“You get a better idea of what you want to do with your life”: needs and experiences of transgender and gender diverse individuals participating in an internet delivered emotion regulation treatment

Background Transgender and gender diverse (TGD) individuals experience elevated rates of emotional distress, often thought to be linked to minority stress, identity-related challenges, and limited access to affirming mental health care. Emotion regulation has emerged as a potential key therapeutic target for improving well-being in this population but less is known about how TGD individuals describe their own needs in relation to psychological treatment. Aim This study aimed to qualitatively explore the emotional and psychological needs of TGD individuals, and their experiences of an internet-delivered emotion regulation intervention (I-ER) specifically developed for TGD people. Method Ten TGD individuals who had received the I-ER treatment participated in semi-structured interviews. Data were analyzed using reflexive thematic analysis. Results Four themes were identified: (1) Emotional Exploration and Self-Understanding, (2) From Emotional Insight to Change, (3) Possibilities for and Limitations in Social Support, and (4) Barriers and Bridges to Treatment Engagement. Participants described the intervention as helpful for emotional insight, identity exploration, and behavioral change. The TGD-specific adaptation fostered a sense of recognition and belonging for most participants. However, challenges related to structure, support access, and individual fit were noted. Conclusion Emotion regulation interventions tailored to TGD individuals can be perceived as helpful and supportive when culturally grounded, flexible, and relationally sensitive. Findings highlight the importance of integrating identity-affirming content and addressing diverse support needs in digital mental health programs.