G. Nic Rider (they/them) is with the Institute for Sexual and Gender Health, Department of Family Medicine and Community Health, University of Minnesota Medical School, Minneapolis. Barbara J. McMorris (she/her), Camille Brown (she/her), Montana Filoteo (they/them), Emily Singerhouse (she/her), and Lauren Martin (she/her) are with the School of Nursing, University of Minnesota, Minneapolis. Marla E. Eisenberg (she/her) and Amy L. Gower (she/her) are with the Division of General Pediatrics and Adolescent Health, Department of Pediatrics, University of Minnesota, Minneapolis. Katie Johnston-Goodstar (she/they) is with the School of Social Work, University of Minnesota, St. Paul.
Am J Public Health. 2022 Mar;112(3):499-508. doi: 10.2105/AJPH.2021.306623.
To describe the prevalence of sex trading by gender and by associations with mental health concerns and protective factors. We used data from 9th and 11th graders who completed the 2019 Minnesota Student Survey. The analytic sample (n = 67 806) included transgender and gender-diverse (TGD) youths and cisgender youths who reported trading sex. Data on 7 mental health measures and 4 school-related and health care-related protective factors were collected. The prevalence of sex trading (5.9%) was 5 times higher among TGD students than cisgender students (1.2%). In addition, the prevalence of all mental health concerns was high among TGD students who traded sex (e.g., 75.9% reported a lifetime suicide attempt, as compared with 45.9% of cisgender students who traded sex). Fewer statistical differences were found across protective factors. When TGD students who traded sex were compared according to sex assigned at birth, no statistically significant differences were found. Our findings support strong calls for increased competence regarding gender and sex trading or exploitation in clinical and school-based settings to decrease health disparities among TGD youths. In this study, we have presented unique prevalence estimates of mental health disparities among TGD students in the United States who trade sex. Our results indicate that TGD students who trade sex are at risk for mental health symptoms and that sensitivity to both gender and sex trading or exploitation will be critical to meeting the needs of this group in clinical as well as school-based settings.
描述按性别和与心理健康问题及保护因素的关联划分的性交易流行情况。我们使用了完成 2019 年明尼苏达州学生调查的 9 年级和 11 年级学生的数据。分析样本（n=67806）包括跨性别和性别多样化（TGD）青年以及报告有性交易行为的顺性别青年。收集了 7 项心理健康指标以及 4 项与学校和医疗保健相关的保护因素的数据。性交易（5.9%）的流行率在 TGD 学生中是顺性别学生的 5 倍（1.2%）。此外，所有心理健康问题在进行过性交易的 TGD 学生中都很普遍（例如，有 75.9%的学生报告曾有过自杀未遂，而进行过性交易的顺性别学生比例为 45.9%）。在保护因素方面，差异较小。当根据出生时的性别分配对进行过性交易的 TGD 学生进行比较时，没有发现统计学上的显著差异。我们的研究结果支持在临床和学校环境中增加关于性别和性交易或剥削的能力的强烈呼吁，以减少 TGD 青年中的健康差距。在这项研究中，我们提出了美国进行性交易的 TGD 学生中独特的心理健康差异的流行率估计。我们的研究结果表明，进行性交易的 TGD 学生面临心理健康症状的风险，并且对性别和性交易或剥削的敏感性对于满足该群体在临床和学校环境中的需求至关重要。
