Department of Pediatrics, Division of Endocrinology and Diabetes, Washington University School of Medicine, Saint Louis, MO, United States.
Washington University School of Medicine, Saint Louis, MO, United States.
Front Endocrinol (Lausanne). 2024 Sep 4;15:1445679. doi: 10.3389/fendo.2024.1445679. eCollection 2024.
The National Academy of Medicine has formally identified transgender adults as an understudied population in critical need of health research. While national surveys, like the US Transgender survey, have characterized higher rates of depression, anxiety, suicidality and socioeconomic need in the transgender community, studies have not examined the impact of sociodemographic and clinical characteristics on mental health related outcomes.
To describe the sociodemographic and mental health characteristics of transgender adults seen at a large Midwest transgender clinic and to determine factors associated with self-reported mental health conditions.
Descriptive, retrospective, cross-sectional study of new transgender patients 18 years and older seen at a large Midwest transgender clinic between December 2019 and June 2022.
A total of 482 charts were reviewed. During their initial evaluation, 11.6% (56/482) reported having a history of suicide attempt and 81.3% (392/482) reported a mental health diagnosis with the most common being depression, anxiety, attention deficit disorder, and post-traumatic stress disorder. Multivariable logistic regression results show no single factor was significantly associated with mental health diagnosis after adjusting for the effect of age and race. Patients who were new to gender affirming hormone therapy (54%, 254/468) are 2.0 (95% CI 1.4-2.9) times more likely to report having a mental health care provider than patients who were seen for continuation of therapy (46%, 214/468). Ten records with race not disclosed, 3 records with gender identity "other" and 2 records with gender identity not disclosed were excluded from analysis.
This study reinforces the finding that transgender adults have an increased lifetime prevalence of mental health conditions. The higher prevalence of mental health conditions in our clinic was not associated with sociodemographic factors included in the study. Furthermore, transgender patients are less likely to have seen mental healthcare providers after initiation of gender affirming hormone therapy.
美国国家医学院已正式将跨性别成年人确定为一个研究不足的群体，他们迫切需要健康研究。虽然像美国跨性别者调查这样的全国性调查已经确定了跨性别群体中更高的抑郁、焦虑、自杀倾向和社会经济需求率，但研究尚未探讨社会人口统计学和临床特征对心理健康相关结果的影响。
描述在一家大型中西部跨性别诊所就诊的跨性别成年人的社会人口统计学和心理健康特征，并确定与自我报告的心理健康状况相关的因素。
这是一项描述性、回顾性、横断面研究，纳入 2019 年 12 月至 2022 年 6 月期间在一家大型中西部跨性别诊所就诊的年龄在 18 岁及以上的新跨性别患者。
共审查了 482 份病历。在他们的初步评估中，11.6%（56/482）报告有自杀企图史，81.3%（392/482）报告有精神健康诊断，最常见的是抑郁、焦虑、注意力缺陷障碍和创伤后应激障碍。多变量逻辑回归结果显示，在调整年龄和种族的影响后，没有单一因素与精神健康诊断显著相关。新开始性别肯定激素治疗的患者（54%，254/468）报告有心理健康护理提供者的可能性是继续治疗的患者（46%，214/468）的 2.0 倍（95%CI 1.4-2.9）。10 份记录未披露种族、3 份记录性别认同为“其他”、2 份记录性别认同未披露的记录被排除在分析之外。
本研究证实了跨性别成年人一生中精神健康状况的发生率更高。本研究纳入的社会人口学因素与我们诊所中更高的精神健康状况发生率无关。此外，在开始性别肯定激素治疗后，跨性别患者更不可能去看心理健康护理提供者。
