With about one in three gender-minority youths changing their gender identity more than once, a study stressed that transitioning gender identities is not associated with depression. In fact, there are higher rates of depression among transgender youths are more closely associated with bullying and victimization.
The study – “Trajectories of Gender Identity and Depressive Symptoms in Youths” by André Gonzales Real, Maria Inês Rodrigues Lobato, and Stephen T. Russell – appeared in JAMA Network Open.
The study followed 366 LGBTQ+ young people ages 15-21 in two US cities from 2011 to 2015 and measured depressive symptoms periodically, as well as the young people’s self-reported gender identity and other factors. During the study period, three-fourths of the participants maintained a gender identity consistent with their sex at birth (known as cisgender) throughout the three years, and another 9% maintained a transgender identity during the study period. Variations in gender identity were observed among other participants, including about 8% who reported a transgender identity earlier on and moved to a cisgender identity by the end of the study.
“Exploring gender identity and gender expression is a normal part of adolescence and growing up for some youth,” said corresponding author Real. “Depression among transgender youth is a big public health concern, but it’s not gender identity or transitioning that is at the root. It’s the bullying, rejection and victimization we need to be worried about.”
The study’s key findings include:
- Of the youths who reported a different gender identity during the study, almost one-third did so more than twice. Among these youths, the rate of depressive symptoms was the lowest of the different groups and remained largely stable throughout the study.
- Young people who transitioned from a cisgender identity to a transgender identity were more likely to experience symptoms of depression than those who maintained a cisgender identity throughout the study.
- When researchers controlled for bullying and victimization, which is more common for transgender youths, there was no statistical difference in depressive symptoms between groups. This lends key context to reports of links between youth depression and gender transition.
“We found that gender identity is not the primary driver of mental health. Mental health is related to the environment young people are living in,” said co-author Russell. “Being a transgender young person does not lead to depression on its own, but the social environment that many of these young people experience does.”
The study similarly established that there was no change in depressive symptoms measured before and after transitions to transgender — or to cisgender. Results were the same regardless of participants’ use of hormones and puberty blockers.
For the researchers, health care clinicians should pay particular attention to youths transitioning to transgender or gender diverse identities. “Additional support in this process can help mitigate the adverse effects of exposure to LGBTQ+ violence from peers or family rejection. Delays in providing care can result in more stress for these youths.”
