Risk and protective factors for mental health morbidity in a community sample of female-to-male trans-masculine adults

Abstract

BackgroundTrans-masculine (TM) individuals, who are assigned female sex at birth and identify along the masculine gender spectrum, face mental health disparities relative to cisgender people. Limited research has sought to explore the multi-level risk and protective factors associated with mental health morbidity for TM populations.MethodsBetween August 2015–September 2016, 150 TM adults were enrolled in a one-time biobehavioral health study. A survey assessed socio-demographics, past 12-month everyday discrimination, lifetime intimate partner violence (IPV), resilience (using the Brief Resilience Scale), and other factors. Bivariate and multivariable logistic regression analyses examined associations between participant characteristics and four mental health statuses: post-traumatic stress disorder (PTSD), depression, anxiety, and non-suicidal self-injury (NSSI).ResultsIn this sample (76.7% had a binary gender identity, i.e., man or transgender man; 74.7% were white, 70.0% were under age 30 years), 42.2% had PTSD based on past 30-day symptoms; 25.7% had depression based on past 7-day symptoms; 31.1% had anxiety based on past 7-day symptoms; and 31.3% had engaged in NSSI within the past 12-months. Results from multivariable models: 1) PTSD: unemployment, lifetime IPV and past 12-month discrimination were each associated with increased odds of PTSD, while having a partner was associated with the reduced odds of PTSD. 2) Depression: lower educational attainment and past 12-month discrimination were each associated with the increased odds of depression, while greater resilience was associated with the reduced odds of depression. 3) Anxiety: low annual household income and past 12-month discrimination were each associated with the increased odds of anxiety, while resilience was associated with the reduced odds of anxiety. 4) NSSI: past 12-month discrimination was associated with the increased odds of past 12-month NSSI, while higher age and greater resilience was associated with the reduced odds of NSSI (all p-values < 0.05).ConclusionsUnemployment, low income, limited education, everyday discrimination, and violence were risk factors for poor mental health, while being in a relationship, higher age, and personal resilience were protective against mental health morbidity. Findings highlight the need for interventions to address the individual, interpersonal, and societal factors that may be driving poor mental health in this population.

Comparing the health of non-binary and binary transgender adults in a statewide non-probability sample

“…Non-binary individuals in this sample were also less likely than binary individuals to have been diagnosed with depression and anxiety by a healthcare provider. The lower prevalence of depression and anxiety diagnoses among non-binary participants in the study likely reflects differential access to opportunities to receive a medical diagnosis as, consistent with other studies, [8,11,57] a significantly higher proportion of non-binary screened-in for current clinically significant depressive distress, yet were less likely to have received mental health care treatment in the last 12 months relative to binary individuals. Additionally, a higher proportion of non-binary vs. binary respondents screened positive for hazardous drinking, which may in part be due to the younger age of the non-binary respondents.…”

Mastectomy in Transgender and Cisgender Patients: A Comparative Analysis of Epidemiology and Postoperative Outcomes

“…19 The degree of psychological comorbidity in this population is difficult to understate, with rates of depression reported at 2–3.6 times that of the general population and rates of suicide attempts up to 25 times as high. 19,25 Furthermore, compared with national averages, transgender individuals have double the rates of unemployment and homelessness, triple the rates of illicit drug use, and four times the rate of HIV infection. 19,26 Moreover, there is a considerable financial burden unique to the healthcare needs of this population, as evidenced by costly hormonal and surgical therapies, and the medical and behavioral health appointments needed to access them.…”

Education and practice developments: Addressing the psychosocial concerns and support needs of LGBT+ people

“…In terms of mental health issues per se, many LGBT+ people, across the life span, can experience anxiety, depression, trauma, suicidality, substance misuse and eating disorders (Kim et al 2017: Russell andFish 2016). From an assessment, treatment and intervention perspective, health services, including mental health providers, responsive to the distinct requirements of LGBT+ people has been recognised as a concern (McDowell et al, 2019;Smith et al, 2018;Steele et al, 2017). For some, they may experience social isolation and loneliness with an opportunity to provide social spaces that maintain and develop social networks and community connectedness (Currin et al 2018).…”