Mental health status of treatment seeking young transgender people: a comparative study between young transgender people and the general population
Arcelus, J1; Bouman, WP2
1: University of Nottingham / Nottingham Centre for transgender health, United Kingdom; 2: Nottingham Centre for Transgender Health
Objectives: To assess the mental health status of young people (<25 years) attending a national transgender health service in the United Kingdom during a 3 years period and to compare the findings to a matched population control group.
Materials and methods: Every young person who was offered an assessment at a national transgender health service in the UK was invited to participate in the study. Measurements of depression and anxiety (Hospital Anxiety and Depression Scale-HADS) were collected and compared to a cisgender (non-trans) population matched by age and sex assigned at birth. The cisgender population was recruited as part of a different project (n=1200). For the matched control comparison 300 people in each group (cisgender and transgender) were selected.
Results: A total of 1095 people were invited for assessment during the study period, of which 565 (51.6%) were younger than 25 years. There were slightly more assigned females at birth (51.9%) than assigned males at birth (48.1%), and 14.7% did not identified as binary transgender. More than half of the people (54.6%) suffered from a possible anxiety disorder and 47.3% a possible depressive disorder. When compared with the cisgender population, the transgender group presented with statistically significant more anxiety and depressive symptoms than the cisgender group (p<.05). Predictors of psychopathology were found to be having a transphobia experience(β = .18, p < .001), low self-esteem(β = -.29, p < .001), and presenting with interpersonal problems) (β = .48, p < .001). Psychopathology did not differ across gender groups in the transgender population. Those presenting with having started cross-sex hormones before assessment (via other professionals or the Internet) did present with less depressive and anxiety symptoms.
Conclusions: Young transgender people have a significantly poorer mental health status than their cisgender counterparts with a high prevalence of anxiety and depression. Low self esteem, transphobia, interpersonal problems and lack of cross-sex hormone treatment predicted poor mental health in young transgender people. Education and legislation aimed at targeting transphobia, psychological support to increase self-esteem and interpersonal function as well as access to hormone treatment are vital to ensure good mental health outcomes for young trans people.
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