ArticleNature and science of sleep2021
Associations Between Transgender Identity, Sleep, Mental Health and Suicidality Among a North American Cohort of College Students.
Article in Nature and science of sleep, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 21 papers, 1 of them a synthesis that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
21 citing papers in PubMed, 1 synthesis or guideline pooled it, 48 citations in OpenAlex.
- Exploring the global prevalence of mood and anxiety disorders in LGBTIQ+ people: A systematic review.Frontiers in psychiatry · 2025Pooled it
- Beyond identity categories: chronotype and mental health as correlates of sleep quality in transgender and gender-diverse adults.Frontiers in psychiatry · 2026Article
- Sleep-Related Concerns Mediate the Association Between Cyber-Sexual Victimization and Psychological Distress Among Diverse University Students.Cyberpsychology, behavior and social networking · 2025Article
- Minority Stress, Resilience, and Trouble Falling Asleep Among Gender and Sexual Minority Adolescents.Journal of adolescence · 2025Article
- Sleep health among sexual and gender minority people in the United States: A scoping review.Sleep medicine · 2025Article
- Gender Identity Disparities in Early Adolescent Sleep: Findings from the Adolescent Brain Cognitive Development Study.LGBT health · 2025Article
- Characterising the activity, lifestyle behaviours and health outcomes of UK university students: an observational cohort study with a focus on gender and ethnicity.BMC public health · 2024Observational
- The relationship of race, ethnicity, gender identity, sex assigned at birth, sexual orientation, parental education, financial hardship and comorbid mental disorders with quality of life in college students with anxiety, depression or eating disorders.Journal of affective disorders · 2024Article
- Article
- Neurologic Care for Transgender and Gender-Diverse People: A Review of Current Evidence and Clinical Implications.Neurology. Clinical practice · 2024Review
- Sexual and Gender Minority Sleep Health Disparities and Minority Stress in Early Adolescence.The Journal of adolescent health : official publication of the Society for Adolescent Medicine · 2024Article
- Efficacy and underlying mechanisms of three-circle post standing qigong on insomnia in college students: a four-arm, double-blind, randomized controlled trial protocol.BMC complementary medicine and therapies · 2024Article
- Images: Irregular sleep-wake rhythm disorder in transgender individuals.Journal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine · 2023Article
- A Pilot Study of Symptoms of Major Depressive Disorder in Medical Students at an Osteopathic Medical School Before and After High-Stakes Examinations.Advances in medical education and practice · 2023Article
- Insomnia among community members in Florida: Associations with demographics, health conditions, and social support.Journal of clinical and translational science · 2023Article
- Nonconforming gender expression and insufficient sleep among adolescents during COVID-19 school closure and after school reopening.BMC public health · 2022Article
- Gender identity and transition: relationships with sleep disorders in US youth.Journal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine · 2022Article
- Sleep disturbance and suicide risk among sexual and gender minority people.Neurobiology of stress · 2022Article
- Examining the associations of gender minority stressors with sleep health in gender minority individuals.Sleep health · 2022Article
- Abnormal hippocampal substructure volume in insomnia disorder.Brain imaging and behavior · 2022Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
6 authors at 2 institutions in 1 country.
Funding
Abstract
purposeThe purpose of this study is to examine the associations between transgender identity, sleep, and mental health among a North American cohort of cisgender and transgender college students. PARTICIPANTS AND
methodsThis cross-sectional study surveyed 221,549 North American college students from the 2016-2017 American College Health Association-National College Health Assessment II. Bivariate and multivariable analysis examined associations among transgender identity and outcomes of insomnia symptoms, daytime sleepiness, sleep disorder diagnoses and treatments. Mental health outcomes included mood symptoms, suicidal behaviors, anxiety and depression diagnoses and treatments.
resultsTransgender identity was reported by 1.6% (n=3471) of United States (US) and 1.7% (n=717) Canadian students, respectively. Mean age was 22.5 ±6. Transgender college students have an increased prevalence of daytime sleepiness, insomnia symptoms, diagnoses and/or treatment of insomnia and other sleep disorders as compared to cisgender college students. Mental Health symptoms are more prevalent with a 2-fold increase in depression and anxiety and nearly a 4-fold increase in suicide attempts among transgender students. A higher burden of mood symptoms exists among transgender college students in the US in comparison to Canadian students.
conclusionTransgender college students have an alarmingly high rate of mood, sleep disturbances and sleep diagnoses, and suicidality. Colleges and universities must provide sufficient resources to address the sleep and mental health needs of transgender students. Institutions must adopt gender affirming policies that promote an inclusive environment. Increased allocation of resources and adoption of policies that enhance the physical and mental health of transgender students could improve sleep, mood, and potentially lower the suicide risk among a population that often experiences health inequities.
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What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.