Comparing the health of non-binary and binary transgender adults in a statewide non-probability sample
Open accessAbstract
BACKGROUND: In the U.S., non-binary refers to transgender people who have a gender identity not aligned with their assigned sex at birth, and who identify outside of the traditional male-female binary, such as genderqueer, genderfluid, or gender nonconforming. Few data are available to characterize the health of non-binary adults. METHODS: The current study sought to fill this gap by conducting a secondary analysis of data from a non-probability sample of transgender and/or gender nonconforming adults in Massachusetts (sample mean age 32.6 years, 63% female assigned sex at birth; 79.4% white non-Hispanic/Latinx). Multivariable models were fit to compare non-binary (e.g., genderqueer) vs. binary (e.g., man/trans man, woman/trans woman) respondents across a range of social and health indicators. RESULTS: Overall, 40.9% identified their gender identity as non-binary. Non-binary respondents significantly differed from binary respondents on (all p<0.05): demographics (younger age, more female assigned sex at birth); gender affirmation (older age of identity recognition, lower current uptake of and future desires for medical gender affirmation); healthcare utilization (lower rates of being up-to-date in annual wellness visit, less mental healthcare utilization in past year); mental health and substance use (higher past-week depressive distress, higher hazardous alcohol use); social history (more unstably housed, more current students), violence victimization (lower rates of lifetime intimate partner violence), and social support (less family support). CONCLUSION: Gender diversity, including whether people endorse a binary or non-binary gender identity, is a prevalent and an important aspect of transgender health. Demographic measures of gender identity that include binary and non-binary response options are recommended to inform future research and clinical care.
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Non-binary individuals are less likely to undertake gender-affirming treatment and are predominantly female sex assigned at birth, forgoing the effects of male puberty.
“non-binary individuals are less likely to undertake gender-affirming treatment and are predominantly female sex assigned at birth [10], forgoing the effects of male puberty.”
From Integrating Transwomen and Female Athletes with Differences of Sex Development (DSD) into Elite Competition: The FIMS 2021 Consensus Statement (2021) · cites this paper as [10]
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- Authors
- Reisner, S. L., & Hughto, J. M. W.
- Affiliations
- Boston Children's Hospital (US)
- Brown University (US)
- Corresponding author
- Reisner, Sari L.
- Venue
- PLOS ONE
- Publisher
- Public Library of Science (PLoS)
- Published
- 2019-08-27
- Volume
- 14
- Issue
- 8
- Pages
- e0221583
- ISSN
- 1932-6203 (ISSN-L)
- PMC
- PMC6711503
- OpenAlex
- W2970713018
- Cited by
- 177
- References
- 62
- Citations by year
- 2026: 14 · 2025: 23 · 2024: 40 · 2023: 32 · 2022: 27 · 2021: 25 · 2020: 15
- FWCI
- 21.04
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- PLoS ONE (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- RePEc: Research Papers in Economics (submittedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Funders
- Harvard University Center for AIDS Research (CFAR-FCHC-15-1)
- Topics
- Social Sciences › Psychology › Social Psychology › LGBTQ Health, Identity, and Policy
- Social Sciences › Gender Studies › Gender and Feminist Studies
- Social Sciences › Gender Studies › Gender Roles and Identity Studies
- Keywords
- non-binary gender identity, transgender adults, transgender health, gender affirmation, health care utilization, mental health, substance use, housing instability, intimate partner violence, family support, Massachusetts
- MeSH terms
- Adolescent, Adult, Aged, Female, Gender Identity, Health, Humans, Male, Mental Health, Middle Aged, Patient Acceptance of Health Care, Probability, Social Support, Violence, Crime Victims, Substance-Related Disorders, Young Adult, Transgender Persons
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