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性别认同、种族和民族的心理健康差异。

Mental Health Disparities at the Intersections of Gender Identity, Race, and Ethnicity.

机构信息

Department of Psychology and Health, and Society, Vanderbilt University, Nashville, Tennessee, USA.

Department of Medicine, Health, and Society, Vanderbilt University, Nashville, Tennessee, USA.

出版信息

LGBT Health. 2021 Nov;8(8):526-535. doi: 10.1089/lgbt.2020.0429. Epub 2021 Sep 30.


DOI:10.1089/lgbt.2020.0429
PMID:34591707
Abstract

Very little research has examined mental health among transgender people of color using population-based data. The objective of this study was to use large-scale data to examine mental health disparities at the intersections of gender identity, race, and ethnicity. Data for this study came from transgender ( = 4024) and cisgender ( = 935,793) adults aged 18 years and older in the 2014-2018 Behavioral Risk Factor Surveillance System. We estimated and compared frequent mental distress and lifetime depression diagnoses using multivariable logistic regression models. Regression results are presented as adjusted odds ratios (AORs) with 95% confidence intervals (CIs). After controlling for sociodemographic characteristics and compared with cisgender White adults, transgender White adults (AOR = 1.81; 95% CI = 1.49-2.21), transgender American Indian or Alaska Native (AIAN) adults (AOR = 8.06; 95% CI = 2.03-32.00), and transgender adults of other/multiple races and ethnicities (AOR = 3.15; 95% CI = 1.78-5.59) had higher odds of exhibiting frequent mental distress. Transgender White adults (AOR = 2.07; 95% CI = 1.75-2.46), transgender AIAN adults (AOR = 3.61; 95% CI = 1.06-12.32), and transgender adults of other/multiple races and ethnicities (AOR = 2.37; 95% CI = 1.41-4.01) had higher odds of reporting a lifetime depression diagnosis compared with White cisgender adults. This study serves as a reminder that LGBT health should be analyzed through an intersectional lens as some individuals with multiple marginalized identities may have worse health as a result of double discrimination. Public health practitioners and health care providers should be mindful of the diversity within the transgender population in their work.

摘要

很少有研究使用基于人群的数据来研究跨性别有色人种的心理健康。本研究的目的是使用大规模数据来研究性别认同、种族和民族交叉点的心理健康差异。本研究的数据来自年龄在 18 岁及以上的 2014-2018 年行为风险因素监测系统中的跨性别者( = 4024)和 cisgender( = 935793)成年人。我们使用多变量逻辑回归模型估计和比较了频繁的精神困扰和终生抑郁诊断。回归结果以调整后的优势比(AOR)和 95%置信区间(CI)表示。在控制了社会人口统计学特征后,与 cisgender 白种成年人相比,跨性别白种成年人(AOR = 1.81;95%CI = 1.49-2.21)、跨性别美国印第安人或阿拉斯加原住民(AOR = 8.06;95%CI = 2.03-32.00)和跨性别其他/多种族裔成年人(AOR = 3.15;95%CI = 1.78-5.59)有更高的出现频繁精神困扰的可能性。跨性别白种成年人(AOR = 2.07;95%CI = 1.75-2.46)、跨性别美国印第安人或阿拉斯加原住民成年人(AOR = 3.61;95%CI = 1.06-12.32)和跨性别其他/多种族裔成年人(AOR = 2.37;95%CI = 1.41-4.01)与白种 cisgender 成年人相比,报告终生抑郁诊断的可能性更高。本研究提醒我们,LGBT 健康应该通过交叉视角进行分析,因为一些具有多种边缘化身份的人可能会因为双重歧视而导致健康状况更差。公共卫生从业人员和医疗保健提供者在工作中应该注意跨性别人群的多样性。

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