Articlegreen2020

Sleep among gender minority adolescents

Jessica C. Levenson · Brian C. Thoma · Jessica L. Hamilton · Sophia Choukas‐Bradley · Rachel H. Salk

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Abstract

STUDY OBJECTIVES: Stigmatized youth experience poorer sleep than those who have not experienced stigma. However, no studies have examined the sleep of gender minority adolescents (GMAs). Examining sleep disparities between GMAs and non-GMAs is critical because poor sleep is associated with mental health outcomes experienced disproportionately by GMAs. We examined sleep duration, sleep problems, and sleep quality among our sample and compared these parameters between GMAs and non-GMAs. METHODS: Adolescents aged 14-18 years (n = 1,027 GMA, n = 329 heterosexual non-GMA, n = 415 sexual minority non-GMA; mean age = 16 years; 83% female sex at birth) completed a cross-sectional online survey, reporting sex assigned at birth and current gender identity, sleep duration, sleep problems (too much/too little sleep and inadequate sleep), sleep quality, and depressive symptoms. RESULTS: Accounting for demographic covariates, GMAs were more likely to report inadequate sleep and shorter sleep duration and had higher odds of reporting poor sleep quality and getting too little/too much sleep than heterosexual non-GMAs. After also adjusting for depressive symptoms, the finding that GMAs more often reported poor sleep quality remained significant. CONCLUSIONS: This first large, nationwide survey of sleep among GMAs suggests that GMAs may be more likely to have poor sleep than non-GMAs. The significance of our results was reduced when adjusting for depressive symptoms, suggesting that poorer sleep may occur in the context of depression for GMAs. Future work should include objective measures of sleep, examine the emergence of sleep disparities among GMAs and non-GMAs, and explore pathways that increase risk for poor sleep among GMAs.

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References

2013Diagnostic and Statistical Manual of Mental Disorders 1977The CES-D Scale 1989The Pittsburgh sleep quality index: A new instrument for psychiatric practice and research 2003Prejudice, social stress, and mental health in lesbian, gay, and bisexual populations: Conceptual issues and research evidence.2008Diagnostic and Statistical Manual of Mental Disorders(DSM)2015National Sleep Foundation’s updated sleep duration recommendations: final report 2012A conceptual framework for clinical work with transgender and gender nonconforming clients: An adaptation of the Minority Stress Model.1998Sleep Schedules and Daytime Functioning in Adolescents

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