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Self-Reported Changes in Attractions and Social Determinants of Mental Health in Transgender Adults

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Abstract

This study examined associations between changes in self-reported attractions and mental health in a community-based sample of self-identified transgender adults. Participants were purposively recruited in 2013 using bimodal sampling methods and completed a one-time survey. Multivariable logistic regression models estimated adjusted risk ratios and 95 % confidence intervals to examine associations between changes in attractions and mental health outcomes (lifetime self-harm, suicide attempts, depression diagnosis; past-week clinically significant depressive distress assessed via CES-D 10) among the entire sample (N = 452; 285 female-to-male spectrum, 167 male-to-female spectrum) and after gender transition among those who had socially transitioned (n = 205; 156 female-to-male spectrum, 49 male-to-female spectrum). Models were adjusted for known population social determinants (age, race/ethnicity, gender identity, socioeconomic status, sexual orientation identity), transgender-specific determinants (age of transgender realization, social transition, medical transition, visual gender nonconformity, non-binary gender identification), and survey mode (online vs. in-person sampling). Lifetime changes in attractions were significantly associated with increased probability of all mental health outcomes; individuals reporting any change in attractions were more likely than individuals not reporting changes to indicate lifetime self-harm, suicide attempts, depression diagnosis, and current depressive distress (all ps < .05). Changes in attractions post-social transition were not significantly associated with mental health outcomes. Many, but not all, population and transgender-specific social determinants were significantly associated with mental health in the full sample and among those who had socially transitioned. Clinical implications of findings about changes in attractions and mental health are discussed for transgender individuals.

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Acknowledgments

This project was supported with funding from the Miller Foundation. Dr. Katz-Wise was additionally supported by a grant from the Eunice Kennedy Shriver National Institute of Child Health and Human Development (K99HD082340). Dr. Reisner was partly supported by a grant from the National Institute of Mental Health (R01MH094323-03S1). Ms. White Hughto was supported by grants from the National Institute of Mental Health (T32MH020031 and P30MH062294). Finally, we would like to thank the participants who contributed data to this study.

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Authors and Affiliations

  1. Division of Adolescent/Young Adult Medicine, Boston Children’s Hospital, Boston, MA, USA

    Sabra L. Katz-Wise

  2. Department of Pediatrics, Harvard Medical School, Boston, MA, USA

    Sabra L. Katz-Wise & Sari L. Reisner

  3. Division of General Pediatrics, Boston Children’s Hospital, Boston, MA, USA

    Sari L. Reisner

  4. Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA

    Sari L. Reisner

  5. The Fenway Institute, Fenway Health, 1340 Boylston Street, 8th Floor, Boston, MA, 02215, USA

    Sari L. Reisner & Jaclyn M. White Hughto

  6. Chronic Disease Epidemiology, Yale School of Public Health, New Haven, CT, USA

    Jaclyn M. White Hughto

  7. Department of Counseling Psychology, University of Wisconsin-Madison, Madison, WI, USA

    Stephanie L. Budge

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  1. Sabra L. Katz-Wise
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  2. Sari L. Reisner
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  3. Jaclyn M. White Hughto
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  4. Stephanie L. Budge
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Correspondence to Sari L. Reisner.

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Katz-Wise, S.L., Reisner, S.L., White Hughto, J.M. et al. Self-Reported Changes in Attractions and Social Determinants of Mental Health in Transgender Adults. Arch Sex Behav 46, 1425–1439 (2017). https://doi.org/10.1007/s10508-016-0812-5

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