Mental Health Disparities at the Intersections of Gender Identity, Race, and Ethnicity

Lee Robertson · Ellesse-Roselee L Akré · Gilbert Gonzales

43 citations0/0 files storedLGBT Health

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LGBTQ Health, Identity, and Policy Racial and Ethnic Identity Research Gender, Health, and Social Inequality

Abstract

Purpose: Very little research has examined mental health among transgender people of color using population-based data. The objective of this study was to use large-scale data to examine mental health disparities at the intersections of gender identity, race, and ethnicity. Methods: Data for this study came from transgender (n = 4024) and cisgender (n = 935,793) adults aged 18 years and older in the 2014–2018 Behavioral Risk Factor Surveillance System. We estimated and compared frequent mental distress and lifetime depression diagnoses using multivariable logistic regression models. Regression results are presented as adjusted odds ratios (AORs) with 95% confidence intervals (CIs). Results: After controlling for sociodemographic characteristics and compared with cisgender White adults, transgender White adults (AOR = 1.81; 95% CI = 1.49–2.21), transgender American Indian or Alaska Native (AIAN) adults (AOR = 8.06; 95% CI = 2.03–32.00), and transgender adults of other/multiple races and ethnicities (AOR = 3.15; 95% CI = 1.78–5.59) had higher odds of exhibiting frequent mental distress. Transgender White adults (AOR = 2.07; 95% CI = 1.75–2.46), transgender AIAN adults (AOR = 3.61; 95% CI = 1.06–12.32), and transgender adults of other/multiple races and ethnicities (AOR = 2.37; 95% CI = 1.41–4.01) had higher odds of reporting a lifetime depression diagnosis compared with White cisgender adults. Conclusion: This study serves as a reminder that LGBT health should be analyzed through an intersectional lens as some individuals with multiple marginalized identities may have worse health as a result of double discrimination. Public health practitioners and health care providers should be mindful of the diversity within the transgender population in their work.

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References

2003Prejudice, social stress, and mental health in lesbian, gay, and bisexual populations: Conceptual issues and research evidence.2009How does sexual minority stigma “get under the skin”? A psychological mediation framework.2012A conceptual framework for clinical work with transgender and gender nonconforming clients: An adaptation of the Minority Stress Model.2012American Indian and Alaska Native Mental Health: Diverse Perspectives on Enduring Disparities 2014Racial disparities in psychotic disorder diagnosis: A review of empirical literature 2019Health disparities between genderqueer, transgender, and cisgender individuals: An extension of minority stress theory.2019Gender Minority Stress: A Critical Review 2018Anxiety and depression across gender and sexual minorities: Implications for transgender, gender nonconforming, pansexual, demisexual, asexual, queer, and questioning individuals.

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