ArticlePloS one2021
Gender-affirming care, mental health, and economic stability in the time of COVID-19: A multi-national, cross-sectional study of transgender and nonbinary people.
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 92 papers, 3 of them syntheses that pooled it.
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Who cites it
92 citing papers in PubMed, 3 syntheses or guidelines pooled it, 144 citations in OpenAlex.
- LGBTQI + Migrants: A Systematic Review and Conceptual Framework of Health, Safety and Wellbeing during Migration.International journal of environmental research and public health · 2022Pooled it
- Pooled it
- Experiences and Perceptions of Trans and Gender Non-Binary People Regarding Their Psychosocial Support Needs: A Systematic Review of the Qualitative Research Evidence.International journal of environmental research and public health · 2021Pooled it
- Health equity and medical mistrust: a mixed-methods analysis of medical and social determinants among transgender women of colour in the TURNNT cohort study.Culture, health & sexuality · 2026Article
- Positive psychological well-being and psychological distress in higher education students.Journal of affective disorders · 2026Article
- Structural barriers to accessing gender-affirming care for transgender and gender diverse (TGD) individuals in the United States.International journal of transgender health · 2026Review
- The Impact of COVID-19 on Healthcare Access for Gender-Diverse Adults: A Qualitative Study.Health services insights · 2026Article
- Article
- Mental health implications of gender affirming care: bridging the communication and supportive gap.Annals of medicine and surgery (2012) · 2026Review
- Worldwide prevalence of anxiety in transgender persons: Systematic review with meta-analysis.International journal of transgender health · 2026Review
- The Association Between Family Planning and Psychological Distress in Individuals With Minoritized Gender Identities in Germany: A Cross-Sectional Study During the COVID-19 Pandemic.Perspectives on sexual and reproductive health · 2025Article
- Perceived access to gender-affirming care, completion of gender-affirming medical interventions, and psychological distress among transgender women of color: the TURNNT cohort study.American journal of epidemiology · 2025Observational
- Race, Ethnicity, and Gender Differences in Patient Reported Well-Being and Cognitive Functioning Within 3 Months of Symptomatic Illness During COVID-19 Pandemic.Journal of racial and ethnic health disparities · 2025Article
- Barriers of Access to Gender-Affirming Health Care and Surgery: A Systematic Review.Transgender health · 2025Review
- Postsurgical Pain, Psychosocial Functioning, and Cannabis Use Among Adolescents and Young Adults Undergoing Gender-Affirming Surgery.Transgender health · 2025Article
- Barriers to Gender-Affirming Care, Health Care Services, and Experiences of Health Care Provider Bias Among Transgender People in Nigeria.American journal of public health · 2025Article
- Facilitators and barriers to using telemedicine for gender-affirming care in gender-diverse youth: A qualitative study.Journal of telemedicine and telecare · 2025Article
- Marginalized Identities, Healthcare Discrimination, and Parental Stress about COVID-19.Journal of marriage and the family · 2025Article
- Predictors, patterns, and correlates of moderate-severe psychological distress among New York City College Students during Waves 2-4 of COVID-19.Scientific reports · 2025Article
- Experiences of gender-affirming healthcare among transgender and gender diverse (TGD) people during the COVID-19 pandemic: An explanatory sequential mixed methods study.International journal of transgender health · 2025Article
32 more citing papers are in PubMed but not listed here.
Corrections and comments
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Authors and funding
7 authors at 2 institutions in 1 country.
Funding
Abstract
backgroundTransgender and nonbinary people are disproportionately affected by structural barriers to quality healthcare, mental health challenges, and economic hardship. This study examined the impact of the novel coronavirus disease (COVID-19) crisis and subsequent control measures on gender-affirming care, mental health, and economic stability among transgender and nonbinary people in multiple countries.
methodsWe collected multi-national, cross-sectional data from 964 transgender and nonbinary adult users of the Hornet and Her apps from April to August 2020 to characterize changes in gender-affirming care, mental health, and economic stability as a result of COVID-19. We conducted Poisson regression models to assess if access to gender-affirming care and ability to live according to one's gender were related to depressive symptoms, anxiety, and changes in suicidal ideation.
resultsIndividuals resided in 76 countries, including Turkey (27.4%, n = 264) and Thailand (20.6%, n = 205). A majority were nonbinary (66.8%, n = 644) or transfeminine (29.4%, n = 283). Due to COVID-19, 55.0% (n = 320/582) reported reduced access to gender-affirming resources, and 38.0% (n = 327/860) reported reduced time lived according to their gender. About half screened positive for depression (50.4%,442/877) and anxiety (45.8%, n = 392/856). One in six (17.0%, n = 112/659) expected losses of health insurance, and 77.0% (n = 724/940) expected income reductions. The prevalence of depressive symptoms, anxiety, and increased suicidal ideation were 1.63 (95% CI: 1.36-1.97), 1.61 (95% CI: 1.31-1.97), and 1.74 (95% CI: 1.07-2.82) times higher for individuals whose access to gender-affirming resources was reduced versus not. DISCUSSION: The COVID-19 crisis is associated with reduced access to gender-affirming resources and the ability of transgender and nonbinary people to live according to their gender worldwide. These reductions may drive the increased depressive symptoms, anxiety, and suicidal ideation reported in this sample. To improve health of transgender and nonbinary communities, increased access to gender-affirming resources should be prioritized through policies (e.g., digital prescriptions), flexible interventions (e.g., telehealth), and support for existing transgender health initiatives.
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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.