In the United States, transgender and gender non-conforming (TGNC) individuals form a historically marginalised group within society. They frequently encounter poorer outcomes in both physical and mental health realms when compared to their cisgender peers. Despite progress in enhancing both psychological and physical healthcare provisions for TGNC individuals over recent years, significant obstacles remain that impede access to essential services. These barriers include, but are not limited to, extended waiting periods, burdensome travel demands, and insufficient insurance coverage.
A recent study highlighted in the May 2024 edition of the American Journal of Public Health delves into shifts in self-reported mental health from 2014 to 2021 within a nationally representative sample of U.S. adults. Utilising data from the U.S. Behavioral Risk Factor Surveillance System Survey, researchers Donn Feir from the University of Victoria and Samuel Mann from the RAND Corporation observed that mental health distress has risen disproportionately among TGNC adults compared to cisgender individuals over this timeframe.
The frequency of self-reported “poor mental health days” per month is used as a critical gauge of mental health, and it aligns with other psychological and physical health markers. Although TGNC individuals recorded a higher number of poor mental health days in 2014, the disparity has notably widened over the subsequent seven years.
“In 2014, cisgender individuals reported an average of 3.68 poor mental health days, while transgender respondents reported an average of 5.42 poor mental health days. The size of this disparity, adjusted for differences in observable characteristics, expanded by 2.75 days throughout the sample period,” Mann clarified.
The researchers also revealed a disproportionate escalation in the frequency of mental health distress reported by TGNC individuals during the seven-year study span. “In 2014, 11.4% of cisgender adults reported frequent mental distress, in contrast to 18.9% of transgender adults. By 2021, these figures had risen to 14.6% of cisgender adults and 32.9% of transgender adults reporting frequent mental distress,” Feir noted.
The observed trend of rapidly increasing mental distress among TGNC adults suggests a potential exacerbation of socioeconomic and other disparities, as well as an augmentation in the barriers preventing access to necessary support services. This uptick in mental distress within the TGNC community might also be attributed to factors such as societal discrimination or restricted access to gender-affirming and mental health care resources.
The worrying increase in the frequency of self-reported mental distress among transgender individuals underscores an urgent need to re-evaluate nationwide initiatives that support TGNC individuals throughout the U.S. Allocating resources that improve access to gender-affirming and mental health services could play a vital role in reducing the mental health disparities existing between TGNC and cisgender individuals.
In conclusion, policy shifts that foster overall well-being and inclusivity for TGNC individuals could significantly enhance mental health outcomes for this underrepresented community in the long term. “Policies are needed to address the deteriorating mental health of transgender and gender-nonconforming people in the United States,” Mann emphasised.
More information: Donn Feir et al, Temporal Trends in Mental Health in the United States by Gender Identity, 2014–2021, American Journal of Public Health. DOI: 10.2105/AJPH.2024.307603
Journal information: American Journal of Public Health Provided by American Public Health Association
