Temporal Trends in Mental Health in the United States by Gender Identity, 2014-2021

Donna L. Feir, Samuel J. Mann

ResearchPosted on rand.org Oct 9, 2024Published in: American Journal of Public Health, Volume 114, No. 5, pages 523-526 (May 2024). DOI: 10.2105/AJPH.2024.307603

Objectives

To examine the temporal trends in the transgender-cisgender mental health disparity in the United States.

Methods

We used 2014-2021 US Behavioral Risk Factor Surveillance System Survey data with logistic and ordinary least squares regression to document temporal trends in the transgender-cisgender disparity in self-reports of the number of poor mental health days in the past month and frequent mental distress.

Results

In 2014, cisgender individuals reported a mean average of 3.68 (95% confidence interval [CI] = 3.65, 3.70) poor mental health days compared with a mean average of 5.42 (95% CI = 4.68, 6.16) poor mental health days among transgender respondents. The size of this disparity adjusted by differences in observable characteristics increased by 2.75 days (95% CI = 0.58, 4.91) over the sample period. In 2014, 11.4% (95% CI = 11.3%, 11.5%) of cisgender adults reported frequent mental distress compared with 18.9% (95% CI = 15.9%, 22%) of transgender adults. By 2021, 14.6% (95% CI = 15.9%, 22%) of cisgender adults and 32.9% (95% CI = 30.7%, 35.1%) of transgender adults reported frequent mental distress.

Conclusions

Policies are needed to address the worsening mental health of transgender and gender-nonconforming people in the United States. Gender minority (i.e., transgender, gender diverse, gender-nonconforming and gender nonbinary) adults have higher rates of depression, anxiety, suicidal behavior, substance use, and self-reported poor mental health than do their cisgender counterparts. However, most previous work has relied on convenience samples or a single year of data, limiting analysis of temporal trends in transgender mental health disparity. Analysis of temporal trends is needed to inform progress in addressing health disparities among gender minority populations. To our knowledge, this study is the first population-representative analysis of temporal trends in the mental health disparity between cisgender and gender minority populations.

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Document Details

  • Copyright: American Public Health Association
  • Publisher: American Journal of Public Health
  • Availability: Non-RAND
  • Year: 2024
  • Pages: 4
  • Document Number: EP-70668

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