Transgender and gender non-conforming teens report significantly poorer health — both physically and mentally — and are less likely to get preventative checkups, according to a new U.S. study.
The study, published this week in the journal Pediatrics, surveyed 80,929 Minnesota high school students. Researchers found that nearly two-thirds of teens who identified as transgender or gender non-conforming (TGNC) listed their general health as "poor," "fair," or "good," as opposed to "very good" or "excellent." This was nearly twice the rate of cisgender youth (those whose gender identity match the sex they were assigned at birth).
Nearly 60 per cent of TGNC teens also reported they had long-term mental health problems, compared to 17 per cent of cisgender teens. Over half said they'd stayed home from school at least once in the last month due to illness, and they reported lower rates of medical and dental checkups. TGNC youth also visited a school nurse more often, the study found.
"When health care providers do have the opportunity to work with TGNC adolescents, it is important to ask them about these health risks as well as barriers they experience in terms of accessing, utilizing and receiving competent and quality care," lead author Nicole Rider of the University of Minnesota, Minneapolis, told Infectious Diseases in Children.
"It is especially important for health care providers to also identify and refer to appropriate follow-up care when necessary. These are some of the ways health care providers can bolster wellness within this community."
Canadian transgender youth report health risks, too
A recent study of 923 transgender youth across Canada found that 33 per cent of younger teens (age 14-18) and 49 per cent of older youth (age 19-25) reported missing needed physical health care in the previous year.
Nearly two-thirds of transgender youth reported self-harming behaviours and more than one in three had attempted suicide. And of those with a family doctor, only 15 per cent felt "very comfortable" discussing health care needs specific to being transgender, the study found.
Transgender people are typically a medically under-served population, Ontario's Trans Pulse Project reports. A 2017 study comparing data from the Trans Pulse Project with data from the Canadian Community Health Survey found "inequalities in perception and reported experiences of health care access," with 43.9 per cent of transgender Ontarians reporting an unmet health care need in the previous year.
Transgender youth have higher rates of emotional distress
"Some of our previous research indicates that, when compared to cisgender youth, (TGNC) adolescents report experiencing higher rates of bullying and subsequently higher rates of emotional distress and substance use following from these incidents," the U.S. study's Nicole Rider told Infectious Diseases in Children.
"These health outcomes may also be a result of negative experiences such as discrimination and other interactions that do not affirm their gender identities and expressions, which other studies indicate does happen in health care settings," Rider said.
One unexpected finding in the study was that nearly three per cent of the youth surveyed identified as transgender or gender non-conforming — a higher rate than the authors expected, Times reported.
"This level of prevalence of TGNC youth supports recent findings that reveal that previous estimates of the size of the TGNC population have been underestimated by orders of magnitude, and serve to inform school administrators, mental health professionals, and medical professionals that they will see youth with diverse gender identities and expressions in their schools and offices," Dr. Daniel Shumer, of the Department of Pediatrics at the University of Michigan, said in an opinion piece in Pediatrics.
"Youth are rejecting this binary thinking and are asking adults to keep up."
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