Mental Health and Gender Affirmation of Black and Latine Transgender/Nonbinary Youth Compared to White Peers Prior to Hormone Initiation

Stanley R. Vance; Diane Chen; Robert Garofalo; David V. Glidden; Diane Ehrensaft; Marco Armando Hidalgo; Amy Tishelman; Stephen M. Rosenthal; Yee Ming Chan; Johanna Olson-Kennedy; Jae Sevelius

doi:10.1016/j.jadohealth.2023.06.022

Mental Health and Gender Affirmation of Black and Latine Transgender/Nonbinary Youth Compared to White Peers Prior to Hormone Initiation

Stanley R. Vance^*, Diane Chen, Robert Garofalo, David V. Glidden, Diane Ehrensaft, Marco Armando Hidalgo, Amy Tishelman, Stephen M. Rosenthal, Yee Ming Chan, Johanna Olson-Kennedy, Jae Sevelius

^*Corresponding author for this work

Research output: Contribution to journal › Article › peer-review

4 Scopus citations

Abstract

Purpose: To compare baseline mental health symptoms and gender affirmation between Black/Latine versus White transgender/nonbinary youth (BLTY vs. WTY) and examine relationships between gender affirmation and mental health symptoms, and whether associations differed by race/ethnicity subgroup. Methods: Baseline data were analyzed from the gender-affirming hormone cohort of the Trans Youth Care United States Study—a 4-clinic site, observational study. Mental health symptoms assessed included depression, suicidality, and anxiety. Gender affirmation measures included the parental acceptance subscale from the perceived Parental Attitudes of Gender Expansiveness Scale-Youth Report; non-affirmation, internalized transphobia, and community connectedness subscales from the Gender Minority Stress and Resilience Measure–Adolescent; and self-reported living full time in affirmed gender. Fisher exact tests and independent sample t tests compared mental health symptoms and gender affirmation between subgroups. Logistic regression analyses evaluated associations between gender affirmation and mental health symptoms. Interaction analyses assessed differences in associations between subgroups. Results: The sample (mean age 16 years, range 12–20 years) included 92 BLTY (35%) and 170 WTY (65%). Subgroups had comparable prevalence of depression and anxiety symptoms. WTY had higher prevalence of lifetime suicidality (73% vs. 59%; p = .02). There were no differences in gender affirmation. Among the whole sample, higher parental acceptance decreased odds of depression symptoms. Not living in affirmed gender increased odds of depression symptoms. Higher non-affirmation and internalized transphobia increased odds of depression and anxiety symptoms and suicidality. Associations did not vary by subgroup. Discussion: BLTY and WTY had comparable mental health symptoms. For both subgroups, gender affirmation decreased odds of those symptoms.

Original language	English (US)
Pages (from-to)	880-886
Number of pages	7
Journal	Journal of Adolescent Health
Volume	73
Issue number	5
DOIs	https://doi.org/10.1016/j.jadohealth.2023.06.022
State	Published - Nov 2023

Funding

This study was supported by a grant from the Robert Wood Johnson Foundation Amos Medical Faculty Development Program (Dr. Vance). Additional support was provided by grants K23MD015044 (Dr. Vance) from the National Institute on Minority Health and Health Disparities ( NIMHD ) and K24DA051328 (Dr. Sevelius) from the National Institute on Drug Abuse ( NIDA ). This work was also supported by R01HD082554 from the Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD). The study sponsors had no role in the design and conduct of the study; collection, management, analysis, and interpretation of the data; preparation, review, or approval of the manuscript; and decision to submit the manuscript for publication.

Keywords

Gender affirmation
Mental health
Transgender persons

ASJC Scopus subject areas

Pediatrics, Perinatology, and Child Health
Public Health, Environmental and Occupational Health
Psychiatry and Mental health

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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10.1016/j.jadohealth.2023.06.022

Cite this

Vance, S. R., Chen, D., Garofalo, R., Glidden, D. V., Ehrensaft, D., Hidalgo, M. A., Tishelman, A., Rosenthal, S. M., Chan, Y. M., Olson-Kennedy, J., & Sevelius, J. (2023). Mental Health and Gender Affirmation of Black and Latine Transgender/Nonbinary Youth Compared to White Peers Prior to Hormone Initiation. Journal of Adolescent Health, 73(5), 880-886. https://doi.org/10.1016/j.jadohealth.2023.06.022

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title = "Mental Health and Gender Affirmation of Black and Latine Transgender/Nonbinary Youth Compared to White Peers Prior to Hormone Initiation",

abstract = "Purpose: To compare baseline mental health symptoms and gender affirmation between Black/Latine versus White transgender/nonbinary youth (BLTY vs. WTY) and examine relationships between gender affirmation and mental health symptoms, and whether associations differed by race/ethnicity subgroup. Methods: Baseline data were analyzed from the gender-affirming hormone cohort of the Trans Youth Care United States Study—a 4-clinic site, observational study. Mental health symptoms assessed included depression, suicidality, and anxiety. Gender affirmation measures included the parental acceptance subscale from the perceived Parental Attitudes of Gender Expansiveness Scale-Youth Report; non-affirmation, internalized transphobia, and community connectedness subscales from the Gender Minority Stress and Resilience Measure–Adolescent; and self-reported living full time in affirmed gender. Fisher exact tests and independent sample t tests compared mental health symptoms and gender affirmation between subgroups. Logistic regression analyses evaluated associations between gender affirmation and mental health symptoms. Interaction analyses assessed differences in associations between subgroups. Results: The sample (mean age 16 years, range 12–20 years) included 92 BLTY (35%) and 170 WTY (65%). Subgroups had comparable prevalence of depression and anxiety symptoms. WTY had higher prevalence of lifetime suicidality (73% vs. 59%; p = .02). There were no differences in gender affirmation. Among the whole sample, higher parental acceptance decreased odds of depression symptoms. Not living in affirmed gender increased odds of depression symptoms. Higher non-affirmation and internalized transphobia increased odds of depression and anxiety symptoms and suicidality. Associations did not vary by subgroup. Discussion: BLTY and WTY had comparable mental health symptoms. For both subgroups, gender affirmation decreased odds of those symptoms.",

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month = nov,

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Vance, SR, Chen, D , Garofalo, R, Glidden, DV, Ehrensaft, D, Hidalgo, MA, Tishelman, A, Rosenthal, SM, Chan, YM, Olson-Kennedy, J & Sevelius, J 2023, 'Mental Health and Gender Affirmation of Black and Latine Transgender/Nonbinary Youth Compared to White Peers Prior to Hormone Initiation', Journal of Adolescent Health, vol. 73, no. 5, pp. 880-886. https://doi.org/10.1016/j.jadohealth.2023.06.022

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T1 - Mental Health and Gender Affirmation of Black and Latine Transgender/Nonbinary Youth Compared to White Peers Prior to Hormone Initiation

AU - Vance, Stanley R.

AU - Chen, Diane

AU - Garofalo, Robert

AU - Glidden, David V.

AU - Ehrensaft, Diane

AU - Hidalgo, Marco Armando

AU - Tishelman, Amy

AU - Rosenthal, Stephen M.

AU - Chan, Yee Ming

AU - Olson-Kennedy, Johanna

AU - Sevelius, Jae

PY - 2023/11

Y1 - 2023/11

N2 - Purpose: To compare baseline mental health symptoms and gender affirmation between Black/Latine versus White transgender/nonbinary youth (BLTY vs. WTY) and examine relationships between gender affirmation and mental health symptoms, and whether associations differed by race/ethnicity subgroup. Methods: Baseline data were analyzed from the gender-affirming hormone cohort of the Trans Youth Care United States Study—a 4-clinic site, observational study. Mental health symptoms assessed included depression, suicidality, and anxiety. Gender affirmation measures included the parental acceptance subscale from the perceived Parental Attitudes of Gender Expansiveness Scale-Youth Report; non-affirmation, internalized transphobia, and community connectedness subscales from the Gender Minority Stress and Resilience Measure–Adolescent; and self-reported living full time in affirmed gender. Fisher exact tests and independent sample t tests compared mental health symptoms and gender affirmation between subgroups. Logistic regression analyses evaluated associations between gender affirmation and mental health symptoms. Interaction analyses assessed differences in associations between subgroups. Results: The sample (mean age 16 years, range 12–20 years) included 92 BLTY (35%) and 170 WTY (65%). Subgroups had comparable prevalence of depression and anxiety symptoms. WTY had higher prevalence of lifetime suicidality (73% vs. 59%; p = .02). There were no differences in gender affirmation. Among the whole sample, higher parental acceptance decreased odds of depression symptoms. Not living in affirmed gender increased odds of depression symptoms. Higher non-affirmation and internalized transphobia increased odds of depression and anxiety symptoms and suicidality. Associations did not vary by subgroup. Discussion: BLTY and WTY had comparable mental health symptoms. For both subgroups, gender affirmation decreased odds of those symptoms.

AB - Purpose: To compare baseline mental health symptoms and gender affirmation between Black/Latine versus White transgender/nonbinary youth (BLTY vs. WTY) and examine relationships between gender affirmation and mental health symptoms, and whether associations differed by race/ethnicity subgroup. Methods: Baseline data were analyzed from the gender-affirming hormone cohort of the Trans Youth Care United States Study—a 4-clinic site, observational study. Mental health symptoms assessed included depression, suicidality, and anxiety. Gender affirmation measures included the parental acceptance subscale from the perceived Parental Attitudes of Gender Expansiveness Scale-Youth Report; non-affirmation, internalized transphobia, and community connectedness subscales from the Gender Minority Stress and Resilience Measure–Adolescent; and self-reported living full time in affirmed gender. Fisher exact tests and independent sample t tests compared mental health symptoms and gender affirmation between subgroups. Logistic regression analyses evaluated associations between gender affirmation and mental health symptoms. Interaction analyses assessed differences in associations between subgroups. Results: The sample (mean age 16 years, range 12–20 years) included 92 BLTY (35%) and 170 WTY (65%). Subgroups had comparable prevalence of depression and anxiety symptoms. WTY had higher prevalence of lifetime suicidality (73% vs. 59%; p = .02). There were no differences in gender affirmation. Among the whole sample, higher parental acceptance decreased odds of depression symptoms. Not living in affirmed gender increased odds of depression symptoms. Higher non-affirmation and internalized transphobia increased odds of depression and anxiety symptoms and suicidality. Associations did not vary by subgroup. Discussion: BLTY and WTY had comparable mental health symptoms. For both subgroups, gender affirmation decreased odds of those symptoms.

KW - Gender affirmation

KW - Mental health

KW - Transgender persons

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Mental Health and Gender Affirmation of Black and Latine Transgender/Nonbinary Youth Compared to White Peers Prior to Hormone Initiation

Abstract

Funding

Keywords

ASJC Scopus subject areas

UN SDGs

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