Your browser doesn't support javascript.
loading
Mental Healthcare Utilization of Transgender Youth Before and After Affirming Treatment.
Hisle-Gorman, Elizabeth; Schvey, Natasha A; Adirim, Terry A; Rayne, Anna K; Susi, Apryl; Roberts, Timothy A; Klein, David A.
Afiliação
  • Hisle-Gorman E; Department of Pediatrics, Uniformed Services University, Bethesda, MD; Department of Preventive Medicine and Biostatistics, Uniformed Services University, Bethesda, MD, USA. Electronic address: elizabeth.hisle-gorman.ctr@usuhs.edu.
  • Schvey NA; Department of Medical and Clinical Psychology, Uniformed Services University, Bethesda, MD, USA.
  • Adirim TA; Department of Preventive Medicine and Biostatistics, Uniformed Services University, Bethesda, MD; Department of Defense, Washington, DC, USA.
  • Rayne AK; Department of Family Medicine, Fort Belvoir Community Hospital, Fort Belvoir, VA, USA.
  • Susi A; Department of Pediatrics, Uniformed Services University, Bethesda, MD; Department of Preventive Medicine and Biostatistics, Uniformed Services University, Bethesda, MD, USA.
  • Roberts TA; Division of Adolescent Medicine, Children's Mercy Kansas City; Department of Pediatrics, University of Missouri-Kansas City School of Medicine, Kansas City, MO, USA.
  • Klein DA; Department of Pediatrics, Uniformed Services University, Bethesda, MD; Department of Family Medicine, Uniformed Services University, Bethesda, MD, USA.
J Sex Med ; 18(8): 1444-1454, 2021 08.
Article em En | MEDLINE | ID: mdl-34247956
ABSTRACT

OBJECTIVE:

Transgender and gender-diverse (TGD) adolescents experience increased mental health risk compared to cisgender peers. Limited research suggests improved outcomes following gender-affirmation. This study examined mental healthcare and psychotropic medication utilization among TGD youth compared to their siblings without gender-related diagnoses and explored utilization patterns following gender-affirming care.

METHOD:

This retrospective cohort study used military healthcare data from 2010-2018 to identify mental healthcare diagnoses and visits, and psychotropic medication prescriptions among TGD youth who received care for gender dysphoria before age 18, and their siblings. Logistic and Poisson regression analyses compared mental health diagnosis, visits, and psychotropic prescriptions of TGD youth to their siblings, and compared healthcare utilization pre- and post-initiation of gender-affirming pharmaceuticals among TGD adolescents.

RESULTS:

3,754 TGD adolescents and 6,603 cisgender siblings were included. TGD adolescents were more likely to have a mental health diagnosis (OR 5.45, 95% CI [4.77-6.24]), use more mental healthcare services (IRR 2.22; 95% CI [2.00-2.46]), and be prescribed more psychotropic medications (IRR = 2.57; 95% CI [2.36-2.80]) compared to siblings. The most pronounced increases in mental healthcare were for adjustment, anxiety, mood, personality, psychotic disorders, and suicidal ideation/attempted suicide. The most pronounced increased in psychotropic medication were in SNRIs, sleep medications, anti-psychotics and lithium. Among 963 TGD youth (Mage 18.2) using gender-affirming pharmaceuticals, mental healthcare did not significantly change (IRR = 1.09, 95% CI [0.95-1.25]) and psychotropic medications increased (IRR = 1.67, 95% CI [1.46-1.91]) following gender-affirming pharmaceutical initiation; older age was associated with decreased care and prescriptions.

CONCLUSION:

Results support clinical mental health screening recommendations for TGD youth. Further research is needed to elucidate the longer-term impact of medical affirmation on mental health, including family and social factors associated with the persistence and discontinuation of mental healthcare needs among TGD youth. Hisle-Gorman E, Schvey NA, Adirim TA, et al. Mental Healthcare Utilization of Transgender Youth Before and After Affirming Treatment. J Sex Med 2021;181444-1454.
Assuntos
Palavras-chave

Texto completo: 1 Base de dados: MEDLINE Assunto principal: Transexualidade / Pessoas Transgênero / Disforia de Gênero Tipo de estudo: Guideline / Observational_studies / Prognostic_studies / Risk_factors_studies Limite: Adolescent / Aged / Humans Idioma: En Ano de publicação: 2021 Tipo de documento: Article

Texto completo: 1 Base de dados: MEDLINE Assunto principal: Transexualidade / Pessoas Transgênero / Disforia de Gênero Tipo de estudo: Guideline / Observational_studies / Prognostic_studies / Risk_factors_studies Limite: Adolescent / Aged / Humans Idioma: En Ano de publicação: 2021 Tipo de documento: Article