In the JournalsPerspective

Gender minority students more likely to have mental health issues

Image of Sarah Ketchen Lipson
Sarah Ketchen Lipson

Gender minority college students have two to four times the prevalence of depression, anxiety, eating disorders, self-injury and suicidality compared with cisgender students, according to a large national study published in American Journal of Preventive Medicine.

"There has never been a more important time for colleges and universities to take action to protect and support trans, genderqueer, and nonbinary students on campus," Sarah Ketchen Lipson, PhD, of Boston University School of Public Health’s department of health law policy and management, said in a press release.

Lipson and colleagues examined mental health status by gender identity among undergraduate and graduate students across U.S. campuses using data from the 2015 to 2017 Healthy Minds Study, an internet-based survey of 63,994 cisgender and 1,237 gender minority students. Using clinically validated screening tools, researchers examined whether students had symptoms of depression, anxiety, eating disorders, nonsuicidal self-injury (NSSI), suicidal ideation, suicide plans, suicide attempts and/or any mental health problem.

Overall, 78% of gender minority college students met the criteria for one or more mental health problems compared with 45% of cisgender students, according to the findings. More gender minority students had depression (58% vs. 28%) and reported self-injury (53% vs. 20%) than cisgender students. More than one in three gender minority students reported suicidal thoughts in the past year compared with one in 10 cisgender students.

Image of college students 
Source: Adobe Stock

Unadjusted logistic regression analysis revealed that gender minority students were more than four times as likely to have one or more mental health issues (OR = 4.3; 95% CI, 3.61-5.12) compared to cisgender students.

Compared with cisgender students, Lipson and colleagues reported that trans masculine (OR = 6.1; 95% CI, 4.81-7.63), transgender female assigned sex at birth (OR = 3.3; 95% CI, 2.18-4.91), genderqueer female assigned sex at birth (OR = 9.3; 95% CI, 6.42-13.31) and other self-identified female assigned sex at birth (OR = 7.9; 95% CI, 4.93-12.6) students were more likely to have mental health problems.

Gender minority students were also more likely to have past-year nonsuicidal self-injury and suicidality; trans masculine students had 2.9 times higher odds of self-injury and 2.6 times higher odds of suicidal thoughts and trans feminine students had 1.6 times higher odds of self-injury and 1.8 times higher odds of suicidal thoughts.

"Mental health outcomes, as well as negative educational outcomes like dropping out, are preventable. The most effective way to prevent them would be, from my perspective, through policy changes. Inclusive policies are necessary to advance equity. And that's what I really want these data to speak to,” Lipson said in the release. – by Savannah Demko

Disclosure: The authors report no relevant financial disclosures.

Image of Sarah Ketchen Lipson
Sarah Ketchen Lipson

Gender minority college students have two to four times the prevalence of depression, anxiety, eating disorders, self-injury and suicidality compared with cisgender students, according to a large national study published in American Journal of Preventive Medicine.

"There has never been a more important time for colleges and universities to take action to protect and support trans, genderqueer, and nonbinary students on campus," Sarah Ketchen Lipson, PhD, of Boston University School of Public Health’s department of health law policy and management, said in a press release.

Lipson and colleagues examined mental health status by gender identity among undergraduate and graduate students across U.S. campuses using data from the 2015 to 2017 Healthy Minds Study, an internet-based survey of 63,994 cisgender and 1,237 gender minority students. Using clinically validated screening tools, researchers examined whether students had symptoms of depression, anxiety, eating disorders, nonsuicidal self-injury (NSSI), suicidal ideation, suicide plans, suicide attempts and/or any mental health problem.

Overall, 78% of gender minority college students met the criteria for one or more mental health problems compared with 45% of cisgender students, according to the findings. More gender minority students had depression (58% vs. 28%) and reported self-injury (53% vs. 20%) than cisgender students. More than one in three gender minority students reported suicidal thoughts in the past year compared with one in 10 cisgender students.

Image of college students 
Source: Adobe Stock

Unadjusted logistic regression analysis revealed that gender minority students were more than four times as likely to have one or more mental health issues (OR = 4.3; 95% CI, 3.61-5.12) compared to cisgender students.

Compared with cisgender students, Lipson and colleagues reported that trans masculine (OR = 6.1; 95% CI, 4.81-7.63), transgender female assigned sex at birth (OR = 3.3; 95% CI, 2.18-4.91), genderqueer female assigned sex at birth (OR = 9.3; 95% CI, 6.42-13.31) and other self-identified female assigned sex at birth (OR = 7.9; 95% CI, 4.93-12.6) students were more likely to have mental health problems.

Gender minority students were also more likely to have past-year nonsuicidal self-injury and suicidality; trans masculine students had 2.9 times higher odds of self-injury and 2.6 times higher odds of suicidal thoughts and trans feminine students had 1.6 times higher odds of self-injury and 1.8 times higher odds of suicidal thoughts.

"Mental health outcomes, as well as negative educational outcomes like dropping out, are preventable. The most effective way to prevent them would be, from my perspective, through policy changes. Inclusive policies are necessary to advance equity. And that's what I really want these data to speak to,” Lipson said in the release. – by Savannah Demko

Disclosure: The authors report no relevant financial disclosures.

    Perspective
    Stephen T. Russell

    Stephen T. Russell

    There has been growing concern for the mental health of sexual and gender minority youth and adults over several decades. Yet, few studies have included questions about gender identity — until recently. Lipson and colleagues provide the largest study yet to consider the mental health of gender minority college students. Consistent with only a few other population-based studies, gender minority college students have dramatically higher odds of mental health concerns.

    The study makes an important call to colleges and universities to address the distinctive mental health needs of gender minority students. At my own institution, we grapple with meeting the distinct needs of gender minority students: establishing gender-inclusive restrooms; getting the right names on students’ diplomas; or fixing data systems so that students’ preferred names are a priority, and they can move through their campus life using the name that matches their identity.

    Gender is a fundamental dimension of our identities. Other research documents a strong link between mental health and supports for gender identity and expression among gender minority youth. This new study shows it is time to address campus culture and climate for gender minority students.

    • Stephen T. Russell, PhD
    • Priscilla Pond Flawn Regents Professor in Child Development
      Chair, Department of Human Development and Family Sciences
      Population Research Center
      The University of Texas at Austin

    Disclosures: Russell reports no relevant financial disclosures.