A comparison of mental health symptomatology and levels of social support in young treatment seeking transgender individuals who identify as binary and non-binary

Background: Previous research has consistently reported high rates of mental health symptomatology and lower social support in young treatment seeking transgender individuals. However, these studies have failed to distinguish between transgender people who identify within the gender binary and those who identify as non-binary. Aims: This study aimed to compare levels of mental health symptomatology (anxiety, depression, and non-suicidal self-injury behavior) and social support of treatment seeking non-binary transgender young individuals with those self-identified as binary transgender young individuals. All participants attended a national transgender health service in the UK during a 2-year period. Measures: Age and gender identity descriptors were collected, as well as clinical measures of anxiety and depression (Hospital Anxiety and Depression Scale), self-esteem (The Rosenberg Self-Esteem Scale), non-suicidal self-injury (Non-Suicidal Self-Injury: Treatment Related), and social support (Multidimensional Scale of Perceived Social Support). Results: A total of 388 young people, aged 16–25 years, agreed participation; 331 (85.3%) identified as binary and 57 (14.7%) as non-binary. Analysis of the data showed the non-binary group experienced significantly more anxiety and depression and had significantly lower self-esteem than the binary group. There were no significant differences between groups in the likelihood of engaging in non-suicidal self-injury behavior or levels of social support.Conclusions: Non-binary identifying treatment seeking transgender youth are at increased risk of developing anxiety, depression, and low self-esteem compared to binary transgender youth. This may reflect the even greater barriers and feelings of discrimination that may be faced by those whose identity does not fit the notion of binary gender that is pervasive in how society views both cis- and transgender populations

High impact of sleeping problems on quality of life in transgender individuals: A cross-sectional multicenter study

<div><p>Introduction</p><p>Studies in the general population suggest that determinants of QoL are often sex-dependent. Sex-dependent analyses of QoL in transgender populations have not been performed so far.</p><p>Aim</p><p>To identify sex-specific and potentially modifiable determinants of QoL in transgender patients</p><p>Methods</p><p>In this cross-sectional multicentre study including 82 transwomen (TW) and 72 transmen (TM) at different treatment stages, we investigated potential determinants for QoL focusing on the impact of mood (BDI, STAI-X), sleep quality (PSQI), chronic pain (GPQ), body image (FBeK) and social support (SSS).</p><p>Main outcome measure</p><p>Health-related quality of life measured with the Short Form (36) Health Survey (SF-36).</p><p>Results</p><p>The age-adjusted SF-36 total score and its subscales did not significantly differ between TM and TW. Using a multivariate regression analysis approach, we identified common but also sex-dependent determinants for QoL (Adjusted R² = 0.228; 0.650 respectively). Accounting for general characteristics such as age, BMI and treatment status, sleep quality according to the PSQI was an independent and strong determinant of QoL in both sexes (β = -0.451, p = 0.003 TM; β = -0.320; p = 0.0029 TW). Chronic pain was a significant independent predictor of QoL in TM (β = -0.298; p = 0.042) but not in TW. In contrast, anxiety (β = -0.451; p< 0.001) being unemployed (β = -0.206; p = 0.020) and insecurity about the own appearance (FBeK) (β = -0.261; p = 0.01) were independent predictors of QoL in TW. The rate of those reporting high sleep disturbances (PSQI ≥5) was high with 79.2% in TW and 81.2% in TM. Accordingly, age-adjusted QoL was also significantly lower in those reporting poor sleep in both sexes.</p><p>Conclusions</p><p>Sleep strongly affected QoL in both genders, while other factors, like pain and body image, seem to be gender specific in transgender individuals.</p></div

Effects of chronic pain on the SF-36 global score.

<p>The age-adjusted SF-36 global score was significantly lower (p = 0.006) in TM that reported to suffer from chronic pain, while this was only true on a trend level (p = 0.052) for TW.</p

Univariate analysis of potential contributors for QoL.

<p>Univariate analysis of potential contributors for QoL.</p

Effects of poor sleep on the SF-36 global score.

<p>The age-adjusted SF-36 global score was significantly lower in TM (p = 0.009) and TW (p < 0.001) that reported to suffer from poor sleep indicated by a PSQI global score of ≥ 5.</p

General characteristics.

<p>General characteristics.</p

Determinants of QoL in Transmen.

<p>Determinants of QoL in Transmen.</p

Determinants of QoL in Transwomen.

<p>Determinants of QoL in Transwomen.</p

Questionnaire data.

<p>Questionnaire data.</p