Accepted for/Published in: Interactive Journal of Medical Research
Date Submitted: Sep 18, 2024
Date Accepted: Feb 24, 2025
Prevalence and correlates of clinically elevated depressive symptoms in a nationwide sample of transgender, nonbinary, and gender diverse young adults in the United States: A cross-sectional study
ABSTRACT
Background:
In the US, universal screening for depression is recommended in primary care settings. Transgender, nonbinary, and gender diverse (TGD) young adults experience increased risk of depression versus cisgender peers. There is a need to screen for depressive symptoms and identify vulnerabilities and protective factors to guide interventions for TGD young adults.
Objective:
This exploratory study investigated the prevalence and correlates of positive screening for depressive symptoms among TGD young adults to inform interventions to detect, evaluate, and refer to mental health services.
Methods:
In August 2022, a US cross-sectional nationwide online survey was conducted with TGD young adults ages 18-25 years (N=104). Measures included sociodemographics, family characteristics, mental healthcare utilization, and the Patient Health Questionnaire-2 (PHQ-2) screener for depression. Poisson regression models with robust variance estimation were fit to estimate adjusted prevalence ratios (aPR) and 95% Confidence Intervals (95%CI) for correlates of PHQ-2 depression (score>=3).
Results:
The sample mean age was 21.8 years; 46.1% were Black, Indigenous, or Other People of Color; 66.3% were nonbinary; and 42.3% screened positive for PHQ-2 depression. In a multivariable model adjusted for age, race/ethnicity, US Census region, and health insurance, factors associated with increased PHQ-2 depression prevalence were non-Christian religion vs unaffiliated (aPR=1.66; 95%CI=1.04-2.63) and low family support vs not (aPR=1.54; 95%CI=1.05-2.27). Factors associated with reduced prevalence were rural vs suburban area-dwelling (aPR=0.48; 95% CI=0.26-0.92) and receiving mental health therapy vs not (aPR=0.71; 95% CI=0.53-0.97).
Conclusions:
The high percentage of TGD young adults with elevated depressive symptoms in this online sample highlights the need for comprehensive mental health evaluation and linkages for this population. Tailored online outreach and telehealth programs for highly burdened TGD subgroups are warranted, such as TGD young adults with low family support.
Citation
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Copyright
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