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 While the study can't say why this was true, the researchers say the
results highlight the need for culturally competent treatment and
care.
"There is a critical need for skilled and well-informed mental
health professionals," said Sari Reisner, the study's lead author
from Boston Children's Hospital.
The researchers write in JAMA Pediatrics that mental health issues
and addiction affect 4 to 26 percent of people in the U.S. Often,
those issues emerge during adolescence and young adulthood.
For the new study, the researchers interviewed 300 transgender women
in Boston and Chicago between 2012 and 2015. The participants, who
ranged in age from 16 to 29, were sexually active and were
participating in an HIV prevention study.
Overall, about 42 percent had one or more health or addiction
diagnoses. About one in five had two or more diagnoses.
Rates of diagnoses among the participants were about two to four
times greater than in the general U.S. population, write the
researchers.
About a third of participants had been depressed at some point, and
about 15 percent currently had the condition. About one in five
participants reported suicidal thoughts within the past 30 days.
Within the last six months, about 8 percent of participants had
anxiety and about one in 10 had post-traumatic stress disorder (PTSD).
About 11 percent reported alcohol dependence in the past year.
Likewise, about 15 percent reported some other kind of addiction
during that time.
The likelihood of mental health and addiction issues appeared to
increase with age.
That finding, coupled with a smaller lifetime prevalence of
depression than what's been seen in previous studies in older
transgender women, suggests there is an opportunity to prevent poor
outcomes.
The new results do not show that transgender women are inherently
predisposed to mental health issues, Reisner told Reuters Health.
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For example, he and his colleagues point out, gender transition and
gender affirmation are stressful events. They may affect a
transgender and gender-variant person's psychiatric health and
well-being during adolescence and young adulthood.
The increased prevalence of mental health and addiction issues
likely stems from the intersection of several minority stressors,
said Dr. Johanna Olson-Kennedy, who is medical director of the
Center for Transyouth Health and Development at Children's Hospital
Los Angeles.
The minority stress theory suggests people in minority groups are at
a greater risk for health problems due to increased exposures to
stressors like prejudice and stigma.
"We can’t forget that trans people continue to face an onslaught of
microaggressions every single day of their lives," said
Olson-Kennedy, who wrote an editorial accompanying the new study.
She told Reuters Health that eliminating stigma goes beyond limited
access to healthcare and stretches to all parts of society.
"It’s about changing the cultural paradigm so we can do whatever we
can to mitigate those challenges," she said.
SOURCE: http://bit.ly/25gtUlj and http://bit.ly/25gtRWG JAMA
Pediatrics, online March 21, 2016.
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