北美大学生群体中跨性别身份认同、睡眠、心理健康与自杀倾向之间的关联
Associations Between Transgender Identity, Sleep, Mental Health and Suicidality Among a North American Cohort of College Students.
作者信息
Hershner Shelley, Jansen Erica C, Gavidia Ronald, Matlen Lisa, Hoban Mary, Dunietz Galit Levi
机构信息
Sleep Disorders Center, Department of Neurology, University of Michigan, Ann Arbor, MI, USA.
Department of Nutritional Sciences, University of Michigan School of Public Health, Ann Arbor, MI, USA.
出版信息
Nat Sci Sleep. 2021 Mar 16;13:383-398. doi: 10.2147/NSS.S286131. eCollection 2021.
PURPOSE
The purpose of this study is to examine the associations between transgender identity, sleep, and mental health among a North American cohort of cisgender and transgender college students.
PARTICIPANTS AND METHODS
This cross-sectional study surveyed 221,549 North American college students from the 2016-2017 American College Health Association-National College Health Assessment II. Bivariate and multivariable analysis examined associations among transgender identity and outcomes of insomnia symptoms, daytime sleepiness, sleep disorder diagnoses and treatments. Mental health outcomes included mood symptoms, suicidal behaviors, anxiety and depression diagnoses and treatments.
RESULTS
Transgender identity was reported by 1.6% (n=3471) of United States (US) and 1.7% (n=717) Canadian students, respectively. Mean age was 22.5 ±6. Transgender college students have an increased prevalence of daytime sleepiness, insomnia symptoms, diagnoses and/or treatment of insomnia and other sleep disorders as compared to cisgender college students. Mental Health symptoms are more prevalent with a 2-fold increase in depression and anxiety and nearly a 4-fold increase in suicide attempts among transgender students. A higher burden of mood symptoms exists among transgender college students in the US in comparison to Canadian students.
CONCLUSION
Transgender college students have an alarmingly high rate of mood, sleep disturbances and sleep diagnoses, and suicidality. Colleges and universities must provide sufficient resources to address the sleep and mental health needs of transgender students. Institutions must adopt gender affirming policies that promote an inclusive environment. Increased allocation of resources and adoption of policies that enhance the physical and mental health of transgender students could improve sleep, mood, and potentially lower the suicide risk among a population that often experiences health inequities.
目的
本研究旨在调查北美一组顺性别和跨性别大学生中，跨性别身份、睡眠与心理健康之间的关联。
参与者与方法
这项横断面研究对2016 - 2017年美国大学健康协会 - 全国大学健康评估II中的221,549名北美大学生进行了调查。双变量和多变量分析研究了跨性别身份与失眠症状、日间嗜睡、睡眠障碍诊断及治疗结果之间的关联。心理健康结果包括情绪症状、自杀行为、焦虑和抑郁诊断及治疗情况。
结果
美国学生中有1.6%（n = 3471）、加拿大学生中有1.7%（n = 717）报告了跨性别身份。平均年龄为22.5±6岁。与顺性别大学生相比，跨性别大学生日间嗜睡、失眠症状、失眠及其他睡眠障碍的诊断和/或治疗的患病率更高。心理健康症状更为普遍，跨性别学生的抑郁和焦虑增加了两倍，自杀未遂增加了近四倍。与加拿大学生相比，美国跨性别大学生的情绪症状负担更高。
结论
跨性别大学生的情绪、睡眠障碍、睡眠诊断及自杀倾向发生率高得惊人。高校必须提供足够的资源来满足跨性别学生的睡眠和心理健康需求。院校必须采取肯定性别的政策，营造包容的环境。增加资源分配并采取能促进跨性别学生身心健康的政策，可能会改善睡眠、情绪，并有可能降低这个经常面临健康不平等人群的自杀风险。
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