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Over 40% of transgender, nonbinary, and gender diverse (TGD) young adults screened positive for depression on the PHQ‑2 in a recent nationwide study.

More than 40% of transgender, nonbinary, and gender diverse (TGD) young adults in the US screened positive for depression on the Patient Health Questionnaire‑2 (PHQ‑2) in a cross-sectional study published online in the Interactive Journal of Medical Research.

“In the United States, TGD young adults experience a higher risk of depression compared to their cisgender peers,” noted first author Sari Reisner, ScD, MA, of the University of Michigan School of Public Health, Ann Arbor, Michigan, and study coauthors. “Understanding factors associated with increased risk of depression within the TGD young adult population is important to guide clinical care as well as inform the development of interventions to reduce mental health disparities.”

Surveys & Interviews

In August 2022, a cross-sectional, nationwide online survey was conducted among US TGD young adults aged 18‐25 (N=104). Measures included sociodemographic variables, family characteristics, mental health care utilization, and the two-item PHQ-2 screener for depression. Poisson regression models with robust variance estimation were fitted to estimate adjusted prevalence ratios (aPR) and 95% CI for correlates of PHQ-2 depression (score ≥3).

The cohort’s mean age was 22 years; 46% identified as Black, Indigenous, or other People of Color, and two‑thirds identified as nonbinary.

High Prevalence of Depressive Symptoms

Overall, 42% of respondents met the PHQ‑2 threshold for elevated depressive symptoms.

Two factors were independently associated with increased depression prevalence: low versus high family support (aPR 1.54; 95% CI 1.05–2.27) and non‑Christian religious affiliation versus no affiliation (aPR 1.66; 95% CI 1.04–2.63).

In contrast, rural versus suburban residency (aPR 0.48; 95% CI 0.26–0.92) and current receipt of mental health therapy versus not (aPR 0.71; 95% CI 0.53–0.97) were linked to lower prevalence.

No significant differences emerged between Christian and unaffiliated participants, nor were differences based on gender identity observed after adjustment.

Mental Health Needs Highlighted

“The high prevalence of depressive symptoms among TGD young adults in this study sample highlights the need for comprehensive mental health evaluation and support in this population,” the authors concluded. “These findings are valuable in informing the development of interventions that aim to improve mental health outcomes among TGD young people.”