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Students with different gender identities are 4 times more likely to develop mental health issues, new study finds

The New York Daily News - 8/16/2019

Aug. 16--A groundbreaking survey on the mental health of gender-minority college students found that individuals who don't identify with the gender they were assigned at birth face a much higher risk of developing mental health issues than their peers.

With "Gender Minority Mental Health in the U.S.: Results of a National Survey on College Campuses," whose findings were published Friday in the American Journal of Preventive Medicine, researchers set out to "describe the mental health inequities and the magnitude of inequities within this population, and then within subgroups of gender minority students," the study's lead author Sarah Ketchen Lipson told the Daily News.

Analyzing the rates of depression, anxiety, eating disorders, self-injury, and suicidality, Boston University researchers found that 78% of the surveyed gender-minority students met the criteria for one or more mental health problems, compared to 45% of cisgender students. Non-cisgender students had 4.3 times higher odds of having at least one mental health problem.

Looking specifically at the rate of clinically significant depression, researchers found that nearly 60% of gender-minority students screened positive for it, compared to 28% of students whose gender aligned with the one assigned at birth.

Researchers found the alarmingly significant disparities when they surveyed the mental health state of over randomly selected 1,200 students on 71 U.S. campuses who identify as transgender, gender nonconforming, genderqueer and nonbinary and then compared it to their cisgender counterparts.

The survey, the largest and most comprehensive campus-based study of its kind, it was the first nationally representative research on young adults to include data on mental health and gender identity.

The findings underscore the importance of recognizing and addressing mental health burdens on transgender and gender nonconforming students, which can be achieved by screening for mental health and providing gender-affirming services.

Lipson, who's an assistant professor of health law, policy and management at Boston University School of Public Health, hopes that the data can help to "create an environment where we're reducing risks," she said.

"In general we know that transgender and gender minority youth are incredibly vulnerable," she continued, underlining the need for people to be aware of the risks that GM youth will face.

"My hope is that this [study] can inform policy changes, changes that can create gender-affirming environments through policies like name-change policies, gender-inclusive restrooms. We know that policies at the national level on a state level are really important for shaping health and the same is true for for campus policies."

"There are 220 million young people who are on college and university campuses," she said. "For many of those students, campus policies are governing so many aspects of their lives -- where they live, the facilities and restrooms they are able to use, their learning environment -- so colleges and universities are in a really powerful position to be able to make change."

A change in policy is just part of the solution, according to Harvard Medical School'sSari Reisner, who's also one of the study's authors.

For Reisner, an assistant professor at Boston'sChildren's Hospital who has done research in transgender health for over a decade, there's also a need for proper training when it comes to health care providers.

"When we talk about gender affirmation, [this is] a key part in transgender people's lives, in terms of being affirmed in who we are," he told The News. This can be achieved through policy structure, but also through a visit to mental health counselors "by being affirmed in one's way of being in the world, and through getting access to -- if folks would like -- things like medical affirmation hormones or surgeries," he said.

And when people and don't fit into either male or female categories, mental health professionals need to "understand what that means."

The enormous mental health gap between gender-minority and cisgender students revealed by the study will hopefully be used for much needed change.

Researchers say that additional research is needed to explore the intersectionality of gender identities with other identities, such as race or religious beliefs, but as a next step, "it will be important to evaluate whether equal rights or the elimination of equal rights for transgender people affects mental health disparities," said Julia Raifman, assistant professor of health law, policy & management at Boston University.

"Knowing the magnitude and the consistency of the disparity can help us learn whether what we're doing is working. If there are policy changes that are widespread, you know we can look at pr- and post and see if those policy changes are changing the magnitude of things that we're seeing in a positive direction, said Reisner. "It kind of gives a metric gives for what we want to do, which is reduce the disparities. So that's a starting point for that work," he added.

"I'm just very hopeful that that these data and continued research in this area is going to heighten the urgency and accelerate the progress that's already happening in a lot of campuses," Lipton concluded.

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