ArticlePloS one2021
Differences in mental health symptom severity and care engagement among transgender and gender diverse individuals: Findings from a large community health center.
Article in PloS one, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 34 papers, 1 of them a synthesis that pooled it.
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Who cites it
34 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Exploring the global prevalence of mood and anxiety disorders in LGBTIQ+ people: A systematic review.Frontiers in psychiatry · 2025Pooled it
- Impact of patient-provider gender concordance on mental health outcomes: scoping review.BJPsych open · 2026Review
- At-Risk Substance Use Among Trans and Gender Diverse Adults in Australia: Findings From the Private Lives 3 Survey.Drug and alcohol review · 2026Article
- Worldwide prevalence of anxiety in transgender persons: Systematic review with meta-analysis.International journal of transgender health · 2026Review
- Birthing beyond the binary: An interpretative Phenomenological analysis of perinatal mental health experiences among genderqueer and nonbinary birthing people.International journal of transgender health · 2026Article
- The Role of Supportive and Unsupportive Family Behaviors in the Mental Health of Transgender and Nonbinary Young Adults.Transgender health · 2025Article
- Missing piece: the imperative of gender-disaggregated data in unraveling health inequity.BMJ global health · 2025Article
- US State Policies and Mental Health Symptoms Among Sexual and Gender Minority Adults.JAMA network open · 2025Article
- Gender identity and its impact on attention deficit hyperactivity disorder manifestations: Challenges in diagnosis and assessment.World journal of psychiatry · 2025Review
- Mental Health Changes in US Transgender Adults Beginning Hormone Therapy Via Telehealth: Longitudinal Cohort Study.Journal of medical Internet research · 2025Article
- Exploring Interactions Between Transgender, Gender-Diverse, and Nonbinary Individuals and Allied Health Professionals in Clinical Practice: A Scoping Review.Transgender health · 2025Review
- Disparities in depression and anxiety at the intersection of race and gender identity in a large community health sample.Social science & medicine (1982) · 2025Article
- Nonbinary people living in a binary world: Minority stress in public and gendered places.International journal of transgender health · 2025Article
- Implementing LGBTQ-affirmative cognitive-behavioral therapy: implementation strategies across five clinical trials.Implementation science communications · 2024Article
- Alcohol Use Patterns Among Underage Autistic and Non-Autistic Youth.Journal of autism and developmental disorders · 2024Article
- Exploring LGBT2Q+ Intracategorical Factors in Mental Health Service Utilization: Differences in Gender Modalities, Sexual Orientations, and Ethnoracial Groups in Canada.Community mental health journal · 2024Article
- Invalidation and Mental Health among Nonbinary Individuals.Psychology of sexual orientation and gender diversity · 2024Article
- Sex and gender reporting in RCTs of internet and mobile-based interventions for depression and anxiety in chronic conditions: A secondary analysis of a systematic review.PLOS mental health · 2024Article
- Oppression-Based Stress and Alcohol Inequities Among Sexual and Gender Minority People: An Intersectional Multilevel Framework.Alcohol research : current reviews · 2024Review
- Right Versus Wrong: A Qualitative Appraisal With Respect to Pandemic Trajectories of Transgender Population in Kerala, India.Journal of bioethical inquiry · 2023Article
Corrections and comments
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Authors and funding
9 authors.
Funding
Abstract
Mental health disparities among transgender and gender diverse (TGD) populations have been documented. However, few studies have assessed differences in mental health symptom severity, substance use behavior severity, and engagement in care across TGD subgroups. Using data from the electronic health record of a community health center specializing in sexual and gender minority health, we compared the (1) severity of self-reported depression, anxiety, alcohol use, and other substance use symptoms; (2) likelihood of meeting clinical thresholds for these disorders; and (3) number of behavioral health and substance use appointments attended among cisgender, transgender, and non-binary patients. Participants were 29,988 patients aged ≥18 who attended a medical appointment between 2015 and 2018. Depression symptom severity (F = 200.6, p < .001), anxiety symptom severity (F = 102.8, p < .001), alcohol use (F = 58.8, p < .001), and substance use (F = 49.6, p < .001) differed significantly by gender. Relative to cisgender and transgender individuals, non-binary individuals are at elevated risk for depression, anxiety, and substance use disorders. Gender was also associated with differences in the number of behavioral health (χ2 = 51.5, p < .001) and substance use appointments (χ2 = 39.3, p < .001) attended. Engagement in treatment among certain gender groups is poor; cisgender women and non-binary patients assigned male at birth were the least likely to have attended a behavioral health appointment, whereas transgender men and cisgender women had attended the lowest number of substance use appointments. These data demonstrate the importance of (1) assessing gender diversity and (2) addressing the barriers that prevent TGD patients from receiving affirming care.
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