Yang Xiaoshi, Wang Lie, Hao Chun, Gu Yuan, Song Wei, Wang Jian, Chang Margaret M, Zhao Qun
Department of Social Medicine, School of Public Health, China Medical University, Shenyang, Liaoning Province, China.
Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, Guangdong Province, China; Takemi Program in International Health, Department of Global Health and Population, Harvard School of Public Health, Boston, Massachusetts, United States of America.
PLoS One. 2015 Sep 14;10(9):e0136975. doi: 10.1371/journal.pone.0136975. eCollection 2015.
Transgender women often suffer from transition-related discrimination and loss of social support due to their gender transition, which may pose considerable psychological challenges and may lead to a high prevalence of depression in this population. Increased self-efficacy may combat the adverse effects of gender transition on depression. However, few available studies have investigated the protective effect of self-efficacy on depression among transgender women, and there is a scarcity of research describing the mental health of Chinese transgender women. This study aims to describe the prevalence of depression among Chinese transgender women and to explore the associated factors.
A cross-sectional study was conducted in Shenyang, Liaoning Province of China by convenience sampling from January 2014 to July 2014. Two hundred and nine Chinese transgender women were interviewed face-to-face with questionnaires that covered topics including the Zung Self-Rating Depression Scale (SDS), demographic characteristics, transition status, sex partnership, perceived transgender-related discrimination, the Multidimensional Scale of Perceived Social Support (MSPSS) and the adapted General Self-efficacy Scale (GSES). A hierarchical multiple regression analysis was performed to explore the factors associated with SDS scores.
The prevalence of depression among transgender women was 45.35%. Transgender women with regular partners or casual partners exhibited higher SDS scores than those without regular partners or casual partners. Regression analyses showed that sex partnership explained most (16.6%) of the total variance in depression scores. Self-efficacy was negatively associated with depression.
Chinese transgender women experienced high levels of depression. Depression was best predicted by whether transgender women had a regular partner or a casual partner rather than transgender-related discrimination and transition status. Moreover, self-efficacy had positive effects on attenuating depression due to gender transition. Therefore, interventions should focus on improving the sense of self-efficacy among these women to enable them to cope with depression and to determine risky sex partnership characteristics, especially for regular and casual partners.
跨性别女性常常因性别转变而遭受与转变相关的歧视并失去社会支持，这可能带来相当大的心理挑战，并可能导致该人群中抑郁症的高患病率。自我效能感的增强可能会对抗性别转变对抑郁症的不利影响。然而，现有的研究很少探讨自我效能感对跨性别女性抑郁症的保护作用，并且缺乏描述中国跨性别女性心理健康状况的研究。本研究旨在描述中国跨性别女性中抑郁症的患病率，并探索相关因素。
2014年1月至2014年7月，在中国辽宁省沈阳市采用便利抽样法进行了一项横断面研究。对209名中国跨性别女性进行了面对面访谈，问卷涵盖的主题包括zung自评抑郁量表（SDS）、人口统计学特征、转变状态、性伴侣关系、感知到的与跨性别相关的歧视、多维感知社会支持量表（MSPSS）以及改编后的一般自我效能量表（GSES）。进行了分层多元回归分析以探索与SDS评分相关的因素。
跨性别女性中抑郁症的患病率为45.35%。有固定伴侣或临时伴侣的跨性别女性的SDS评分高于没有固定伴侣或临时伴侣的女性。回归分析表明，性伴侣关系解释了抑郁症评分总方差的大部分（16.6%）。自我效能感与抑郁症呈负相关。
中国跨性别女性经历了高水平的抑郁症。抑郁症的最佳预测因素是跨性别女性是否有固定伴侣或临时伴侣，而非与跨性别相关的歧视和转变状态。此外，自我效能感对减轻因性别转变导致的抑郁症有积极作用。因此，干预措施应侧重于提高这些女性的自我效能感，使她们能够应对抑郁症，并确定危险性伴侣关系特征，特别是对于固定伴侣和临时伴侣。
