Transgender people in England are much more likely to suffer from long-term mental illness, the first study of its kind has found, with some at five times greater risk than cisgender people.
Research previously suggested a higher risk of conditions such as depression and anxiety in transgender, non-binary and gender diverse people. However, this was based on small studies that cannot be generalized to the entire population.
Now, the first nationally representative survey of its kind has calculated the burden of mental health issues among the transgender population, and the extent to which they report having their needs unmet.
The risk of long-term mental illness in England is around one in six for transgender men and women (16.4% and 15.9% respectively) and one in ten for cisgender men and women (8.8% and 12%), according to the study report.
The risk of reporting a mental illness was even higher for some gender minority groups, at almost one in two (47.2%) for non-binary transgender people.
The research, led by the University of Manchester in partnership with the Proud Trust and LGBT Foundation, was published in the journal Lancet Public Health.
“Trans, non-binary and gender diverse people across England face widespread discrimination, leading to stressful social interactions and feelings of unacceptance, increasing the risk of poor mental health,” said Dr Luke Munford, senior lecturer in health economics in Manchester and co-author of the article.
“Additionally, gender dysphoria – a feeling of discomfort resulting from a discrepancy between a person’s biological sex and their gender identity – can increase the risk of poor mental health in some trans, non-binary and gender diverse people, especially when combined with very long waiting times for NHS gender identity clinics.”
The survey of 1.5 million people aged 16 and over in England, including 8,000 transgender people, used data from the 2021 and 2022 waves of the English GP Survey, which asked patients if they had a mental health condition.
The researchers noted limitations to their study. They include the fact that pooling two years of data could mean that some participants were resampled “which would lead to biased estimates”, and that the clinical language in the survey and the reliance on self-reporting could have influenced which patients reported a mental illness. .
The survey questions did not specify when their mental health status developed. Munford said the researchers therefore could not rule out the possibility that the mental health condition predated the change in their gender identity.
As well as examining the frequency of mental health conditions, the researchers also looked at how well people’s mental health needs were met during GP appointments. Those with a gender identity other than cisgender men or cisgender women were more likely to report unmet needs at their last consultation.
One in six cisgender men and cisgender women reported that their mental health needs were not being met (15.6% and 15.9%, respectively). This was lower than all other gender identity groups, ranging from one in five (20%) for transgender men and one in four (28.6%) among patients who preferred not to reveal their gender identity.
“Poor communication from healthcare professionals and inadequate relationships between staff and patients may explain why trans, non-binary and gender diverse patients were more likely to report having their mental health needs not met,” said study co-author Dr Ruth Watkinson. a research fellow at the University of Manchester.
“Changes are urgently needed to ensure the NHS becomes a more supportive service for transgender, non-binary and gender diverse patients, including better recording of gender in healthcare record systems and training of staff to ensure healthcare professionals healthcare to meet the mental health needs of everyone. patients, regardless of their gender.”
Meanwhile, a coalition of charities and human rights organizations said on Wednesday they were “strongly opposed” to the government’s draft guidelines on how schools in England should treat transgender students.
The alliance, which includes Stonewall, Liberty and Mermaids, said the guidance “seeks to deny the existence of transgender students” and could lead to them being forcibly excluded. “It hinders teachers’ ability to tackle bullying and ultimately threatens to cause further harm and exclusion of trans youth,” the group said, calling for the guidelines to be withdrawn.
The draft guidance, published late last year, advised schools that they had no “general duty” to allow students to change their preferred names or uniforms – known as social transition – and stressed that parents should be involved where possible.