Yale Pediatric Gender Program

APPIC #118328

Overview

This placement provides fellows with the opportunity to receive comprehensive clinical training within two multidisciplinary services. Fellows are provided the opportunity to serve in the Yale Pediatric Gender Program (YPGP) for the bulk of their time, where clinical care utilizes an affirmative approach to supporting youth and their families as they navigate their youth’s individual gender journey. This setting offers fellows training in provision of consultation services for youth who are exploring their gender identity and family support during transition. Fellows also conduct an initial biopsychosocial assessment with each patient to better understand the individual’s gender journey, supports, health concerns and needs and goals for the future. In addition, fellows carry a caseload of individual patients and participate in biweekly parent and youth groups. Additionally, fellows help to support clinical program development efforts by monitoring effectiveness of interventions and evaluating clinical outcomes for patients in the program. Fellows within this placement have the opportunity to engage in a range of clinical activities that are similar to those of a staff psychologist within the same setting. Opportunities are also available to supervise an advanced psychology graduate student.

Twice per month fellows also participate in the Variations of Sexual Development clinic. Fellows are able to participate in a consultative role to individuals and families who attend the clinic, in conjunction with providers in Gynecology, Urology, Endocrinology and Genetics. Fellows are also able to engage in multi-site research and training opportunities on this rotation.

Above and beyond these core training activities, fellows have the option to receive individual psychodynamically-informed psychotherapy training, on an elective basis, through the hospital's Long-Term Care Clinic.

Placement Options

Primary Placement:

This track consists of a year-long, full-time placement at the Yale New Haven Children’s Hospital Pediatric Gender Program and Variations of Sexual Development Clinic for a total of 50 hours per week.

Secondary Placement:

None

Number of Fellows

One doctoral fellow will be selected for the Pediatric Gender Program Track for the 2024-2025 academic year.

The Setting

The Yale Pediatric Gender Program (YPGP)is an interdisciplinary team that provides services for transgender and gender diverse youth 3-25 and their families. The program includes a comprehensive, interdisciplinary approach to help youth and families explore and receive expert care around issues of gender identity. The overarching team includes professionals in the fields of psychology, endocrinology, psychiatry, obstetrics, gynecology, medical ethics, chaplaincy and law. Providers within the program also consult with urology, plastic surgery and general medicine.

The Gender Program serves economically and ethnically diverse groups of families who are interested in learning more about the social and medical transition options associated with diverse gender identities. Services available through YPGP include:

consultation
intake assessments
individual psychotherapy
group therapy
parental support/consultation
family therapy, and
clinical consultation with professionals in other service delivery systems.

Our clinicians follow current medical protocols, which do not allow for either surgery or drug therapy for prepubescent children. Social transition is the only medically accepted form of gender-affirming care—and the only form of care we provide—for that age group.

Lastly, providers in the program work to maintain close contact with community providers to facilitate ongoing provision of mental health and medication management services, for youth receiving care through the clinic.

Fellows will participate in clinical rounds twice per month. During this meeting, clinical teams discuss each individual presenting to clinic, their health needs, interventions and plans for the future. Fellows will share updates on individual and/or family treatment as well as consultations from outside providers. In addition, fellows will have the opportunity to provide feedback on symptomatology of all patients, as measures of health are completed at each clinic appointment.

The Internship

Yale Pediatric Gender Program: Fellows will provide ongoing consultation to the YPGP interdisciplinary team, complete comprehensive biopsychosocial intake evaluations with youth and families and provide individual and family therapy to patients served in the program. The fellow will also have the opportunity to participate in monthly Journal Club meetings with other fellows, residents and medical faculty, and will co-lead bi-weekly treatment groups for gender expansive youth and parents. YPGP also provides regular training to medical residents, staff and community providers, which the fellow will be able to assist with.

The clinical work done within YPGP is supervised by an interdisciplinary treatment team comprised of faculty representing the disciplines of psychiatry, psychology, pediatrics, and nursing. Interdisciplinary huddles within the program to deal with immediate problems that occur in the treatment of patients are common.

Scholarly opportunities are also available within the YPGP, including access to existing data and collaboration with ongoing projects. YPGP currently has a HIC-approved registry which allows the program to track a multitude of health outcomes for patients throughout their treatment within our program. Additional projects examining cardiovascular functioning, eating behaviors, physical activity, bone health and educational initiatives centering transgender health are also available.

Variations of Sexual Development Clinic: Fellows will be embedded in the multidisciplinary Variations of Sexual Development Clinic twice per month. In this setting, fellows will provide consultation and brief interventions to youth and families presenting to clinic on an as-needed basis.

Long Term Care Clinic: All Yale-New Haven Hospital (YNHH) doctoral fellows have the option of receiving weekly supervised individual psychotherapy training within the Long-Term Care Clinic (LTCC). This is an outpatient psychotherapy training clinic operated by the Department of Psychiatry and YNHH. Individual patients are referred to this clinic by the Yale University Health Services, and as such, are typically members of the University community who are seeking insight-oriented psychotherapy for a variety of issues, most commonly related to developmental, relationship, mood, and/or anxiety concerns.

Evidence-Based Practices

The following evidence-based practices (EBPs) are used in these placement settings: Cognitive Behavior Therapy (CBT), Acceptance and Commitment Therapy (ACT), Positive Psychology and skills from Dialectical Behavior Therapy (DBT). Fellows generally have exposure to most of these EBPs though do not necessarily receive training or supervised experience in all of them.

Psychological Assessment

The psychological assessment experience for Yale Pediatric Gender Program fellows involves conducting comprehensive biopsychosocial intake assessments. In addition to a clinical interview and record review, the psychology fellow typically will use standardized instruments to assess level of symptomatology and changes in symptoms over time. Feedback sessions with youth and their families will be conducted after the assessment is completed to discuss additional supports that may be useful for the family as they support their youth on their gender journey. These assessments are seen as “a moment in time” and will be used as a basis for letters of support for future interventions, as needed.

Diversity

At YNHH diversity and inclusion are important values. The hospital is committed to providing an environment of inclusion that supports the diversity among its patients, visitors, employees, business partners and communities. Serving the Greater New Haven area and surrounding Southern New England region, YNHH admits a diverse population of patients, both diagnostically as well as demographically. Racially, approximately 65 percent of patients admitted to the hospital are Caucasian, 15 percent Black, 15 percent Hispanic and 5 percent Asian. Nearly 60 percent of patient hospital costs are covered through Medicare or Medicaid. The hospital is committed to providing the highest standard of care to all patients regardless of socioeconomic status, race, ethnicity, language, nationality, sex, gender identity, sexual orientation, religion, geography, disability and age.

Scholarly Activity

Four hours per week of protected time is provided to allow fellows the opportunity to design and conduct a scholarly project of their choice. Individual project objectives are coordinated with the primary advisor, or another faculty mentor involved in a program of active research. Fellows may design a project with faculty within their primary training placement, or request to be matched with other faculty in the Yale School of Medicine (Yale University, School of Nursing, School of Public Health, etc.) based on their shared interests and faculty availability. The fellow’s scholarly activity can take many forms. In consultation with the faculty advisor, the fellow may choose to engage in an ongoing research project, evaluate a clinical service or program, or help design and implement a new project that will benefit the individuals receiving services within the YNHH system.

Faculty

Christy L. Olezeski, Ph.D., Primary Advisor
Nicolas Meade, Psy.D., Clinical Supervisor
Katie Herzig, Ph.D., Voluntary Faculty Clinical Supervisor
Whitney Randall, Psy.D., Voluntary Faculty Clinical Supervisor

Supervision

The fellow has weekly individual supervision with a primary advisor and additional clinical supervisors. They also participate weekly in clinical consultation team meetings or rounds and receive assessment supervision as needed. Fellows may receive additional individual supervision for optional clinical activities such as with the Long-Term Care Clinic. Formal evaluations are completed and serve as opportunities to review progress on training goals and address progress toward achieving the required core competencies.

Seminars and Specialized Training

YPGP fellows attend and participate in the weekly core seminar held within the Department of Psychiatry, as well as separate weekly hospital-based seminars for fellows and other psychology trainees based at YNHH. In addition to the internship Core seminar and a hospital-based seminar with other YNHH fellows, additional didactic behavioral health related case conferences, seminars and grand rounds are offered through the Yale School of Medicine. Participation in these optional activities is at the discretion of the fellow and their primary advisor as schedules permit.

Applicant Qualifications

Strong applicants for this placement generally have prior experience working with gender diverse youth and their families including patients who struggle with high-risk impulsive behaviors. In addition, strong applicants will have experience conducting evidence-based therapies and have an interest in program development. Fellows who match with this placement typically have strong interests in treatment and/or scholarship related to gender expansive youth and show promise for developing a leadership role in the field.

Applicants selected for this placement must successfully pass background checks conducted by Yale University and Yale-New Haven Hospital.