Transgender Adolescents More Likely to Be Depressed

A new study based on data from the Sidney Borum Jr. Health Center shows what a handful of local and regional studies on transgender youth have long suggested: Transgender youth have disparately negative mental health outcomes compared to non-transgender youth.

"To date, there are limited comparative mental health data available in transgender adolescents and young adults to document health inequities by gender minority status. This research points to the need for gender-affirming mental health services and interventions to support transgender youth," said Sari Reisner, ScD, Research Scientist at The Fenway Institute and Postdoctoral Research Fellow in the Department of Epidemiology at Harvard School of Public Health, and the lead author of the report. "It is clear that clinicians serving transgender youth should routinely screen for mental health concerns."

The study examined data from the electronic health records of 180 transgender patients age 12-29 years matched with non-transgender patients who were seen for healthcare at the Sidney Borum Jr. Health Center. Compared with non-transgender youth, transgender youth had an elevated probability of being diagnosed with depression (50.6% vs. 20.6%); suffering from anxiety (26.7% vs. 10%); attempting suicide (17.2% vs. 6.1%); and engaging in self-harming activities without lethal intent (16.7% vs. 4.4%).

Among transgender patients, there were 106 female-to-male youth and 74 male-to-female youth, and there were no statistically significant differences in negative mental health outcomes between female-to-male and male-to-female youth.

The findings are detailed in Mental health of transgender youth in care at an adolescent urban community health center: A matched retrospective cohort study, which was published January 6, 2015 in the Journal of Adolescent Health.

Findings from the study also point to the need to integrate gender-inclusive measures into electronic health records, including assigned sex at birth and current gender identity at patient registration. Including these questions facilitates clinic-based epidemiologic research as well as quality improvement efforts to ensure high-quality, gender-affirming care.

Although the Sidney Borum, Jr. Health Center devotes a good part of its resources to the care of transgender youth, it is still a primary care clinic for adolescents and emerging adults. Therefore, this study shows that expanded care for transgender youth can be provided in the context of overall pediatric care: integration of behavioral health, psychiatry, and pediatric primary care -- a medical home approach -- can more than adequately support the medical and behavioral health needs of transgender youth and provide a locus of care for reduction of psychiatric outcomes described by the study.

For more than forty years, Fenway Health has been working to make life healthier for the people in our neighborhood, the LGBT community, people living with HIV/AIDS and the broader population. The Fenway Institute at Fenway Health is an interdisciplinary center for research, training, education and policy development focusing on national and international health issues. Fenway's Sidney Borum Jr. Health Center cares for youth and young adults ages 12 to 29 who may not feel comfortable going anywhere else, including those who are LGBT or just figuring things out; homeless; struggling with substance use; or living with HIV/AIDS.

The full report is available here: http://www.jahonline.org/pb/assets/raw/Health%20Advance/journals/jah/feature.pdf