Enacted stigma, mental health, and protective factors among transgender youth in Canada

Purpose: We aimed to assess the Minority Stress Model which proposes that the stress of experiencing stigma leads to adverse mental health outcomes, but social supports (e.g., school and family connectedness) will reduce this negative effect. Methods: We measured stigma-related experiences, social supports, and mental health (self-injury, suicide, depression, and anxiety) among a sample of 923 Canadian transgender 14- to 25-year-old adolescents and young adults using a bilingual online survey. Logistic regression models were conducted to analyze the relationship between these risk and protective factors and dichotomous mental health outcomes among two separate age groups, 14- to 18-year-old and 19- to 25-year-old participants. Results: Experiences of discrimination, harassment, and violence (enacted stigma) were positively related to mental health problems and social support was negatively associated with mental health problems in all models among both age groups. Among 14–18 year olds, we examined school connectedness, family connectedness, and perception of friends caring separately, and family connectedness was always the strongest protective predictor in multivariate models. In all the mental health outcomes we examined, transgender youth reporting low levels of enacted stigma experiences and high levels of protective factors tended to report favorable mental health outcomes. Conversely, the majority of participants reporting high levels of enacted stigma and low levels of protective factors reported adverse mental health outcomes. Conclusion: While these findings are limited by nonprobability sampling procedures and potential additional unmeasured risk and protective factors, the results provide positive evidence for the Minority Stress Model in this population and affirm the need for policies and programs to support schools and families to support transgender youth

Being Safe, Being Me: Results of the Canadian Trans Youth Health Survey

Cette étude a été financée par la subvention no MOP119472 des Instituts de recherche en santé du Canada, Institut de la santé des femmes et des hommes.Disponible en français dans EDUQ.info sous le titre "Être en sécurité, être soi-même : résultats de l’enquête canadienne sur la santé des jeunes trans".A national study by SARAVYC showed that while Canada’s transgender youth face significant physical and mental health issues, strong family, school and community connections help many of them navigate these challenges. The study, funded by the Canadian Institute for Health Research and completed in collaboration with universities and health researchers across Canada, was the first and largest of its kind in Canada, with 923 individuals participating between the ages 14-25. They answered a range of questions in English or French on their home and school life, physical and mental health, access to health care, and gender identity. The report called for measures to improve the well-being of trans youth, including: improved support for families, so they can better understand and support their transgender children; developing safer, more inclusive schools; retooling health care to provide gender-affirming services for trans youth; and reducing health care disparities between provinces

Être en sécurité, être soi-même : résultats de l’enquête canadienne sur la santé des jeunes trans

Cette étude a été financée par la subvention no MOP119472 des Instituts de recherche en santé du Canada, Institut de la santé des femmes et des hommes.Disponible en anglais dans EDUQ.info sous le titre "Being Safe, Being Me: Results of the Canadian Trans Youth Health Survey

Primary care access and foregone care: A survey of transgender adolescents and young adults

Objective. To examine the issues of primary care access and foregone health care among transgender adolescents and young adults. Methods. This cross-sectional analysis of data from the Canadian Trans Youth Health Survey was conducted online during 2013–2014. Participants included 923 youth aged 14–25 (323 adolescents aged 14–18 and 600 young adults aged 19–25). Main outcome measures were self-reported general and mental health status, comfort discussing transgender identity and health care needs with general practitioners, and types of and reasons for self-identified foregone health care. Results. Most youth reported poor/fair general and mental health status. Comfort with a family doctor was positively correlated with both general health (r(528) = 21, P < 0.001) and mental health (r(450) = 26, P < 0.001) status, as was having a doctor who was aware of one’s transgender status. 47.2% (n = 219) of young adults reported foregoing needed health care. Among adolescents, levels of comfort with family doctor were negatively correlated with foregone mental health care in the previous 12 months (F₃,₁₆₆ = 3.829, P = 0.011), but not correlated with foregone physical health care (F₃,₁₆₅ = 0.506, P = 0.679). Reasons for missing needed care spanned the dimensions of health care access, ranging from cost barriers to previous negative experiences with health care providers, and concerns that a doctor would be uneducated about transgender people. Conclusion. General practitioners can play a key role in improving the health of transgender youth by demonstrating understanding of the health care needs of transgender youth and competence in gender-affirming care, and by ensuring that their practices are accessible to all transgender youth in need of care