LGBT Identity, Untreated Depression, and Unmet Need for Mental Health Services by Sexual Minority Women and Trans-Identified People

Steele, Leah S.; Daley, Andrea; Curling, Deone; Gibson, Margaret F.; Green, Datejie C; Williams, Charmaine C.; Ross, Lori E.

doi:10.1089/jwh.2015.5677

Cited by 135 publications

(93 citation statements)

References 42 publications

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“…A primary analysis focused on sexual and gender minority mental health is reported elsewhere (Steele et al . ). The study was reviewed and approved by the Research Ethics Board of the Centre for Addiction and Mental Health and the University of Toronto.…”

Section: Methodsmentioning

confidence: 97%

“…Further details of this recruitment strategy are explained in our previous paper (Steele et al . ). Racial classifications were based on those used in the Canadian census.…”

Section: Methodsmentioning

confidence: 97%

“…This paper is based on secondary analysis of crosssectional survey data collected during a study of access to depression treatment for Lesbian, Bisexual and Transgender Women in Ontario, Canada (Ross et al 2011), which, on the basis of advice from our community advisory board, was ultimately expanded in scope to include transgender people of any gender identity. A primary analysis focused on sexual and gender minority mental health is reported elsewhere (Steele et al 2017). The study was reviewed and approved by the Research Ethics Board of the Centre for Addiction and Mental Health and the University of Toronto.…”

Section: Samplementioning

confidence: 99%

“…We used targeted convenience sampling to recruit adult women, transgender and gender liminal people from across Ontario, with selection to ensure that we had representation of different intersections of socio-demographic factors including lower socioeconomic status, racial minority identities, and minority sexual and gender identities. Further details of this recruitment strategy are explained in our previous paper (Steele et al 2017). Racial classifications were based on those used in the Canadian census.…”

Section: Samplementioning

confidence: 99%

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Depression and discrimination in the lives of women, transgender and gender liminal people in Ontario, Canada

Williams

Curling

Steele

et al. 2017

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This article uses an intersectionality lens to explore how experiences of race, gender, sexuality, class and their intersections are associated with depression and unmet need for mental healthcare in a population of 704 women and transgender/gender liminal people from Ontario, Canada. A survey collecting demographic information, information about mental health and use of mental healthcare services, and data for the Everyday Discrimination Scale and the PHQ-9 Questionnaire for Depression was completed by 704 people via Internet or pen-and-paper between June 2011 and June 2012. Bivariate and regression analyses were conducted to assess group differences in depression and discrimination experiences, and predictors of depression and unmet need for mental healthcare services. Analyses revealed that race, gender, class and sexuality all corresponded to significant differences in exposure to discrimination, experiences of depression and unmet needs for mental healthcare. Use of interaction terms to model intersecting identities and exclusion contributed to explained variance in both outcome variables. Everyday discrimination was the strongest predictor of both depression and unmet need for mental healthcare. The results suggest lower income and intersections of race with other marginalised identities are associated with more depression and unmet need for mental healthcare; however, discrimination is the factor that contributes the most to those vulnerabilities. Future research can build on intersectionality theory by foregrounding the role of structural inequities and discrimination in promoting poor mental health and barriers to healthcare.

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Section: Methodsmentioning

confidence: 97%

“…Further details of this recruitment strategy are explained in our previous paper (Steele et al . ). Racial classifications were based on those used in the Canadian census.…”

Section: Methodsmentioning

confidence: 97%

Section: Samplementioning

confidence: 99%

Section: Samplementioning

confidence: 99%

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Depression and discrimination in the lives of women, transgender and gender liminal people in Ontario, Canada

Williams

Curling

Steele

et al. 2017

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“…Sounds like excellent care, right? Yet how would you feel if you knew that you missed a very important part of this young woman's history that puts her at increased risk for teen pregnancy, substance abuse, suicide, depression, and fewer health care screenings across her lifetime? Unfortunately, health care providers all too often miss key pieces of information: gender identity and sexual orientation. Individuals who are lesbian, gay, bisexual, transgender, and/or queer/questioning (LGBTQ) experience increased risk for significant health disparities across their lifetimes .…”

Section: Evidence‐based Care Of Individuals Who Are Lesbian Gay Bismentioning

confidence: 99%

Current Resources for Evidence‐Based Practice, November/December 2017

Carlson¹

2017

J Midwife Womens Health

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Health Care Experiences of Patients Discontinuing or Reversing Prior Gender-Affirming Treatments

et al. 2022

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IMPORTANCEMedical education, research, and clinical guidelines are available to support the initiation of gender-affirming care for transgender and nonbinary people. By contrast, little is known about the clinical experiences of those who discontinue or seek to reverse gender-affirming medical or surgical interventions due to a change in gender identity, often referred to as detransition. OBJECTIVE To examine the physical and mental health experiences of people who initiated medical or surgical detransition to inform clinical practice.DESIGN, SETTING, AND PARTICIPANTS Using constructivist grounded theory as a qualitative approach, data were collected in the form of in-depth interviews. Data were analyzed using an inductive 2-stage coding process to categorize and interpret detransition-related health care experiences to inform clinical practice. Between October 2021 and January 2022, individuals living in Canada who were aged 18 years and older with experience of stopping, shifting, or reversing a gender transition were invited to partake in semistructured virtual interviews. Study advertisements were circulated over social media, to clinicians, and within participants' social networks. A purposive sample of 28 participants who discontinued, shifted, or reversed a gender transition were interviewed. MAIN OUTCOMES AND MEASURESIn-depth, narrative descriptions of the physical and mental health experiences of people who discontinued or sought to reverse prior gender-affirming medical and/or surgical interventions. RESULTS Among the 28 participants, 18 (64%) were assigned female at birth and 10 (36%) were assigned male at birth; 2 (7%) identified as Jewish and White, 5 (18%) identified as having mixed race and ethnicity (which included Arab, Black, Indigenous, Latinx, and South Asian), and 21 (75%) identified as White. Participants initially sought gender-affirmation at a wide range of ages (15 [56%] were between ages 18 and 24 years). Detransition occurred for various reasons, such as an evolving understanding of gender identity or health concerns. Participants reported divergent perspectives about their past gender-affirming medical or surgical treatments. Some participants felt regrets, but a majority were pleased with the results of gender-affirming medical or surgical treatments. Medical detransition was often experienced as physically and psychologically challenging, yet health care avoidance was common. Participants described experiencing stigma and interacting with clinicians who were unprepared to meet their detransition-related medical needs.CONCLUSIONS AND RELEVANCE This study's results suggest that further research and clinical guidance is required to address the unmet needs of this population who discontinue or seek to reverse prior gender-affirming interventions.

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LGBT Identity, Untreated Depression, and Unmet Need for Mental Health Services by Sexual Minority Women and Trans-Identified People

Cited by 135 publications

References 42 publications

Depression and discrimination in the lives of women, transgender and gender liminal people in Ontario, Canada

Depression and discrimination in the lives of women, transgender and gender liminal people in Ontario, Canada

Current Resources for Evidence‐Based Practice, November/December 2017

Health Care Experiences of Patients Discontinuing or Reversing Prior Gender-Affirming Treatments

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