Depression and suicidality common among youth with gender dysphoria

By Will Boggs MD

NEW YORK (Reuters Health) - Transgender youth with gender dysphoria commonly report depression and thoughts of suicide, according to results of a recent study.

"Even for youth who are presenting for care, there are high levels of depression, suicidal ideation, and suicide attempts," lead author of the study, Dr. Johanna Olson from Children's Hospital Los Angeles in California, wrote in an email to Reuters Health.

"While this is not new information, I do think it drives home the point that despite increased visibility, transgender youth continue to struggle with very serious and life threatening issues," she said.

In response to the dearth of studies about the physical and psychosocial impact of medical treatment on youth with gender dysphoria, Dr. Olson and her colleagues are investigating the physiological and psychosocial characteristics of a group of multiethnic transgender youth over time.

This study, published online July 21 in the Journal of Adolescent Health, presents the baseline physiologic and psychosocial characteristics of the 101 transgender youths participating in this large, prospective observational study.

More than a third of transfeminine youth (38%) and 59% of transmasculine youth were overweight or obese.

More than half of the transfeminine youth (57%) and 94% of the transmasculine youth were living in the role of their asserted gender and had started doing so at an average age of 16.8 years. Eighty-eight percent of participants had come out as transgender to their families at an average age of 17.1 years.

"There was quite a gap between the age at which one realized their gender was different from their assigned gender and the age at which they came out to family or others," Dr. Joey Bonifacio, an adolescent health specialist at The Hospital for Sick Children in Toronto, Canada, who was not involved in the study, wrote in an email to Reuters Health. "This finding is extremely important as it underscores the need to ask questions regarding gender identity at earlier ages."

The rate of gender dysphoria was significantly higher among transmasculine youth than among transfeminine youth (55.9% vs. 50.1%, respectively; p<0.001).

More than half of transfeminine youth (59.6%) identified their sexual orientation as heterosexual females, and a similar fraction (55%) of transmasculine youth identified their sexual orientation as heterosexual male.

Nearly a quarter of participants had Beck Depression Inventory scores in the mild-to-moderate depression range, with 11% having scores indicating severe to extreme depression.

Fifty-one percent of participants reported suicidal thoughts at some time in their lives, and 30% had attempted suicide at least once.

Most reported having used alcohol, tobacco, and cannabis; nearly half reported being sexually active; and a few reported having traded sex for money, food, drugs, or a place to live.

All participants expressed a desire to begin hormonal intervention to assist in bringing their physical bodies into better alignment with their internal gender identity.

"I am hoping that by improving the scientific body of knowledge around transgender experiences health care professionals will feel more comfortable providing the support, medications, and/or surgeries that transgender youth need and deserve," Dr. Olson said.

Future articles will report on the follow-up of these youth over time, the researchers note.

Funding for this study was provided by The Saban Research Institute Clinical Research Academic Career Development Award, the National Center for Research Resources and the National Center for Advancing Translational Sciences, part of the National Institutes of Health (NIH).

SOURCE: http://bit.ly/1JdUyRO

J Adolesc Health 2015.

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