Collaborative Care in Affirming Primary Care: Comparable Depression and Anxiety Outcomes Across Gender Identities

Aynsley Scheffert; Michael A Strong; Katherine L Imborek

doi:10.17077/pp.006811

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Collaborative Care in Affirming Primary Care: Comparable Depression and Anxiety Outcomes Across Gender Identities

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Collaborative Care in Affirming Primary Care: Comparable Depression and Anxiety Outcomes Across Gender Identities

Aynsley Scheffert, Michael A Strong and Katherine L Imborek

p.26 pages

University of Iowa

07/30/2026

DOI: 10.17077/pp.006811

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Abstract

Transgender and gender nonbinary (TGNB) individuals experience disproportionately high rates of depression and anxiety, often driven by minority stress, stigma, and barriers to accessing affirming behavioral health care. The Collaborative Care Model (CoCM), which integrates behavioral health services into primary care, has demonstrated effectiveness in general populations but has been minimally examined among TGNB patients. This study examined whether participation in CoCM was associated with within-person changes in depression and anxiety symptoms and whether symptom change differed by gender identity. A retrospective chart review was conducted for 33 adults (15 cisgender and 18 TGNB) who completed CoCM treatment in an affirming primary care setting. Results indicated statistically significant reductions in depression and anxiety symptoms from pre- to post-treatment. Importantly, symptom improvement did not differ by gender identity, indicating comparable clinical benefit for cisgender and TGNB patients. These findings suggest that, when delivered within affirming primary care environments, CoCM may support equitable mental health symptom improvement across gender identities.

gender-affirming care

mental health care

integrative behavioral health

collaborative care

Details

Title: Subtitle: Collaborative Care in Affirming Primary Care: Comparable Depression and Anxiety Outcomes Across Gender Identities
Creators: Aynsley Scheffert - University of Iowa, School of Social Work
Michael A Strong - University of Iowa, Psychiatry
Katherine L Imborek - University of Iowa, Family and Community Medicine
Resource Type: Preprint
Publication Details: p.26 pages
DOI: 10.17077/pp.006811
Publisher: University of Iowa; Iowa City, Iowa, USA
Language: English
Date posted: 07/30/2026
Academic Unit: Psychiatry; School of Social Work; Center for Social Science Innovation
Record Identifier: 9985182896202771

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