence of certain mental health concerns among TNB individuals. Next, we summarize the predictive factors associated with higher rates of depression, anxiety, suicidality, trauma-related concerns, disordered eating behaviours and substance use. We also review TNB coping, resilience and resistance to anti-trans stigma, as well as psychological well-being, flourishing and gender euphoria. Tying these topics together, we discuss affirming interventions for reducing mental health disparities and promoting psychological health in TNB individuals and communities. We conclude by discussing future research directions.

Individuals who are transgender or nonbinary experience a higher prevalence of certain mental health concerns, including depression, anxiety and disordered eating behaviours. In this Review, Tebbe and Budge discuss these disparities along with factors that protect these individuals from negative outcomes and promote well-being.