Mental Health of Transgender and Gender Nonconforming Youth Compared With Their Peers

American Academy of Pediatrics (AAP) - Tập 141 Số 5 - 2018
Tracy A. Becerra-Culqui1, Yuan Liu2, Rebecca Nash3, Lee Cromwell4, W. Dana Flanders3, Darios Getahun1, Shawn V. Giammattei5, Enid M. Hunkeler6, Timothy L. Lash3, Andrea Millman6, Virginia P. Quinn1, Brandi Robinson4, Douglas Roblin7, David E. Sandberg8, Michael J. Silverberg6, Vin Tangpricha9,10, Michael Goodman3
1Department of Research and Evaluation, Kaiser Permanente Southern California, Pasadena, California
2Departments of Biostatistics and Bioinformatics and
3Epidemiology, Rollins School of Public Health, and
4Center for Clinical and Outcomes Research, Kaiser Permanente Georgia, Atlanta, Georgia
5Rockway Institute, Alliant International University, San Francisco, California;
6Division of Research, Kaiser Permanente Northern California, Oakland, California
7Mid-Atlantic Permanente Research Institute, Kaiser Permanente Mid-Atlantic States, Rockville, Maryland
8Department of Pediatrics, Medical School, University of Michigan, Ann Arbor, Michigan; and
9Atlanta Veterans Affairs Medical Center, Atlanta, Georgia
10Emory School of Medicine, Emory University, Atlanta, Georgia;

Tóm tắt

BACKGROUND: Understanding the magnitude of mental health problems, particularly life-threatening ones, experienced by transgender and/or gender nonconforming (TGNC) youth can lead to improved management of these conditions. METHODS: Electronic medical records were used to identify a cohort of 588 transfeminine and 745 transmasculine children (3–9 years old) and adolescents (10–17 years old) enrolled in integrated health care systems in California and Georgia. Ten male and 10 female referent cisgender enrollees were matched to each TGNC individual on year of birth, race and/or ethnicity, study site, and membership year of the index date (first evidence of gender nonconforming status). Prevalence ratios were calculated by dividing the proportion of TGNC individuals with a specific mental health diagnosis or diagnostic category by the corresponding proportion in each reference group by transfeminine and/or transmasculine status, age group, and time period before the index date. RESULTS: Common diagnoses for children and adolescents were attention deficit disorders (transfeminine 15%; transmasculine 16%) and depressive disorders (transfeminine 49%; transmasculine 62%), respectively. For all diagnostic categories, prevalence was severalfold higher among TGNC youth than in matched reference groups. Prevalence ratios (95% confidence intervals [CIs]) for history of self-inflicted injury in adolescents 6 months before the index date ranged from 18 (95% CI 4.4–82) to 144 (95% CI 36–1248). The corresponding range for suicidal ideation was 25 (95% CI 14–45) to 54 (95% CI 18–218). CONCLUSIONS: TGNC youth may present with mental health conditions requiring immediate evaluation and implementation of clinical, social, and educational gender identity support measures.

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American Academy of Pediatrics (AAP)

Tập 141 Số 5

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