Zwickl Sav, Angus Lachlan M, Qi Alex Wong Fang, Ginger Ariel, Eshin Kalen, Cook Teddy, Leemaqz Shalem Y, Dowers Eden, Zajac Jeffrey D, Cheung Ada S
Trans Health Research Group, Department of Medicine (Austin Health), The University of Melbourne, Heidelberg, Victoria, Australia.
Department of Endocrinology, Austin Health, Gender Clinic, Heidelberg, Victoria, Australia.
Int J Transgend Health. 2021 Mar 11;24(3):281-291. doi: 10.1080/26895269.2021.1890659. eCollection 2023.
Trans and gender diverse individuals (people who identify with a gender different to what was presumed for them at birth) are one of the most medically and socially marginalized groups in our community. The COVID-19 pandemic may compound preexisting depression and thoughts of self-harm or suicide.
We aimed to explore the impact of the COVID-19 pandemic on the Australian trans community.
An online cross-sectional survey was conducted between 1st May 2020 and 30th June 2020, amidst strict Australia-wide social restrictions. Australian trans people aged ≥16 years were eligible to participate. Survey questions explored the impact of the COVID-19 pandemic on living situation, employment, financial situation, and healthcare. Logistic regression to assess negative impacts due to COVID-19 on depression and thoughts of self-harm or suicide (measured by Patient Health Questionnaire-9 (PHQ-9) are presented as odds ratios (95% confidence interval)).
Of 1019 participants, 49.6% reported experiencing financial strain, 22% had reduced working hours, and 22.4% were unemployed (three times the national rate). Concerningly, 61.1% experienced clinically significant symptoms of depression (Patient Health Questionnaire-9 score ≥10), considerably higher than pre-COVID rates for the trans community and over twice the national rate. Moreover, 49% reported thoughts of self-harm or suicide (over three times the national rate) which was more likely if a person experienced cancelation or postponement of gender-affirming surgery (OR 1.56 (1.04, 2.35)), financial strain (OR 1.80 (1.36, 2.38)), or felt unsafe or afraid in their household (OR 1.96 (1.23, 3.08)).
Given rates of clinically significant depression and thoughts of self-harm or suicide are far higher in trans people than the general population, specific strategies to improve mental health in the trans community during the COVID-19 pandemic must be made a priority for policymakers, researchers, and health service providers to prevent suicide.
Supplemental data for this article is available online at https://doi.org/10.1080/26895269.2021.1890659.
跨性别及性别多样化个体（即那些认同的性别与出生时被认定的性别不同的人）是我们社区中在医学和社会层面最边缘化的群体之一。新冠疫情可能会加重他们先前就存在的抑郁情绪以及自我伤害或自杀念头。
我们旨在探究新冠疫情对澳大利亚跨性别群体的影响。
在2020年5月1日至2020年6月30日期间，在澳大利亚全国严格的社会限制措施实施期间，开展了一项在线横断面调查。年龄在16岁及以上的澳大利亚跨性别者有资格参与。调查问题探讨了新冠疫情对生活状况、就业、财务状况和医疗保健的影响。采用逻辑回归分析来评估新冠疫情对抑郁以及自我伤害或自杀念头的负面影响（通过患者健康问卷-9（PHQ-9）进行测量），结果以比值比（95%置信区间）呈现。
在1019名参与者中，49.6%报告经历了财务紧张，22%的工作时间减少，22.4%失业（是全国失业率的三倍）。令人担忧的是，61.1%经历了具有临床意义的抑郁症状（患者健康问卷-9得分≥10），这一比例远高于跨性别群体在新冠疫情前的水平，是全国平均水平的两倍多。此外，49%报告有自我伤害或自杀念头（是全国平均水平的三倍多），如果一个人经历了性别确认手术被取消或推迟（比值比1.56（1.04，2.35））、财务紧张（比值比1.80（1.36，2.38））或在家中感到不安全或害怕（比值比1.96（1.23，3.08）），那么出现这种情况的可能性更大。
鉴于跨性别者中具有临床意义的抑郁以及自我伤害或自杀念头的发生率远高于普通人群，在新冠疫情期间改善跨性别群体心理健康的具体策略必须成为政策制定者、研究人员和医疗服务提供者预防自杀的优先事项。
本文的补充数据可在网上获取，网址为https://doi.org/10.1080/26895269.2021.1890659。
