Document Type : Review Articles
Authors
1 Department of Nursing, School of Nursing, Larestan University of Medical Sciences, Larestan, Iran
2 Student Research Committee, Larestan University of Medical Sciences, Larestan, Iran
3 Student of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
Abstract
Background: In the last two decades, the number of people who have referred to mental health services due to concerns about gender identity has increased dramatically. The aim of this study was to present the most important and fundamental results of studies on transgender psychological and behavioral disordersand compare these results.
Methods: This is a narrative review study. Search for articles related to common psychological and behavioral disorders in transgender people was done by two trained researchers between December 2019 and March 2020 in 5 Latin scientific databases (Google Scholar, PubMed / Medline, Scopus, ISI Web of Science and Embase).
Results: Psychological and behavioral disorders were much higher in transgender people than in the general population. The most common disorders included anxiety and depression, suicidal attempt, drug abuse, self-injury without suicidal tendency, and HIV.
Conclusion: Transgender people are constantly harassed and abused by friends, acquaintances, classmates and teachers, and even their families. Having multiple sexual partners increases the risk of HIV infection and other sexual misconduct. Therefore, governments need to implement their support programs through training centers and counseling for transgender individuals.
Keywords
1. Castilla-Peón MF. Medical management of transgender children and adolescents. Boletin medico del Hospital Infantil de Mexico. 2018;75(1):7-14.
2. Vance SR, Ehrensaft D, Rosenthal SM. Psychological and medical care of gender nonconforming youth. Pediatrics. 2014;134(6):1184-92.
3. Green EL, Benner K, Pear R. transgender. Could Be Defined Out of Existence Under Trump Administration, The New York Times. 2018.
4. Connolly MD, Zervos MJ, Barone II CJ, Johnson CC, Joseph CL. The mental health of transgender youth: Advances in understanding. Journal of Adolescent Health. 2016;59(5):489-95.
5. Marshall BD, Socías ME, Kerr T, Zalazar V, Sued O, Arístegui I. Prevalence and correlates of lifetime suicide attempts among transgender persons in Argentina. Journal of Homosexuality. 2016;63(7):955-67.
6. Delam H, Bazrafshan M-R. Anxiety and self-esteem score in adults with a suicide attempt history. Journal of Health Sciences & Surveillance System. 2019;7(4):166-70.
7. Bazrafshan M-R, Delam H. Evaluation of depression score in suicide attempters referring to hospitals affiliated to Shiraz University of Medical Sciences in 2018. Journal of Health Sciences & Surveillance System. 2019;7(4):194-8.
8. Atkinson SR, Russell D. Gender dysphoria. Australian family physician. 2015;44(11):792.
9. Bauer GR, Scheim AI, Pyne J, Travers R, Hammond R. Intervenable factors associated with suicide risk in transgender persons: a respondent driven sampling study in Ontario, Canada. BMC public health. 2015;15(1):525.
10. Tucker RP. Suicide in transgender veterans: prevalence, prevention, and implications of current policy. Perspectives on psychological science. 2019;14(3):452-68.
11. Sevlever M, Meyer-Bahlburg HF. Late-onset transgender identity development of adolescents in psychotherapy for mood and anxiety problems: approach to assessment and treatment. Archives of sexual behavior. 2019;48(7):1993-2001.
12. Rood BA, Puckett JA, Pantalone DW, Bradford JB. Predictors of Suicidal Ideation in a Statewide Sample of Transgender Individuals. LGBT health. 2015;2(3):270-5.
13. Selkie E, Adkins V, Masters E, Bajpai A, Shumer D. Transgender Adolescents' Uses of Social Media for Social Support. The Journal of adolescent health : official publication of the Society for Adolescent Medicine. 2020;66(3):275-80.
14. Weiselberg EC, Shadianloo S. Overview of care for transgender children and youth. Current Problems in Pediatric and Adolescent Health Care. 2019;49(9).
15. Peng K, Zhu X, Gillespie A, Wang Y, Gao Y, Xin Y, et al. Self-reported Rates of Abuse, Neglect, and Bullying Experienced by Transgender and Gender-Nonbinary Adolescents in China. JAMA network open. 2019;2(9):e1911058.
16. Valentine SE, Shipherd JC. A systematic review of social stress and mental health among transgender and gender non-conforming people in the United States. Clinical psychology review. 2018;66:24-38.
17. Veale JF, Peter T, Travers R, Saewyc EM. Enacted Stigma, Mental Health, and Protective Factors Among Transgender Youth in Canada. Transgender health. 2017;2(1):207-16.
18. Su D, Irwin JA, Fisher C, Ramos A, Kelley M, Mendoza DAR, et al. Mental Health Disparities Within the LGBT Population: A Comparison Between Transgender and Nontransgender Individuals. Transgender health. 2016;1(1):12-20.
19. Reisner SL, Biello KB, White Hughto JM, Kuhns L, Mayer KH, Garofalo R, et al. Psychiatric Diagnoses and Comorbidities in a Diverse, Multicity Cohort of Young Transgender Women: Baseline Findings From Project LifeSkills. JAMA pediatrics. 2016;170(5):481-6.
20. Lytle MC, Blosnich JR, Kamen C. The Association of Multiple Identities with Self-Directed Violence and Depression among Transgender Individuals. Suicide & life-threatening behavior. 2016;46(5):535-44.
21. Clark TC, Lucassen MF, Bullen P, Denny SJ, Fleming TM, Robinson EM, et al. The health and well-being of transgender high school students: results from the New Zealand adolescent health survey (Youth'12). Journal of Adolescent Health. 2014;55(1):93-9.
22. Nuttbrock L, Bockting W, Rosenblum A, Hwahng S, Mason M, Macri M, et al. Gender abuse, depressive symptoms, and HIV and other sexually transmitted infections among male-to-female transgender persons: a three-year prospective study. American journal of public health. 2013;103(2):300-7.
23. Poteat T, German D, Kerrigan D. Managing uncertainty: a grounded theory of stigma in transgender health care encounters. Social science & medicine (1982). 2013;84:22-9.
24. Nemoto T, Bödeker B, Iwamoto M. Social support, exposure to violence and transphobia, and correlates of depression among male-to-female transgender women with a history of sex work. American Journal of Public Health. 2011;101(10):1980-8.
25. Faramarzian Z, Delam H, Habibikhah Z, Bazrafshan MR. Demographic characteristics of adolescents with a history of suicide attempt in Larestan, Iran: 2012-2018. Payesh (Health Monitor). 2019;18(5):475-83.
26. Taliaferro LA, McMorris BJ, Rider GN, Eisenberg ME. Risk and Protective Factors for Self-Harm in a Population-Based Sample of Transgender Youth. Archives of suicide research : official journal of the International Academy for Suicide Research. 2019;23(2):203-21.
27. Kota KK, Salazar LF, Culbreth RE, Crosby RA, Jones J. Psychosocial mediators of perceived stigma and suicidal ideation among transgender women. BMC Public Health. 2020;20(1):125.
28. Adams N, Hitomi M, Moody C. Varied reports of adult transgender suicidality: Synthesizing and describing the peer-reviewed and gray literature. Transgender health. 2017;2(1):60-75.
29. Kattari SK, Bakko M, Hecht HK, Kattari L. Correlations between healthcare provider interactions and mental health among transgender and nonbinary adults. SSM - population health. 2020;10:100525.
30. Chen R, Zhu X, Wright L, Drescher J, Gao Y, Wu L, et al. Suicidal ideation and attempted suicide amongst Chinese transgender persons: National population study. Journal of Affective Disorders. 2019;245:1126-34.
31. Azeem R, Zubair UB, Jalil A, Kamal A, Nizami A, Minhas F. Prevalence of Suicide Ideation and its Relationship with Depression among Transgender Population. Journal of the College of Physicians and Surgeons--Pakistan : JCPSP. 2019;29(4):349-52.
32. Kuper LE, Adams N, Mustanski BS. Exploring Cross-Sectional Predictors of Suicide Ideation, Attempt, and Risk in a Large Online Sample of Transgender and Gender Nonconforming Youth and Young Adults. LGBT health. 2018;5(7):391-400.
33. Veale JF, Watson RJ, Peter T, Saewyc EM. Mental Health Disparities Among Canadian Transgender Youth. The Journal of adolescent health : official publication of the Society for Adolescent Medicine. 2017;60(1):44-9.
34. Perez-Brumer A, Day JK, Russell ST, Hatzenbuehler ML. Prevalence and Correlates of Suicidal Ideation Among Transgender Youth in California: Findings From a Representative, Population-Based Sample of High School Students. Journal of the American Academy of Child and Adolescent Psychiatry. 2017;56(9):739-46.
35. Kreiss JL, Patterson DL. Psychosocial issues in primary care of lesbian, gay, bisexual, and transgender youth. Journal of pediatric health care : official publication of National Association of Pediatric Nurse Associates & Practitioners. 1997;11(6):266-74.
36. Strauss P, Morgan H, Wright Toussaint D, Lin A, Winter S, Perry Y. Trans and gender diverse young people's attitudes towards game-based digital mental health interventions: A qualitative investigation. Internet interventions. 2019;18:100280.
37. James S, Herman J, Rankin S, Keisling M, Mottet L, Anafi Ma. The report of the 2015 US transgender survey. 2016.
38. Oransky M, Burke EZ, Steever J. An Interdisciplinary Model for Meeting the Mental Health Needs of Transgender Adolescents and Young Adults: The Mount Sinai Adolescent Health Center Approach. Cognitive and Behavioral Practice. 2019;26(4):603-16.
39. McDowell MJ, Hughto JMW, Reisner SL. Risk and protective factors for mental health morbidity in a community sample of female-to-male trans-masculine adults. BMC psychiatry. 2019;19(1):16.
40. Gower AL, Rider GN, Brown C, McMorris BJ, Coleman E, Taliaferro LA, et al. Supporting Transgender and Gender Diverse Youth: Protection Against Emotional Distress and Substance Use. American journal of preventive medicine. 2018;55(6):787-94.
41. Grant JM, Motter LA, Tanis J. Injustice at every turn: A report of the national transgender discrimination survey. 2011.
42. Reisner SL, White JM, Bradford JB, Mimiaga MJ. Transgender health disparities: comparing full cohort and nested matched-pair study designs in a community health center. LGBT health. 2014;1(3):177-84.
43. Grossman AH, D'Augelli AR. Transgender youth and life‐threatening behaviors. Suicide and Life‐Threatening Behavior. 2007;37(5):527-37.
44. Clements-Nolle K, Marx R, Katz M. Attempted suicide among transgender persons: The influence of gender-based discrimination and victimization. J Homosex. 2006;51(3):53-69.
45. Olson J, Schrager SM, Belzer M, Simons LK, Clark LF. Baseline Physiologic and Psychosocial Characteristics of Transgender Youth Seeking Care for Gender Dysphoria. The Journal of adolescent health : official publication of the Society for Adolescent Medicine. 2015;57(4):374-80.
46. Testa RJ, Sciacca LM, Wang F, Hendricks ML, Goldblum P, Bradford J, et al. Effects of violence on transgender people. Professional Psychology: Research and Practice. 2012;43(5):452-9.
47. Reisner SL, Juntunen CL. Non-suicidal self-injury in a large online sample of transgender adults. Professional Psychology: Research and Practice. 2015;46(1):3.
48. Jackman KB, Dolezal C, Levin B, Honig JC, Bockting WO. Stigma, gender dysphoria, and nonsuicidal self-injury in a community sample of transgender individuals. Psychiatry research. 2018;269:602-9.
49. Taliaferro LA, McMorris BJ, Eisenberg ME. Connections that moderate risk of non-suicidal self-injury among transgender and gender non-conforming youth. Psychiatry research. 2018;268:65-7.
50. Jackman K, Honig J, Bockting W. Nonsuicidal self‐injury among lesbian, gay, bisexual and transgender populations: An integrative review. Journal of Clinical Nursing. 2016;25(23-24):3438-53.
51. Brennan SL, Irwin J, Drincic A, Amoura NJ, Randall A, Smith-Sallans M. Relationship among gender-related stress, resilience factors, and mental health in a Midwestern U.S. transgender and gender-nonconforming population. International Journal of Transgenderism. 2017;18(4):433-45.
52. Kaplan RL, El Khoury C, Wehbe S, Lize N, Mokhbat J. Pilot Results from the First HIV/AIDS Intervention Among Transgender Women in the Middle East: Gender Affirmation and Social Support from Within Trans Communities in Beirut, Lebanon. AIDS research and human retroviruses. 2020.
53. Operario D, Nemoto T. HIV in transgender communities: syndemic dynamics and a need for multicomponent interventions. Journal of acquired immune deficiency syndromes (1999). 2010;55(Suppl 2):S91.
54. Nuttbrock L, Hwahng S, Bockting W, Rosenblum A, Mason M, Macri M, et al. Lifetime risk factors for HIV/STI infections among male-to-female transgender persons. Journal of acquired immune deficiency syndromes (1999). 2009;52(3):417.
55. Nemoto T, Operario D, Keatley J, Han L, Soma T. HIV risk behaviors among male-to-female transgender persons of color in San Francisco. American journal of public health. 2004;94(7):1193-9.
56. Clements-Nolle K, Marx R, Guzman R, Katz M. HIV prevalence, risk behaviors, health care use, and mental health status of transgender persons: implications for public health intervention. American journal of public health. 2001;91(6):915.
57. Kosenko KA. Contextual influences on sexual risk-taking in the transgender community. Journal of Sex Research. 2011;48(2-3):285-96.
58. Poteat T, Scheim A, Xavier J, Reisner S, Baral S. Global epidemiology of HIV infection and related syndemics affecting transgender people. Journal of acquired immune deficiency syndromes (1999). 2016;72(Suppl 3):S210.
59. Herbst JH, Jacobs ED, Finlayson TJ, McKleroy VS, Neumann MS, Crepaz N, et al. Estimating HIV prevalence and risk behaviors of transgender persons in the United States: a systematic review. AIDS and Behavior. 2008;12(1):1-17.
60. Baral SD, Poteat T, Strömdahl S, Wirtz AL, Guadamuz TE, Beyrer C. Worldwide burden of HIV in transgender women: a systematic review and meta-analysis. The Lancet infectious diseases. 2013;13(3):214-22.
61. Reback CJ, Fletcher JB. HIV prevalence, substance use, and sexual risk behaviors among transgender women recruited through outreach. AIDS and Behavior. 2014;18(7):1359-67.
62. Santos GM, Rapues J, Wilson EC, Macias O, Packer T, Colfax G, et al. Alcohol and substance use among transgender women in S an F rancisco: Prevalence and association with human immunodeficiency virus infection. Drug and alcohol review. 2014;33(3):287-95.
63. Nuttbrock L, Bockting W, Rosenblum A, Hwahng S, Mason M, Macri M, et al. Gender abuse, depressive symptoms, and substance use among transgender women: a 3-year prospective study. American Journal of Public Health. 2014;104(11):2199-206.
64. Scandurra C, Amodeo AL, Valerio P, Bochicchio V, Frost DM. Minority stress, resilience, and mental health: A study of Italian transgender people. Journal of Social Issues. 2017;73(3):563-85.
65. Oswalt SB, Lederer AM. Beyond depression and suicide: The mental health of transgender college students. Social Sciences. 2017;6(1):20.
)