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Trans adolescents exhibit disproportionate levels of mental health problems; mental health disparities understudied

73% of transgender adolescents reported psychological abuse, 39% reported physical abuse, and 19% reported sexual abuse.

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Transgender adolescents have disproportionate levels of mental health problems compared with cisgender adolescents, though – unfortunately – psychosocial processes underlying mental health disparities among them remain understudied.

This is according to a study – “Disparities in Childhood Abuse Between Transgender and Cisgender Adolescents” by Brian C. Thoma, Taylor L. Rezeppa, Sophia Choukas-Bradley, Rachel H. Salk and Michael P. Marshal – that appeared in Pediatrics.

For this study, 1,836 adolescents aged 14 to 18 completed a cross-sectional online survey related to the topic.

It was found that 73% of transgender adolescents reported psychological abuse, 39% reported physical abuse, and 19% reported sexual abuse. Compared with heterosexual signer adolescents, they had higher odds of psychological abuse (odds ratio = 1.84), physical abuse (OR = 1.61), and sexual abuse (OR = 2.04).

Within separate subgroup analyses, transgender males and nonbinary adolescents assigned female at birth had higher odds of reporting psychological abuse than cisgender adolescents.

There are various recommendations from the researchers, including:

  • pediatric medical and mental health professionals screen for child abuse to recognize and respond to ongoing maltreatment among children and adolescents
  • providers should pay particular attention to parent-adolescent relationships when treating transgender people assigned female at birth
  • providers should assess gender identity privately without parents present if possible, including level of parental knowledge of gender identity among transgender adolescents
  • limit the chances that interactions with providers could increase family discord related to gender identity, which has the potential to exacerbate childhood abuse among transgender adolescents
  • implement family-based cognitive-behavioral interventions to reduce the risk of future abuse within families
  • provide access to evidence-based treatment, such as trauma-focused cognitive-behavioral therapy, to reduce mental health symptoms of transgender adolescents who experienced abuses
  • providers should carefully tailor their interventions to ensure their care is validating of transgender adolescents’ gender identity while limiting rejection and fostering acceptance by family members


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