Differences in Mental Health Among Transgender Youth by Race/Ethnicity Before and After Gender-Affirming Care

Abstract

Gender-affirming care is life-saving care for transgender young people, reducing rates of anxiety, depression, and suicide. However, there is limited research on the mental health outcomes of transgender adolescents of color before and after gender-affirming care. In this paper, we compared the mental health of transgender youth of color and White transgender youth before and after receiving gender-affirming care. Participants were recruited from the Trans Youth Project, a longitudinal study tracking outcomes of transgender and cisgender youth. Participants’ parents were asked to complete measures to identify their child’s ethnicity and race. Participants completed measures to gauge their depression, anxiety, and their engagement with gender-affirming care. Similarly, participants’ parents completed similar proxy measures. Additionally, supplementary qualitative data was analyzed to complement quantitative findings. We found that there is a significant difference in the change in self-reported levels of depression between trans youth of color and White trans youth from before to after beginning gender-affirming care. Overall, we found that trans youth of color experience a larger increase in depression scores compared to their White trans peers who experience no change in depression scores. This increase in depression symptoms may be attributed to lack of culturally competent gender-affirming care. This research is particularly timely given the recent introduction of anti-trans legislation and legislative bans on teaching critical race theory.