The health of transgender and gender-diverse (TGD) people seems to be getting worse with the passing of time.
This is according to a study – “Health Status and Mental Health of Transgender and Gender-Diverse Adults” by Michael Liu, Vishal R. Patel, Sari L. Reisner, et al – that appeared in the JAMA Internal Medicine.
The researchers noted that, as it is, the National Institutes of Health (NIH) already designated TGD people as a population that experiences health disparities. In the US, as an example, a 2017 study documented physical and mental health inequities between TGD and cisgender adults. And with a record number of laws enacted there to threaten protections of TGD people (including restricting access to gender-affirming care and permitting discrimination in public accommodations), they deemed it apt to “evaluate recent trends in health status and mental health among TGD adults”.
For this study, the researchers used data from the 2014 to 2022 Behavioral Risk Factor Surveillance System (BRFSS). The BRFSS introduced an optional gender identity module in 2014, with more US states adopting the module over the study period. They particularly assessed three self-reported health outcomes: poor or fair health status, frequent mental distress, and depression. Frequent mental distress was defined as reporting 14 or more poor mental health days during the past month.
In total, included were 1,921,731 respondents, of whom 1,912,847 (99.43% weighted) were classified as cisgender adults, and 8,884 (0.57% weighted) as TGD adults.
The study found:
- Between 2014 and 2022, prevalence of poor or fair health status increased from 26.6% to 35.1% among TGD adults but decreased among cisgender adults.
- Health status trends were significantly different by gender identity, indicating that the gap in health status widened between TGD and cisgender adults.
- Prevalence of frequent mental distress increased from 18.8% in 2014 to 38.9% in 2022 among TGD adults and from 11.2% to 15.5% among cisgender.
- Prevalence of depression more than doubled from 19.7% to 51.3% among TGD adults, whereas smaller increases occurred among cisgender adults.
- Worsening of mental health outcomes was significantly more pronounced among TGD than cisgender adults.
In a gist, “health status, mental health, and health inequities among TGD adults… worsened from 2014 to 2022. This population experienced over two-fold increases in prevalence of frequent mental distress and depression, while significantly smaller changes were observed among their cisgender counterparts,” the researchers stated.
The researchers similarly noted that “poor health outcomes among TGD adults are associated with exposure to stress in the form of multilevel stigma and discrimination attributed to belonging to a marginalized group.”
Recommendations from the researchers included: further research to identify factors contributing to the widening health inequities in this population, especially amid recent proliferation of anti-TGD legislation; and the need for the health sector to follow established standards of care and advocate for policies that protect TGD health.
