The Impact of Discrimination on the Mental Health of Trans*Female Youth and the Protective Effect of Parental Support.

Abstract

Significant health disparities exist for transgender female (trans*female) youth. We assessed differences in mental health outcomes based on exposure to discrimination among transgender female youth in the San Francisco Bay Area aged 16-24years. Youth were recruited using a combination of respondent driven sampling with online and social media methods. Logistic regression models were used to estimate odds ratios for the mental health outcomes, comparing levels of discrimination and levels of resiliency promoting protective factors among sexually active youth in the sample (N=216). High transgender-based discrimination was significantly associated with greater odds of PTSD (AOR, 2.6; 95% CI 1.4-5.0), depression (AOR, 2.6; 95% CI 1.2-5.9), and stress related to suicidal thoughts (AOR 7.7, 95% CI 2.3-35.2). High racial discrimination was significantly associated with greater odds of psychological stress (AOR 3.6; 95% CI 1.2-10.8), PTSD (AOR 2.1; 95% CI 1.1-4.2) and stress related to suicidal thoughts (AOR 4.3, 95% CI 1.5-13.3). Parental closeness was related to significantly lower odds of all four mental health outcomes measured, and intrinsic resiliency positively reduced risk for psychological stress, PTSD, and stress related to suicidal thoughts. Transgender and racial discrimination may have deleterious effects on the mental health of trans*female youth. Interventions that address individual and intersectional discrimination and build resources for resiliency and parental closeness may have success in preventing mental health disorders in this underserved population.