Li Jiaqi, Jin Yu, Xu Shicun, Wilson Amanda, Chen Chang, Wang Yuanyuan
Key Laboratory of Brain, Cognition and Education Sciences, Ministry of Education, China; School of Psychology, Center for Studies of Psychological Application, and Guangdong Key Laboratory of Mental Health and Cognitive Science, South China Normal University, Guangzhou, China.
College of Education for the Future, Beijing Normal University, Beijing, China.
Int J Transgend Health. 2024 Mar 12;25(3):456-470. doi: 10.1080/26895269.2023.2273360. eCollection 2024.
Gender dysphoria (GD) is frequently reported among transgender, nonbinary, and gender-diverse (TNG) populations, and is closely related to anxiety, depression, suicidal ideation, and non-suicidal self-injury (NSSI). This study aimed to understand how GD influences the four mental health disparities among TNG youth, and to compare these outcomes depending on the severity of GD. 96,218 College students participated in the survey, of which the analysis was run on an extracted sub-set data of 2,315 (2.40%) TNG youth, with a mean age of 19.46 (SD = 1.52). Self-reported inventories measured sociodemographic factors, the severity of GD (Utrecht Gender Dysphoria Scale-Gender Spectrum), anxiety (seven-item Generalized Anxiety Disorder Questionnaire), depression (nine-item Patient Health Questionnaire), suicidal ideation (Suicidal Behaviors Questionnaire-Revised), and NSSI (Clinician-Rated Severity of Non-Suicidal Self-Injury Scale). Binary logistic regression assessed the association between significant GD and the four psychiatric disorders. Adjusted multiple logistic regression, and directed acyclic graph (DAG) analyses were conducted to explore the activating relationship among GD, sociodemographic factors, and psychiatric disorders. 1,582 (68.30%) TNG youth who experienced significant levels of GD (total scores cutoff >= 46) were entered into the analyses. Binary logistic regression displayed significantly positive associations between significant GD and anxiety, depression, suicidal ideation, and NSSI. Multiple regression models showed risk factors included poor relationship with one's father/mother, tobacco smoking, alcohol consumption, and having a lower subjective social status. While family harmony, a higher father's educational level, and partaking in exercise were protective factors that exerted distinct impacts on these four psychiatric disorders. DAG findings showed a poor relationship with one's father with significant GD via other socio-demographic characteristics, activated psychiatric disorders. TNG youth with higher levels of GD also exhibited more severe anxiety, depression, suicidal ideation, and NSSI. Tailored interventions should be provided to prioritize relieving those with severe GD to protect TNG youth from psychiatric outcomes further.
性别焦虑症（GD）在跨性别、非二元性别和性别多样化（TNG）人群中经常被报告，并且与焦虑、抑郁、自杀意念和非自杀性自伤（NSSI）密切相关。本研究旨在了解GD如何影响TNG青年中的这四种心理健康差异，并根据GD的严重程度比较这些结果。96218名大学生参与了调查，其中对2315名（2.40%）TNG青年的提取子集数据进行了分析，平均年龄为19.46岁（标准差=1.52）。自我报告的量表测量了社会人口学因素、GD的严重程度（乌得勒支性别焦虑量表-性别光谱）、焦虑（七项广泛性焦虑障碍问卷）、抑郁（九项患者健康问卷）、自杀意念（自杀行为问卷修订版）和NSSI（临床医生评定的非自杀性自伤严重程度量表）。二元逻辑回归评估了显著GD与四种精神障碍之间的关联。进行了调整后的多元逻辑回归和有向无环图（DAG）分析，以探讨GD、社会人口学因素和精神障碍之间的激活关系。1582名（68.30%）经历显著水平GD（总分临界值>=46）的TNG青年被纳入分析。二元逻辑回归显示，显著GD与焦虑、抑郁、自杀意念和NSSI之间存在显著正相关。多元回归模型显示，风险因素包括与父亲/母亲关系不佳、吸烟、饮酒以及主观社会地位较低。而家庭和睦、父亲教育水平较高以及参加体育锻炼是对这四种精神障碍产生不同影响的保护因素。DAG研究结果显示，与父亲关系不佳通过其他社会人口学特征与显著GD相关，激活了精神障碍。GD水平较高的TNG青年也表现出更严重的焦虑、抑郁、自杀意念和NSSI。应提供针对性的干预措施，优先缓解严重GD患者的症状，以进一步保护TNG青年免受精神疾病的影响。
