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Poor mental health common in young transgender women, health care reform needed

Mental health, substance abuse and comorbid psychiatric disorders were common in a community-recruited sample of young transgender women, further indicating a need to restructure transgender health care.

“Although community surveys of transgender persons in the United States have found a high prevalence of depression, anxiety and substance use relative to that of the general adult U.S. population, studies typically use screening instruments or subthreshold symptom questions and do not use diagnostic interviews, such as the Mini-International Neuropsychiatric Interview (MINI), to assess prevalence of mental health psychopathology and substance dependence, with one exception,” Sari L. Reisner, ScD, of Boston Children’s Hospital/Harvard Medical School, and colleagues wrote.

To determine the prevalence of mental health, substance dependence and comorbid psychiatric disorders in transgender youth, researchers conducted an observational study of 298 sexually active, young transgender women, aged 16 through 29 years. Study participants were enrolled in Project LifeSkills, an ongoing randomized controlled HIV prevention intervention efficacy trial in Chicago and Boston. Researchers used the Mini-International Neuropsychiatric Interview to evaluate mental health and substance dependence disorders.

The study cohort included 49% black, 12.4% Latina, 25.5% white and 13.1% other minority race/ethnicities women.

Overall, 41.5% of participants had one or more mental health or substance dependence diagnoses and 20.1% had two or more comorbid psychiatric diagnoses.

Thirty-five percent of women experienced a lifetime major depressive episode, 14.7% experienced a current major depressive episode, 20.2% experienced suicidality, 7.9% had generalized anxiety disorder, 9.8% had PTSD, 11.2% had alcohol dependence and 15.2% had nonalcohol psychoactive substance use dependence.

“Although care services for transgender youth have expanded around the country, the scientific and professional provider community still remains largely uncertain about the complex nature of transgender experience, especially in regard to youth,” Johanna Olson-Kennedy, MD, of Children’s Hospital Los Angeles, wrote in an accompanying editorial. “The entire framework of transgender health care would benefit from a restructuring to meet the needs of patients and clients, as well as acknowledging pragmatic limitations of available professionals.” – by Amanda Oldt

Disclosure: The researchers report no relevant financial disclosures.