Re: Psychiatric disorders in the U.S. transgender population much higher

pyotr filipivich <[email protected]> wrote in
news:[email protected]: 

> Duque Mantee wrote
> 
>> Lock these fucking nuts up away from children.

Abstract
Purpose
The purpose of the study was to determine the prevalence and odds of 
mental disorder diagnoses at discharge in U.S. transgender hospital 
encounters as compared with cisgender hospital encounters using nationally 
representative data.

Methods
The National Inpatient Sample was used to identify 25,233 transgender and 
254,437,363 cisgender inpatient encounters from 2007 to 2014. Univariate 
analyses were performed to compare the prevalence of mental disorders and 
comorbid medical diagnoses at the time of discharge. Multivariable 
analyses controlling for medical comorbid diagnoses were performed to 
assess the multivariable odds of mental disorder diagnoses in transgender 
versus cisgender hospital encounters. The prevalence of medical comorbid 
diagnoses in transgender encounters with and without mental disorder 
diagnoses was also compared.

Results
The prevalence of mental disorder diagnoses was higher in transgender 
hospital encounters (77% vs. 37.8%, P < .001). The prevalence of each 
examined mental disorder diagnosis was significantly higher in transgender 
hospital encounters. A multivariable analysis demonstrated significantly 
higher odds of all mental disorder diagnoses (odds ratio [OR] = 7.94; 
confidence interval [CI], 7.63–8.26; P < .001), anxiety (OR = 3.44; CI, 
3.32–3.56; P < .001), depression (OR = 1.63; CI, 1.57–1.70; P < .001), and 
psychosis (OR = 2.46; CI, 2.36–2.56; P < .001) among transgender versus 
cisgender inpatient encounters. Transgender encounters with a mental 
disorder diagnosis had a higher prevalence of chronic medical comorbid 
diagnoses as compared with transgender encounters without mental disorder 
diagnoses.

Conclusions
Our findings suggest a high prevalence and significantly higher odds of 
mental disorder diagnoses in the transgender population as compared with 
the cisgender population using data that are nationally representative of 
the U.S. population.

Introduction
Mental health disorders are common, with an estimated prevalence in U.S. 
adults of 18.9% in 2016 [1]. Although a large body of literature exists 
characterizing psychiatric illness in various subsets of the U.S. 
population, there is a paucity of data quantifying the prevalence of 
psychiatric illness and its burden in the adult transgender population. 
The term transgender is used to refer to persons whose gender identity 
differs from their natal sex [[2], [3], [4]]. The incongruence between 
gender identity and natal sex can result in gender dysphoria or 
psychological distress associated with decreased functioning that is 
common in the transgender population. Transgender individuals are also 
subject to numerous disparities as compared with the general populace. 
These disparities include increased rates of discrimination, economic 
hardship, homelessness, poor access to health care, receipt of substandard 
health care services, physical and verbal abuse, psychiatric illness, and 
sexual assault [5].

In the past decade, a small but growing body of literature has shed light 
on the subject of psychiatric illness within the transgender community. 
The literature suggests an increase in the rates of mood, personality, and 
psychotic disorders, suicide, as well as various forms of substance abuse, 
including misuse of tobacco, alcohol, and illicit substances [[5], [6], 
[7], [8], [9], [10], [11]]. These findings were corroborated by data 
derived from several surveys, the largest of which was the 2015 U.S. 
Transgender Survey [[5], [6], [7], [8], [9], [10], [11]]. In an effort to 
address the health care disparities and characterize the health care needs 
of this underserved population, the U.S. Department of Health and Human 
Services Healthy People 2020 initiative and the National Institute of 
Medicine have called for prioritizing research on transgender and gender 
nonconforming patients using nationally representative data [2,12].

The present study examined the prevalence and odds of mental disorder 
diagnoses in transgender hospital encounters as compared with cisgender 
hospital encounters using data from the National Inpatient Sample (NIS) 
from 2007 through 2014. In addition, differences in the presence of 
medical comorbidities and the financial burden of disease in transgender 
hospital encounters with and without concomitant mental disorder diagnoses 
were analyzed.

Section snippets
Data source
Weighted discharge records from the NIS for the years 2007 through 2014 
were used to identify the study population. The NIS is the largest 
publicly available all-payer inpatient database in the United States and 
is a part of the Healthcare Cost and Utilization Project, sponsored by the 
Agency for Healthcare Research and Quality [13]. To create the NIS, the 
State Inpatient Databases are used as a sampling frame, which contains 
discharge data for >95% of US community hospital encounters.

Results
The demographic characteristics of the adult transgender (n = 25,233) and 
cisgender (n = 254,437,363) hospital encounters studied are detailed in 
Table 1. Transgender patients were younger than cisgender patients (mean 
age ~40 years vs. 57 years, P < .01). Although white patients comprised 
the vast majority of both study groups, the transgender patient group had 
a higher proportion of African American inpatient encounters (18.9% vs. 
14.6%, P < .01). There was a higher rate of nonelective

Discussion
Current research on the mental health of the lesbian, gay, bisexual, and 
transgender community is limited, particularly in the adult transgender 
population [15]. One of the important barriers is that until recent times, 
there was no systematic data collection of gender identity and sexual 
orientation at the national level. For instance, of 50 states 
participating in the 2017 Behavioral Risk Factor Surveillance System, only 
28 states have asked questions about sexual orientation and gender

<https://www.sciencedirect.com/science/article/abs/pii/S1047279719302832>