ArticleBMC public health2025
The interplay between gender identity and sex assigned at birth in adolescents' health and wellbeing: a cross-sectional study.
Article in BMC public health, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundThere is a growing body of evidence on health inequalities according to gender identity, in which sex assigned at birth is often overlooked. The aim of our study was to assess the relevance of examining both gender identity and sex assigned at birth in health population surveys, by comparing the health outcomes, behaviours, and interpersonal relationships in cisgender boys, cisgender girls, transgender and gender expansive (TGE) youth assigned male at birth (AMAB) and TGE youth assigned female at birth (AFAB), in a general population sample of adolescents schooled in Catalonia, Spain.
methodsCross-sectional study using a questionnaire in students aged 12-19 years from Catalonia (N = 9177) in 2021-2022. We assessed the differences in health outcomes (self-perceived overall health and mental wellbeing), health-related behaviours (quality of diet, physical activity, consumption of tobacco, alcohol and cannabis, and compulsive screen and digital entertainment use), and interpersonal relationships (family relationships, bullying victimization, and sexual violence) in cisgender boys, cisgender girls, TGE AMAB and TGE AFAB, using descriptive statistics and Pearson chi-square tests. We used Poisson regression models with robust variance to examine the associations between the health outcomes and gender identity and sex assigned at birth.
resultsTGE AMAB adolescents had a greater prevalence of worse overall health (PR
conclusionsTGE adolescents have worse health outcomes than cisgender peers and, simultaneously, adolescents who were AFAB (cisgender girls and TGE AFAB) have worse health outcomes than those AMAB (cisgender boys and TGE AMAB, respectively). In health research, gender identity should complement, not substitute, sex assigned at birth.
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