Mental health disparities growing among transgender adults

In the U.S., transgender and gender non-conforming (TGNC) individuals represent a historically marginalized segment of society. They often report unfavorable outcomes in terms of both physical and mental health compared to their cisgender counterparts. Despite advancement in psychological and physical healthcare provisions for TGNC individuals over the years, they face significant barriers that hinder access to crucial services, including but not limited to, lengthy waiting lists, inconvenient travel requirements and a lack of insurance coverage.

In a recent study published in the May 2024 issue of the American Journal of Public Health, researchers examined changes in self-reported mental health from 2014 to 2021 among a nationally representative adult population. By analyzing data from the U.S. Behavioral Risk Factor Surveillance System Survey, researchers Donn Feir of the University of Victoria and Samuel Mann of the RAND Corporation found that mental health distress increased disproportionately among TGNC adults over this period, compared to cisgender adults.

The number of self-reported “poor mental health days” per month serves as a reliable indicator of mental health, correlating with other psychological and physical health indicators. While TGNC individuals reported more poor mental health days in 2014, the statistics worsened significantly over the next seven years. 

“In 2014, cisgender individuals reported a mean average of 3.68 poor mental health days, compared with a mean average of 5.42 poor mental health days among transgender respondents. The size of this disparity adjusted by differences in observable characteristics increased by 2.75 days over the sample period,” explained Mann.

Researchers also uncovered a disproportionate rise in the frequency of mental health distress reported by TGNC individuals during the seven-year study period. “In 2014, 11.4% of cisgender adults reported frequent mental distress compared with 18.9% of transgender adults. By 2021, [those numbers rose to] 14.6% of cisgender adults and 32.9% of transgender adults report[ing] frequent mental distress,” Feir noted.

The observed trend of rapidly increasing mental distress among TGNC adults indicates potential worsening of socioeconomic and other disparities, as well as an increase in the barriers that prevent them from accessing the support services they need. This increase in mental distress within the TGNC population could also stem from factors such as societal discrimination or lack of access to gender-affirming and mental health care resources.

The alarming increase in the frequency of self-reported mental distress among transgender individuals suggests an urgent need to recalibrate country-wide initiatives supporting TGNC individuals across the U.S. Resource allocation that enhances access to gender-affirming and mental health services may also be a crucial step in mitigating disparities in mental health between TGNC and cisgender people.

Finally, policy changes that promote overall well-being and inclusivity for TGNC individuals may help improve mental health outcomes for this underserved community in the long run. “Policies are needed to address the worsening mental health of transgender and gender-nonconforming people in the United States,” Mann concluded.