Zimmerman Mark, Benjamin Isabel, Seijas-Rodriguez Craig
Department of Psychiatry and Human Behavior, Brown Medical School, and the Department of Psychiatry, Rhode Island Hospital, Providence, Rhode Island.
Corresponding author: Mark Zimmerman, MD, 146 West River St, Providence, RI 02904 (
J Clin Psychiatry. 2022 Sep 26;83(6):21m14062. doi: 10.4088/JCP.21m14062.
Sexual and gender minority persons (ie, those reporting sexual orientation other than heterosexual and gender identity other than cisgender, respectively) experience high rates of various forms of psychopathology. However, discussions of sexual minority populations are often focused on aspects of mental health associated with sexual orientation, with relatively less emphasis placed on transgender and gender diverse (TGD) individuals' mental health. No prior studies have compared psychiatric diagnoses between TGD and cisgender patients presenting for psychiatric treatment in a systematic way using semistructured diagnostic interviews assessing a broad range of disorders. Between April 2014 and January 2021, we administered semistructured diagnostic interviews for disorders to 2,212 psychiatric patients, 69 of whom reported TGD identity (ie, gender identity other than cisgender such as transgender, genderqueer, or nonbinary identity). The patients completed a demographic questionnaire on which they indicated their assigned sex at birth and their current gender identity. TGD patients had on average more diagnoses than cisgender patients (3.54 ± 1.88 vs 3.04 ± 1.72, = 2.37, = .02). After controlling for age, TGD patients were significantly more likely to be diagnosed with posttraumatic stress disorder and borderline personality disorder than cisgender patients ( < .05). To the best of our knowledge, this is the first study of psychiatric patients using semistructured diagnostic interviews to compare the frequency of psychiatric disorders between cisgender and TGD patients. These results bear implications for creating gender-inclusive treatment facilities. Psychiatry programs interested in qualifying as Safe Zones and treating TGD patients should have or develop expertise in treating posttraumatic stress disorder and borderline personality disorder.
性与性别少数群体（即分别报告非异性恋性取向和非顺性别性别认同的人群）经历各种形式精神病理学的比例很高。然而，关于性少数群体的讨论往往集中在与性取向相关的心理健康方面，相对较少关注跨性别和性别多样化（TGD）个体的心理健康。此前没有研究使用评估广泛疾病的半结构化诊断访谈，以系统的方式比较接受精神科治疗的TGD和顺性别患者之间的精神科诊断。在2014年4月至2021年1月期间，我们对2212名精神科患者进行了疾病的半结构化诊断访谈，其中69人报告了TGD身份（即非顺性别性别认同，如跨性别、性别酷儿或非二元性别认同）。患者完成了一份人口统计问卷，在问卷中表明他们的出生时被指定的性别和当前的性别认同。TGD患者平均诊断出的疾病比顺性别患者多（3.54±1.88对3.04±1.72，t=2.37，P=0.02）。在控制年龄后，TGD患者被诊断患有创伤后应激障碍和边缘性人格障碍的可能性明显高于顺性别患者（P<0.05）。据我们所知，这是第一项使用半结构化诊断访谈对精神科患者进行的研究，以比较顺性别和TGD患者之间精神障碍的发生率。这些结果对创建性别包容的治疗设施具有启示意义。有兴趣成为安全区并治疗TGD患者的精神科项目应该拥有或培养治疗创伤后应激障碍和边缘性人格障碍的专业知识。
