Thoma, Brian C., and Sophia Choukas-Bradley. "Mental Health of Transgender Adolescents Around the Globe—A Call for Comprehensive Assessment of Gender Identity." JAMA Network Open 3.10 (2020): e2023412-e2023412.
The article by Wang and colleagues in JAMA Network Open makes an important contribution to the global health literature examining the well-being of transgender youth.1 Using a school-based population survey of secondary school students in Suzhou, China, from 2019, the authors document that transgender adolescents report higher rates of anxiety, depressive symptoms, sleep problems, and suicidality when compared with their cisgender peers. The data set used by the authors includes detailed items measuring both sex assigned at birth and current gender identity, allowing the authors to accurately identify transgender youth and examine how mental health problems and potential psychosocial correlates differ within subgroups of transgender youth—a key advancement over the majority of the existing literature examining the mental health of this vulnerable population.
This work adds to the nascent but growing global literature documenting dire mental health disparities between transgender youth and their cisgender peers. Researchers have described extremely high rates of mental health problems among transgender youth. For example, using a nationwide online sample of adolescents in the United States, we recently found that 85% of transgender youth experienced suicidal ideation during their lifetime, and more than half of transgender youth reported a prior suicide attempt.2 In the current Chinese sample, risk for suicidal ideation and behavior were uniformly elevated among subgroups of transgender youth. However, in our US sample, risk for suicidal ideation and behavior was highest among transgender youth with binary identities. These findings indicate that subgroup analyses are indispensable in identifying which transgender youth are at highest risk for mental health problems and should be prioritized in future risk reduction interventions. The alarming rates of mental health problems among transgender youth may result from disproportionate experiences of psychosocial stress during childhood and adolescence, including peer victimization, parental rejection, and pervasive stigmatization of their minority gender identity.
Unfortunately, unlike the data set used by Wang et al,1 the vast majority of representative surveys of adolescents do not include the necessary measures of gender identity to accurately identify transgender youth and categorize them into meaningful subgroups. Thus, we cannot rigorously assess the mental health of transgender youth in our highest-quality surveys of adolescent health, and we still lack knowledge of accurate epidemiologic estimates of how many youth in countries around the world currently identify as transgender. Read more via JAMA Network