Primary Care clinicians should routinely screen transgender youth for mental health concerns
Transgender youth have disparately negative mental health outcomes related to depression, anxiety, suicide ideation, suicide attempt, and self-harm without lethal intent compared to their non-transgender youth counterparts. The finding is detailed in a new study entitled “Mental Health of Transgender Youth in Care at an Adolescent Urban Community Health Center: A Matched Retrospective Cohort Study” published Thursday in the Journal of Adolescent Health.
“To date, there are limited comparative mental health data available in transgender adolescents and young adults to document health inequities by gender minority status. This research points to the need for gender-affirming mental health services and interventions to support transgender youth,” said Sari Reisner, ScD, Research Scientist at The Fenway Institute and Postdoctoral Research Fellow in the Department of Epidemiology at Harvard School of Public Health, and the lead author of the report. “It is clear that clinicians serving transgender youth should routinely screen for mental health concerns.”
The study examined data from the electronic health records of 180 transgender patients age 12-29 years matched with non-transgender patients who were seen for health care at the Sidney Borum Jr. Health Center, a Boston-based community health center serving youth. There were 106 female-to-male patients and 74 male-to-female patients. Key findings from the study show that transgender patients have disparately negative mental health outcomes compared to their non-transgender youth counterparts (depression, anxiety, suicide ideation, suicide attempt, and self-harm without lethal intent). There were no statistically significant differences in negative mental health outcomes between female-to-male and male-to-female youth.
The findings show that clinicians serving transgender youth should screen for mental health concerns. It is also recommended that gender-inclusive measures be integrated into electronic health records, including assigned sex at birth and current gender identity at patient registration. Including these questions facilitates clinic-based epidemiologic research as well as quality improvement efforts to ensure high-quality, gender-affirming care.
The Sidney Borum, Jr. Health Center, the clinic site where this study took place, while devoting a good part of its resources to the care of transgender youth, is still a primary care clinic for adolescents and emerging adults. Therefore, this study shows that expanded care for transgender youth can be provided in the context of overall pediatric care: integration of behavioral health, psychiatry, and pediatric primary care – a medical home approach – can more than adequately support the medical and behavioral health needs of transgender youth and provide a locus of care for reduction of psychiatric outcomes described by the study.
The full report is available here.