Transgender young people report worse mental health than general population
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Key takeaways:
- Transgender young people scored lower on quality of life questionnaires than the general public.
- Teens who had multiple gender-confirming treatments reported quality of life improvements.
Transgender and gender-expansive young people report worse quality of life mental health scores compared with the general U.S. population, according to study data.
In 2020, researchers conducted a cross-sectional health-related quality of life study that found transgender and gender-expansive youths scored lower on quality of life questionnaires than those across the U.S. In findings from a follow-up study published in Transgender Health, researchers followed up with participants about 2 years after they completed the prior study and found mental health-related quality of life scores continued to be low.
“At follow-up, most youth (60%) reported being able to accept their bodily appearance and most (67%) reported high levels of social support,” Anne M. Gadomski, MD, MPH, FAAP, attending physician of pediatrics and clinical researcher at the Bassett Research Institute, Bassett Medical Center in Cooperstown, New York, and colleagues wrote. “However, health-related quality-of-life mental health scores remained statistically significantly lower than U.S. population standards for both age groups, even though 64% were receiving mental health counseling at follow-up.”
Transgender and gender-expansive young people aged 8 to 25 years who were receiving gender-confirming care at the Gender Wellness Center in Oneonta, New York, were invited to participate in the follow-up study about 2 years after participating in the baseline study. Participants younger than 18 years completed the Child Health Questionnaire-Child Form 87 questionnaire and adults aged 18 to 25 years completed the SF-36v2 survey during regular clinic visits. Scores on both surveys ranged from 0 to 100, with higher scores indicating better health-related quality of life. Psychosocial well-being was assessed using the WHO Quality-of-Life Brief Version Psychological Domain. The Multidimensional Scale of Perceived Social Support was conducted to assess perceived support levels.
There were 108 young people who completed the study. Of the participants, 84% were attending high school, 60% lived in a rural area, 67% reported high levels of social support and 60% reported being able to accept their bodily appearance.
There were 55 adolescents who completed the Child Health Questionnaire-Child Form 87, including 40 transmasculine youths, eight transfeminine adolescents and seven who were gender expansive. Adolescents had improvements in the behavior (P = .002) and role/social limitations – physical (P = .29) subscales from the initial study until follow-up. Gender-expansive youths had lower scores on the role/social limitations – physical subscale than transgender boys or transgender girls. Those who received multiple gender-confirming treatments had an increase in overall score, from 63.91 at baseline to 77.39 at follow-up (P = .032). Those who did not undergo treatment had decreases in family cohesion score. from 61.67 at baseline to 30 at follow-up (P = .034). Similar to the baseline study, follow-up scores for adolescents were lower than the 2015-2016 U.S population standardized scores.
Among young adults who participated in the study, there was no change in any scores on the SF-36v2 survey from baseline to follow-up. Young adults scored higher than the 2009 U.S. standard for nearly all physical subscales, but scored lower for mental health subscales. The number of gender-confirming treatments received was not associated with any quality of life changes.
“The co-occurrence of the COVID-19 pandemic and anti-transgender/gender-expansive political environment may have adversely affected these study participants,” the researchers wrote. “Transgender/gender-expansive people and the clinicians providing gender-affirming care became targets of anti-transgender/gender-expansive and anti-LGBTQ legislation. These legislative attacks on transgender/gender-expansive rights were a continuous source of negative news and likely represent a cumulative social and mainstream media insult to transgender and gender-expansive youth, which may have increased their stigmatization.”
The researchers concluded that mental health is a primary concern for transgender and gender-expansive youths. They said future studies should examine sociocultural factors that may contribute to changes in quality of life.
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