Division of Plastic and Reconstructive Surgery, Northwestern University Feinberg School of Medicine, Chicago, Illinois.
Pritzker Department of Psychiatry and Behavioral Health, Ann & Robert H Lurie Children's Hospital of Chicago, Chicago, Illinois; Potocsnak Family Division of Adolescent and Young Adult Medicine, Ann & Robert H Lurie Children's Hospital of Chicago, Chicago, Illinois; Department of Psychiatry and Behavioral Sciences, Northwestern University Feinberg School of Medicine, Chicago, Illinois; Department of Pediatrics, Northwestern University Feinberg School of Medicine, Chicago, Illinois.
J Adolesc Health. 2021 Jun;68(6):1135-1141. doi: 10.1016/j.jadohealth.2021.02.024. Epub 2021 Apr 10.
The purpose of this study was to determine the existence and strength of association between chest dysphoria and mental health in transmasculine and nonbinary adolescents.
This is a cross-sectional cohort study of transmasculine and nonbinary adolescents designated female at birth between 12 and 18 years old. None had undergone prior top surgery. Patients complete the Chest Dysphoria Measure and Youth Inventory-4 (YI-4) upon presentation to our institution. Outcomes were retrospectively reviewed. The primary outcome of interest was the association between chest dysphoria and anxiety and depression symptom severity, as measured by the YI-4.
One hundred fifty-six patients met inclusion criteria. Mean age was 15.3 years (standard deviation [SD] = 1.7). Most patients identified as transmasculine (n = 132); 18 identified as nonbinary and 6 as questioning. Mean (SD) YI-4 symptom severity scores were 10.67 (6.64) for anxiety and 11.99 (7.83) for depression. Mean (SD) Chest Dysphoria Measure composite score was 30.15 (9.95); range 2-49. Chest dysphoria was positively correlated with anxiety (r = .146; p = .002) and depression (r = .207; p < .001). In multivariate linear regression models, chest dysphoria showed a significant, positive association with anxiety and depression, after accounting for gender dysphoria, degree of appearance congruence, and social transition status.
Chest dysphoria is associated with higher anxiety and depression in transmasculine and nonbinary adolescents designated female at birth. This association is independent of level of gender dysphoria, degree of appearance congruence, and social transition status. Treatment options aimed at alleviating chest dysphoria should be made accessible to adolescents and tailored to individual needs.
本研究旨在确定出生时被指定为女性的跨性别男性和非二元青少年的胸部不适与心理健康之间是否存在关联，以及这种关联的强度如何。
这是一项针对出生时被指定为女性的 12 至 18 岁跨性别男性和非二元青少年的横断面队列研究。这些患者均未接受过先前的胸部整形手术。患者在就诊于我院时完成胸部不适量表和青少年清单 4 版（YI-4）。对结果进行回顾性评估。主要观察指标为 YI-4 评估的胸部不适与焦虑和抑郁症状严重程度之间的相关性。
共有 156 例患者符合纳入标准。平均年龄为 15.3 岁（标准差 [SD] = 1.7）。大多数患者为跨性别男性（n=132）；18 例为非二元性别，6 例为性别存疑。焦虑症状 YI-4 平均（SD）评分 10.67（6.64），抑郁症状 11.99（7.83）。胸部不适量表综合评分平均（SD）为 30.15（9.95），范围为 2-49。胸部不适与焦虑（r=0.146，p=0.002）和抑郁（r=0.207，p<0.001）呈正相关。在多变量线性回归模型中，在考虑到性别不安、外貌一致程度和社会过渡状态后，胸部不适与焦虑和抑郁显著正相关。
在出生时被指定为女性的跨性别男性和非二元青少年中，胸部不适与更高的焦虑和抑郁相关。这种关联独立于性别不安程度、外貌一致程度和社会过渡状态。应向青少年提供旨在缓解胸部不适的治疗方案，并根据个体需求进行定制。
