Transgender and gender nonconforming youth are more likely to report mental health issues and less likely to seek help, according to a new study that evaluates risks for adolescents who don’t identify along typical gender norms.
Published on Monday in the journal Pediatrics, the study found that, of a sample size of more than 2,000 self-identifying transgender and gender non-conforming (TGNC) youth, 62.1 percent had negative responses toward their health. This included lower rates of preventive checkups, more nurse visits compared to doctor visits, and more long-term mental health problems.
Of cisgender youth — those whose gender identity aligns with their birth sex — 33.1 percent reported such health outcomes.
Respondents included people who identify as transgender (being of a different gender than their birth gender) and as gender non-conforming (not adhering to societal norms of male and female).
The researchers highlighted that the health risks associated with poor access for TGNC youth are especially dangerous. They are more likely to be “at an elevated risk for harassment and victimization,” which can lead to depression, self-harm, post-traumatic stress, eating disorders and suicidal thoughts.
The study’s data came from the 2016 Minnesota Student Survey, which included responses from nearly 81,000 ninth- and 11th-graders across the state.
There are no official and accurate federal statistics on transgender youth and adults in the U.S., said Jody Herman, a senior scholar at the Williams Institute, a think-tank based at the University of California-Los Angeles who was not involved in the study.
“Researchers, like me and others, have just been using what data are available to try and learn about that population, but it’s kind of piecemeal at this point,” Ms. Herman said.
Part of the problem includes not having questions that accurately identify gender minorities without confusing the larger population as part of large-scale, randomized and representative surveys.
But state-level surveys and those by community-based groups have put together a portrait of this community. In 2015, the Williams Institute published a report estimating the U.S. population of transgender adults at 1.4 million. In another study, about 27 percent of California youth said their peers would consider them gender nonconforming.
The Minnesota survey is one of the few U.S. reports that inquire about gender identity and expression and that can be applied to the wider population, said lead author Nic Rider, a post-doctoral fellow in human sexuality at the University of Minnesota.
“What makes this study unique and really important is that it’s one of the first population based studies to look at transgender and gender nonconforming youth in terms of health status and care use,” said the researcher. “The results are more generalizable.”
Researchers noted that in a different study the prevalence of TGNC persons makes it a comparable health priority to other concerns for early intervention, such as children with autism spectrum disorder (1.5 percent of the population), those with food allergies (3.9 percent) and youth with developmental delays (3.7 percent).
Ms. Herman said these numbers reinforce the importance that federal data-gathering needs to pay close attention to the population size of this community and their risk factors.
“There is a trend in the findings that there are some challenges that this community is facing and in order for us to identify the problems and do anything about them, we need the data sources,” she said.
In the latest study, the Minnesota researchers were “concerned” to see so many TGNC youth reporting poorer overall health, but were heartened by data showing that many of the respondents weren’t experiencing long-term physical health problems.
“[This] means we have a lot of opportunities to identify ways to help healthcare providers feel more competent, confident and comfortable working with transgender and gender nonconforming youth,” said the study’s lead author, who does not use personal pronouns like “he” or “she.”
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