Effects of the COVID19 Pandemic on Transgender and Gender Non-Conforming Adolescents' Mental Health.
Ontology highlight
ABSTRACT:
SUBMITTER: Perl L
PROVIDER: S-EPMC9754683 | biostudies-literature | 2021 Aug
REPOSITORIES: biostudies-literature
Publications
Effects of the COVID19 Pandemic on Transgender and Gender Non-Conforming Adolescents' Mental Health.
Perl Liat L Oren Asaf A Klein Zohar Z Shechner Tomer T
Psychiatry research 20210604
We assessed the effects of the COVID19 lockdown on the mental health of transgender and gender non-conforming (TGN) youth (n = 18) vs cisgender youth (29 males; 29 females). Coronavirus Health Impact Survey (CRISIS) and Emotion Regulation Questionnaire were used in an online study. No group differences were found in demographic variables and exposure to COVID19. Negative emotions/feeling increased for all groups. Cisgender youth reported using more adaptive emotion regulation strategies than TGN ...[more]
Similar Datasets
Project description:Post-COVID19 complications such as pediatric inflammatory multisystem syndrome (PIMS) and Long-COVID19 move increasingly into focus, potentially causing more harm in young adolescents than the acute infection. To better understand the symptoms of long-term mental health outcomes in adolescents and distinguish infection-associated symptoms from pandemic-associated symptoms, we conducted a 12 question Long-COVID19 survey. Using this survey, we compared the responses on neurocognitive, general pain and mood symptoms from seropositive and seronegative adolescents in a cross-sectional study design. Since May 2020, students grade 8-12 in fourteen secondary schools in Eastern Saxony were enrolled in the SchoolCovid19 study. Serostatus was assessed regularly in all participants. In March/April 2021, 1560 students with a median age of 15 years participated at the regular study visit after re-opening of the schools in mid-March and responded to our Long-COVID19 survey as part of this visit. 1365 (88%) students were seronegative, 188 (12%) were seropositive. Each symptom asked in the Long-COVID19 survey was present in at least 35% of the students within the last seven days before the survey. With the exception of seropositive students being less sad, there was no significant difference comparing the reported symptoms between seropositive students and seronegative students. The lack of differences comparing the reported symptoms between seropositive and seronegative students suggests that Long-COVID19 might be less common than previously thought and emphasizes on the impact of pandemic-associated symptoms regarding the well-being and mental health of young adolescents.Clinical Trial Registration: SchoolCoviDD19: Prospektive Erfassung der SARS-CoV-2 Seropositivität bei Schulkindern nach Ende der unterrichtsfreien Zeit aufgrund der Corona-Schutz-Verordnung (COVID-19), DRKS00022455, https://www.drks.de/drks_web/navigate.do?navigationId=trial.HTML&TRIAL_ID=DRKS00022455.
| S-EPMC8831534 | biostudies-literature
Project description:BACKGROUND:Transgender and gender non-conforming (TGNC) people face high rates of poverty, joblessness, and homelessness, rendering this population vulnerable to experiencing food insecurity. Yet, there is almost no empirical evidence concerning food insecurity and the use of local and federal food assistance resources in the TGNC community. Food insecurity, the use of local and Federal food assistance resources, and associations with gender-related minority stressors and resilience using the Gender Minority Stress and Resilience (GMSR) scale among TGNC individuals living in the Southeast United States (U.S.) were documented in this study. METHODS:A cross-sectional online survey was conducted with TGNC people living in the Southeast U.S. Participants were recruited via targeted Facebook advertisements. RESULTS:In total, 105 TGNC people completed the survey; 79% of survey participants experienced food insecurity, 19% utilized Federal, and 22% utilized local food assistance resources. High levels of minority stress and community resilience were reported. The GMSR resilience scale Pride (aOR = 1.09, 95% CI 1.00-1.19, p = .04) was significantly associated with the use of local food pantries, but minority stressors were not. No significant associations were found between GMSR and food security. CONCLUSION:TGNC people living in the Southeast U.S. experienced food insecurity, unstable housing, low wages, and social stigma that were a barrier to using emergency food resources. Multi-level public health solutions that address discriminatory legislative policies and create linkages between TGNC people and local and federal food assistance are required to address issues of food insecurity in the TGNC population.
| S-EPMC7191729 | biostudies-literature
Project description: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.
| S-EPMC5914494 | biostudies-literature
Project description:IntroductionWithin gender-diverse populations, gender-affirming changes in gender on record may improve mental or behavioral health. This study uses claims data to investigate whether sex assigned at birth modifies the association between change in gender on record and mental or behavioral health.MethodsAdult Oregon Medicaid beneficiaries with gender identity-related diagnoses and enrolled during 2010-2019 were included. Sex assigned at birth was inferred from medical and pharmacy claims and was categorized as assigned female, assigned male, or unknown sex assigned at birth. Self-reported gender ascertained at initial enrollment differing from sex assigned at birth indicated a change in gender on record. Multivariable logistic regression estimated the association between change in gender on record and mental (anxiety, depression, suicidal ideation, post-traumatic stress disorder) or behavioral (alcohol, substance, or tobacco use disorders) health. Analyses were conducted in February 2021.ResultsThis study included 2,940 transgender and nonbinary adults. Of the 1,451 self-reporting female gender and 1,489 self-reporting male gender, 449 (30.9%) were assigned male at birth, and 303 (20.3%) were assigned female at birth, classified as changing their gender on record. Predicted probability of mental or behavioral conditions was significantly lower in those who changed their gender on record. Sex assigned at birth modified the association with mental health: assigned female at birth reporting female gender had the highest burdens, followed by assigned male at birth reporting male. Secondary analyses using a modified change in gender definition or alternative sex assigned at birth inference method found similar trends.ConclusionsOregon Medicaid gender-diverse beneficiaries who changed their gender on record had a meaningfully lower probability of mental and behavioral health conditions. Those assigned female at birth reporting female gender had the highest burdens.
| S-EPMC9035075 | biostudies-literature
Project description:ImportanceTransgender and nonbinary (TNB) youths are disproportionately burdened by poor mental health outcomes owing to decreased social support and increased stigma and discrimination. Although gender-affirming care is associated with decreased long-term adverse mental health outcomes among these youths, less is known about its association with mental health immediately after initiation of care.ObjectiveTo investigate changes in mental health over the first year of receiving gender-affirming care and whether initiation of puberty blockers (PBs) and gender-affirming hormones (GAHs) was associated with changes in depression, anxiety, and suicidality.Design, setting, and participantsThis prospective observational cohort study was conducted at an urban multidisciplinary gender clinic among TNB adolescents and young adults seeking gender-affirming care from August 2017 to June 2018. Data were analyzed from August 2020 through November 2021.ExposuresTime since enrollment and receipt of PBs or GAHs.Main outcomes and measuresMental health outcomes of interest were assessed via the Patient Health Questionnaire 9-item (PHQ-9) and Generalized Anxiety Disorder 7-item (GAD-7) scales, which were dichotomized into measures of moderate or severe depression and anxiety (ie, scores ≥10), respectively. Any self-report of self-harm or suicidal thoughts over the previous 2 weeks was assessed using PHQ-9 question 9. Generalized estimating equations were used to assess change from baseline in each outcome at 3, 6, and 12 months of follow-up. Bivariate and multivariable logistic models were estimated to examine temporal trends and investigate associations between receipt of PBs or GAHs and each outcome.ResultsAmong 104 youths aged 13 to 20 years (mean [SD] age, 15.8 [1.6] years) who participated in the study, there were 63 transmasculine individuals (60.6%), 27 transfeminine individuals (26.0%), 10 nonbinary or gender fluid individuals (9.6%), and 4 youths who responded "I don't know" or did not respond to the gender identity question (3.8%). At baseline, 59 individuals (56.7%) had moderate to severe depression, 52 individuals (50.0%) had moderate to severe anxiety, and 45 individuals (43.3%) reported self-harm or suicidal thoughts. By the end of the study, 69 youths (66.3%) had received PBs, GAHs, or both interventions, while 35 youths had not received either intervention (33.7%). After adjustment for temporal trends and potential confounders, we observed 60% lower odds of depression (adjusted odds ratio [aOR], 0.40; 95% CI, 0.17-0.95) and 73% lower odds of suicidality (aOR, 0.27; 95% CI, 0.11-0.65) among youths who had initiated PBs or GAHs compared with youths who had not. There was no association between PBs or GAHs and anxiety (aOR, 1.01; 95% CI, 0.41, 2.51).Conclusions and relevanceThis study found that gender-affirming medical interventions were associated with lower odds of depression and suicidality over 12 months. These data add to existing evidence suggesting that gender-affirming care may be associated with improved well-being among TNB youths over a short period, which is important given mental health disparities experienced by this population, particularly the high levels of self-harm and suicide.
| S-EPMC8881768 | biostudies-literature
Project description:Few studies have disentangled differences in victimization exposures and mental health symptoms among gender diverse subgroups, nor considered the role of potential protective factors in ameliorating the impact of victimization on gender diverse youths' mental health. Here we report findings from a secondary data analysis, in which we address this gap by analyzing cross-sectional survey data (N = 11,264 in the final analytic sample) from a population-based survey of youth in participating school districts in a large Midwestern U.S. county. Relative to cisgender youth with gender conforming expression, transgender youth and cisgender youth with nonconforming gender expression are more likely to experience victimization and severe mental health concerns. Additionally, school-connectedness moderates the association between bias-based harassment and depression for cisgender youth with gender nonconforming expression, and family support/monitoring buffers the association of peer victimization with suicide attempts among transgender youth. Findings highlight the need to better understand factors which may confer protection among gender diverse adolescents, so that in turn appropriate supports across key contexts can be implemented.
| S-EPMC10955934 | biostudies-literature
Project description:Previous research suggests that people encode gender starting in childhood. The present research asked whether gender diverse children (i.e., children whose gender identity or expression differs from that expected based on assigned sex) encode gender. Results showed that 3- to 5-year-old gender diverse participants (N = 71), siblings of gender diverse children (N = 52), and gender conforming controls (N = 69) did not significantly differ in degree of gender encoding. These results converge with prior research to suggest that gender diverse children process gender in ways that do not differ from gender conforming children, and provide further evidence that gender encoding may be a common aspect of person perception in societies that support a binary view of gender.
| S-EPMC7722060 | biostudies-literature
Project description:Among adolescents, mental health issues (i.e., stress and depressive symptoms) negatively affect sleep. We assessed whether the association between mental health and sleep varied between genders among Saudi adolescents. A total of 2206 school students (grades 7-12) from 40 randomly selected schools in four cities of Al-Qassim province in Saudi Arabia participated in this cross-sectional study. The survey assessed demography, lifestyle, sleep (12-item Medical Outcomes Study Sleep Scale), depression (Depression, Anxiety, Stress Scale (DASS-21)) and stress (10-item Perceived Stress Scale). Adjusted associations with sleep were tested with linear and logistic regressions. Of the sample, 55% were girls, and their average sleep score was lower than that of the boys (58.7 vs. 63.4, p < 0.001). Girls had worse mental health than boys; the proportion of girls with both severe stress and severe depressive symptoms was three times higher than that of the boys (12% vs. 4%, p < 0.001). For both boys and girls, those with severe depressive symptoms only or both severe depressive symptoms and severe stress had significantly lower sleep scores than those who had neither of the two conditions (reference group). On the other hand, among those who had severe stress only, the sleep score was significantly lower for the girls (p = 0.002) than for the boys (p = 0.19). Overall, girls had a significantly lower sleep score and worse mental health than boys. The association between mental health and sleep significantly differed between the sexes. Severe stress was negatively associated with sleep in girls but not in boys.
| S-EPMC8448587 | biostudies-literature
Project description:ObjectiveGender-affirming hormones (GAH)-the use of sex hormones to induce desired secondary sex characteristics in transgender individuals-is vital healthcare for many transgender people. Among prescribers of GAH, there is debate regarding the value of a universal requirement for an evaluation by a mental health provider prior to GAH initiation. The purpose of this qualitative study was to describe the range of attitudes and approaches to mental health evaluation among GAH providers in the United States. We analyzed the providers' attitudes and base our recommendations on this analysis.MethodsWe conducted semi-structured interviews with 18 healthcare providers who prescribe GAH across the United States. Participants were purposefully recruited using professional networks and snowball sampling to include those who require mental health evaluation and those who do not. We adapted domains from the Theoretical Domains Framework-a framework for understanding influences on health professional behavior-to inform the interviews and analysis. Guided by these domains, we iteratively coded text and identified theoretical relationships among the categories.ResultsWhile some felt a universal requirement for mental health "clearance" was necessary for the identification of appropriate candidates for GAH, others described this requirement as a form of "gatekeeping" that limits access to care. Themes we identified included providers' ability to ascertain gender identity; concern about mental illness; GAH provider and mental health provider expertise; and provider roles. All providers appreciated the potential advantages of mental health support during GAH treatment.ConclusionProviders in our study practice on a continuum of care rather than adhering to strict rules about the requirement for mental health evaluation prior to GAH treatment. Where they fall on this continuum is influenced primarily by their perceptions of transgender identity and transition, and their interpretation of risk for significant mental illness and its association with transness. Providers who required universal evaluation by a mental health professional tended to hold essentialist, medicalized, and binary ideas of gender and transness.
| S-EPMC9387802 | biostudies-literature
Project description:ObjectiveTransgender people face substantial mental health disparities, and this population's emotional well-being can be particularly volatile during gender transition. Understanding gender transition sentiment patterns can positively impact transgender people by enabling them to anticipate, and put support in place for, particularly difficult time periods. Yet, tracking sentiment over time throughout gender transition is challenging using traditional research methods. This study's objective was to use social media data to understand average gender transition sentiment patterns.Materials and methodsComputational sentiment analysis and statistics were used to analyze 41 066 posts from 240 Tumblr transition blogs (online spaces where transgender people document gender transitions) to understand sentiment patterns over time and quantify relationships between transgender identity disclosures, sentiment, and social support.ResultsFindings suggest that sentiment increases over time on average throughout gender transition, particularly when people receive supportive responses to transgender identity disclosures. However, after disclosures to family members, people experienced temporary increased negative sentiment, followed by increased positive sentiment in the long term. After transgender identity disclosures on Facebook, an important means of mass disclosure, those with supportive networks experienced increased positive sentiment.ConclusionsWith foreknowledge of sentiment patterns likely to occur during gender transition, transgender people and their mental healthcare professionals can prepare with proper support in place throughout the gender transition process. Social media are a novel data source for understanding transgender people's sentiment patterns, which can help reduce mental health disparities for this marginalized population during a particularly difficult time.
| S-EPMC6696505 | biostudies-literature