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Cited by 149LGBTQ Health, Identity, and PolicyHIV/AIDS Research and InterventionsAdolescent and Pediatric Healthcare

Psychiatric Diagnoses and Comorbidities in a Diverse, Multicity Cohort of Young Transgender Women: Baseline Findings From Project LifeSkills

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Reisner, Sari L., Biello, Katie B., White Hughto, Jaclyn M., Kuhns, Lisa, Mayer, Kenneth H., Garofalo, Robert, Mimiaga, Matthew J.·2016·JAMA Pediatrics
DOI 10.1001/jamapediatrics.2016.0067PMC PMC4882090
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Abstract

IMPORTANCE: Transgender youth, including adolescent and young adult transgender women assigned a male sex at birth who identify as girls, women, transgender women, transfemale, male-to-female, or another diverse transfeminine gender identity, represent a vulnerable population at risk for negative mental health and substance use outcomes. Diagnostic clinical interviews to assess prevalence of mental health, substance dependence, and comorbid psychiatric disorders in young transgender women remain scarce. OBJECTIVE: To report the prevalence of mental health, substance dependence, and comorbid psychiatric disorders assessed via clinical diagnostic interview in a high-risk community-recruited sample of young transgender women. DESIGN, SETTING, AND PARTICIPANTS: Observational study reporting baseline finding from a diverse sample of 298 sexually active, young transgender women aged 16 through 29 years (mean age, 23.4 years; 49.0% black, 12.4% Latina, 25.5% white, and 13.1% other minority race/ethnicity) and enrolled in Project LifeSkills, an ongoing randomized controlled HIV prevention intervention efficacy trial in Chicago and Boston, between 2012 and 2015. EXPOSURE: Transfeminine gender identity. MAIN OUTCOMES AND MEASURES: Age- and site-adjusted prevalence and comorbidities of mental health and substance dependence disorders assessed via the Mini-International Neuropsychiatric Interview, including 1 or more diagnoses, 2 or more comorbid diagnoses, major depressive episode (current and lifetime), past 30-day suicidal risk (no/low risk vs moderate/high risk), past 6-month generalized anxiety disorder and posttraumatic stress disorder, and past 12-month alcohol dependence and nonalcohol psychoactive substance use dependence. RESULTS: Of the 298 transgender women, 41.5% of participants had 1 or more mental health or substance dependence diagnoses; 1 in 5 (20.1%) had 2 or more comorbid psychiatric diagnoses. Prevalence of specific disorders was as follows: lifetime and current major depressive episode, 35.4% and 14.7%, respectively; suicidality, 20.2%; generalized anxiety disorder, 7.9%; posttraumatic stress disorder, 9.8%; alcohol dependence, 11.2%; and nonalcohol psychoactive substance use dependence, 15.2%. CONCLUSIONS AND RELEVANCE: Prevalence of psychiatric diagnoses was high in this community-recruited sample of young transgender women. Improving access to routine primary care, diagnostic screening, psychotherapy, and pharmacologic treatments, and retention in care in clinical community-based, pediatric, and adolescent medicine settings are urgently needed to address mental health and substance dependence disorders in this population. Further research will be critical, particularly longitudinal studies across development, to understand risk factors and identify optimal timing and targets for psychosocial interventions.

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  • Being perceived as transgender may make youth vulnerable to minority stress, which has been proposed as an explanation for high rates of mental health difficulties in this group.

    “Being perceived as transgender may make youth vulnerable to minority stress, which has been proposed as an explanation for the high rates of mental health difficulties reported among this group.3–5”

    From Enacted Stigma, Mental Health, and Protective Factors Among Transgender Youth in Canada (2017) · cites this paper as [4]

    The Discussion reports high rates of psychiatric disorders among young transgender women and proposes that stressors associated with gender transition and affirmation may affect their mental health. It does not specifically say that being perceived as transgender exposes youth to minority stress or identify that as the explanation for the elevated rates. The cited study also concerns young transgender women, rather than transgender youth generally. (LLM, conf=0.83)

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1 of the 56 references couldn’t be matched to a known paper.

Research works printed but not linked: 5

  1. Reisner SL, Vetters R, Leclerc M, et al. Mental health of transgender youth in care at an adolescent urban community health center. J Adolesc Health. 2015;56(3):274-279.
  2. Center for Substance Abuse Treatment. Chapter 4: screening and assessment. In: Trauma-Informed Care in Behavioral Health Services (Treatment Improvement Protocol [TIP] Series, No.
  3. Hoertel N, McMahon K, Olfson M, et al. A dimensional liability model of age differences in mental disorder prevalence. J Psychiatr Res. 2015; 64:107-113.
  4. Conron KJ, Landers SJ, Reisner SL, Sell RL. Sex and gender in the US health surveillance system. Am J Public Health. 2014;104(6):970-976.
  5. Cochran BN, Peavy KM, Robohm JS. Do specialized services exist for LGBT individuals seeking treatment for substance misuse? Subst Use Misuse. 2007;42(1):161-176.

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Authors
Reisner, S. L., Biello, K. B., White Hughto, J. M., Kuhns, L., Mayer, K. H., Garofalo, R., & Mimiaga, M. J.
Affiliations
  • Boston Children's Hospital (US)
  • Harvard University (US)
  • The Fenway Institute, Fenway Health, Boston, Massachusetts7Chronic Disease Epidemiology, Yale School of Public Health, New Haven, Connecticut
  • Northwestern University (US)
  • Beth Israel Deaconess Medical Center (US)
Corresponding author
Reisner, Sari L.
ORCID
Venue
JAMA Pediatrics
Publisher
American Medical Association (AMA)
Published
2016-05-01
Volume
170
Issue
5
Pages
481
ISSN
  • 1072-4710 (ISSN-L)
  • 2168-6203
DOI
10.1001/jamapediatrics.2016.0067
PMC
PMC4882090
OpenAlex
W2303754164
Cited by
149
References
56
Citations by year
2026: 9 · 2025: 14 · 2024: 13 · 2023: 17 · 2022: 17 · 2021: 19 · 2020: 18 · 2019: 18 · 2018: 12 · 2017: 8 · 2016: 4
FWCI
22.01
Type
journal article
Language
en
Open access
Locations
  • Archives of Pediatrics and Adolescent Medicine (publishedVersion)
  • PubMed (publishedVersion)
  • Europe PMC (PubMed Central) (acceptedVersion)
  • PubMed Central (acceptedVersion)
Funders
National Institute of Mental Health (R01MH094323, T32MH020031, P30MH062294)
Topics
  • Social Sciences › Psychology › Social Psychology › LGBTQ Health, Identity, and Policy
  • Health Sciences › Medicine › Infectious Diseases › HIV/AIDS Research and Interventions
  • Health Sciences › Health Professions › Speech and Hearing › Adolescent and Pediatric Healthcare
Keywords
transgender women, psychiatric comorbidity, mental health prevalence, substance dependence, major depressive episode, suicidality, generalized anxiety disorder, post-traumatic stress disorder, alcoholism, HIV prevention interventions, racial and ethnic minorities, sexual minority youth, Mini International Neuropsychiatric Interview
MeSH terms
Adolescent, Adult, Mental Disorders, Boston, Chicago, Female, Gender Identity, Humans, Male, Risk Factors, Transsexualism, Randomized Controlled Trials as Topic, Young Adult, Transgender Persons

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