Abstract

Transgender and gender diverse individuals experience high rates of health disparities, as compared with their cisgender (non-transgender) counterparts. One area in which these disparities is most grave is that of mental health, with some studies indicating transgender and gender diverse individuals as having a 40% rate of lifetime suicide attempts and similarly high rates of depression, anxiety, and suicidal ideation. These rates vary further within this population, with differential rates seen across sociodemographic factors, including race/ethnicity, gender, sexual orientation, disability status, education level, and income. This study explores mental health experiences across different social identities, using data from the 2018 Michigan Trans Health Survey (N = 659), a community-based participatory action research project collected in Michigan, United States, analyzed using chi-square tests of independence and logistic regressions. Findings indicate incredibly high rates of mental health concerns; 72.2% had been diagnosed with depression in their lifetime and 73.0% had been diagnosed with anxiety in their lifetime. In the past year, 49.9% had had non-suicidal self-injury (NSSI) thoughts, 45.4% had suicidal thoughts, 26.3% engaged in NSSI, and 7.7% had attempted suicide. Bivariate regressions showed some nuanced experiences of rates of mental health diagnoses and experiences, such as greater odds of experiencing all mental health disparities among those with disabilities, and differential odds across gender in regard to ever having a depression diagnosis, non-suicidal self-injury thoughts and engaging in non-suicidal self-injury behavior. This indicates a need for social workers, counselors, therapists, and other human services professionals to act more intentionally and with an intersectional lens when it comes to exploring the mental health of transgender and gender diverse persons.

Highlights

  • Transgender and gender diverse (TGD) people are a diverse group of individuals whose gender identity and/or expression do not align with societal expectations associated with the sex they were labelled at birth [1,2]

  • Smith et al [79] found that conservative community beliefs, restrictive local policies, and geographic barriers to accessing trans-affirming care may contribute to mental health disparities, while interpersonal factors, such as a strong support system, may serve as a more influential protective factor for rural TGD than TGD people in urban areas

  • Members of the TGD population experience incredibly high rates of mental health concerns, much of which may be due to navigating a world of stigma, discrimination, and victimization

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Summary

Introduction

Transgender (trans) and gender diverse (TGD) people are a diverse group of individuals whose gender identity and/or expression do not align with societal expectations associated with the sex they were labelled at birth [1,2]. TGD individuals may include those who identify as transmasculine/trans men/men, transfeminine/trans women/women, in addition to individuals whose genders are more fluid and/or may not fit within a masculine/feminine binary (e.g., nonbinary, genderqueer, agender). Res. Public Health 2020, 17, 6805; doi:10.3390/ijerph17186805 www.mdpi.com/journal/ijerph

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