ArticleInternational journal of transgender health2026
Structural stigma, parenthood patterns and depressive symptoms among transgender and gender diverse individuals across 30 countries in Europe.
Article in International journal of transgender health, 2026. 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
Introduction: Life circumstances of transgender and gender diverse individuals are strongly influenced by where they live. Little is known about how structural factors, for example, laws, policies, and population attitudes relating to transgender and gender diverse populations, affect their family building or mental health as parents. Objectives: We aimed to examine parenthood patterns among European transgender and gender diverse individuals, and whether their likelihood of biological parenthood differed by sex assigned at birth, gender identity or country level structural stigma. Another goal was to assess patterns of depressive symptoms by country level structural stigma based on parenthood. Methods: Using multi-level regression, we combined cross-sectional individual level data on parenthood, gender identity, sex assigned at birth and depressive symptoms from 13,302 transgender and gender diverse individuals with a measure of country level structural stigma based on national legislation, policies and population attitudes across 30 European countries. Results: In total, 8.3% were parents. Biological parenthood was more common among individuals assigned male than female. The odds ratio of biological parenthood was higher for transgender women than gender diverse individuals assigned male but lower for transgender men than gender diverse individuals assigned female. Country level structural stigma was not significantly associated with parenthood. Parenthood status and structural stigma did not predict depressive symptoms. Conclusion: Gender identity and sex assigned at birth influence family building in transgender and gender diverse individuals, most likely through societal factors and gender dysphoria. An association between structural stigma, parenthood and mental health could not be established.
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