Faculty of Māori and Indigenous Studies, University of Waikato, Hamilton, New Zealand.
Transgender Health Research Lab, School of Psychology, University of Waikato, Hamilton, New Zealand.
LGBT Health. 2022 Aug-Sep;9(6):401-410. doi: 10.1089/lgbt.2021.0240. Epub 2022 May 23.
This study sought to expand on previous scholarship focused on gender-concordant identity documents (IDs) as a social determinant of health. We examined the association between barriers to legal gender recognition and the mental health of transgender and nonbinary people in Aotearoa/New Zealand. We used data from a 2018 nationwide community-based survey of trans and nonbinary people in Aotearoa ( = 818). Variables of investigation included: gender-concordant IDs, mental health (past-month psychological distress, past-year nonsuicidal self-injury, past-year suicidality) and barriers to changing gender markers on a birth certificate or passport. Associations between gender-concordant IDs and mental health were determined using generalized linear regression models. In total, 34.8% reported the correct name on all of their IDs. The proportion with the correct gender marker on both birth certificates and passports was 16.0%. Participants with gender-concordant IDs were more likely to be older, have higher levels of income and education, and have had genital reconstruction. In addition, 68.7% of participants reported experiencing at least one barrier to changing gender markers on their IDs, and these participants had significantly higher average points of psychological distress scores ( = 2.39) and greater odds of suicidal ideation (odds ratio = 2.02) than those with gender-concordant IDs, after adjusting for sociodemographic variables. We present novel findings on higher levels of mental health problems among trans and nonbinary people who faced barriers in trying to obtain gender-concordant IDs compared with those with gender-concordant IDs. Removing barriers to legal gender recognition may be an effective way to improve mental health.
本研究旨在扩展先前关注性别一致身份文件（IDs）作为健康社会决定因素的学术研究。我们研究了在新西兰奥塔哥/新泽西亚裔人群中，法律性别认可障碍与跨性别和非二元性别者心理健康之间的关联。我们使用了 2018 年针对该地区跨性别和非二元性别者的全国性社区调查数据（ = 818）。调查变量包括：性别一致的 IDs、心理健康（过去一个月的心理困扰、过去一年的非自杀性自我伤害、过去一年的自杀意念）以及更改出生证明或护照上性别标记的障碍。使用广义线性回归模型确定性别一致 ID 与心理健康之间的关联。总共有 34.8%的人报告其所有 ID 上的姓名正确。在出生证明和护照上均有正确性别标记的比例为 16.0%。拥有性别一致 ID 的参与者更有可能年龄较大、收入和教育水平较高，并且进行过生殖器重建。此外，68.7%的参与者报告在更改 ID 上的性别标记时至少遇到了一个障碍，与拥有性别一致 ID 的参与者相比，这些参与者的心理困扰平均得分（ = 2.39）显著更高，并且有自杀意念的可能性更高（优势比 = 2.02），在调整社会人口统计学变量后。我们提出了新的发现，即在试图获得性别一致 ID 时遇到障碍的跨性别和非二元性别者比拥有性别一致 ID 的人心理健康问题水平更高。消除法律性别认可障碍可能是改善心理健康的有效方法。
