Age Trends in Gender-Identity Related Disparities in Mental Health, Substance Use, and Bias-Based Bullying

• In Event: Sexual and Gender Minority Youth’s Mental Health: Learning Over Time

Abstract

A growing body of research documents gender-identity related disparities in mental health, substance use, and peer victimization (Day et al., 2017; Perez-Brumer, 2017). Due to data limitations, there remains limited knowledge on how risk for poor mental health, substance use, and peer victimization change across adolescence for transgender and gender diverse youth. Prospective-longitudinal and age-based designs offer unique perspectives about when gender-identity related disparities emerge and their course during adolescence. These perspectives are important given that adolescence is a common developmental period for mental health and substance use onset, and heightened peer victimization. Thus, identifying when gender identity differences in mental health, substance use, and peer victimization emerge can inform the timing of prevention efforts. The current study used population-based data to document age-specific gender-identity differences in (1) mental health, (2) past-month alcohol, cigarette, and marijuana use, and (3) bias-based bullying among youth aged 12 to 18.

Sample and Method. We use cross-sectional data from the 2013 and 2015 biennial California Health Kids Survey (CHKS), a state-wide, school-based survey administered to students in grades 7, 9, and 11 (n=655,581). Depressive symptoms were assessed with a single item asking “During the past 12 months, did you ever feel so sad or hopeless almost every day for two weeks or more that you stopped doing some usual activities?” with response options of yes=1 and no=0. Past-month alcohol (including binge drinking), cigarette, and marijuana use was assessed and recoded to reflect use=1 and no use=0. Youth also reported their experiences with bullying in the past 12 months on the basis of several personal characteristics/identities, including LGB status (yes=1 and no=0) and gender (yes=1 and no=0). Logistic regression models were used to estimate the prevalence of each outcome among non-transgender and transgender youth for each age year using interactions between sex, gender identity, and age. Analyses were design-adjusted and included race/ethnicity and parental education as covariates.

Results. Transgender youth ages 12-18+ reported higher rates of depressive symptomology compared to same-aged non-transgender boys; among 12- and 13-year-olds, transgender youth had higher rates than non-transgender girls (see Figure 1). Compared to non-transgender boys and girls, transgender youth also reported higher prevalence of e-cigarette use, combustible cigarette use, heavy episodic binge drinking, and marijuana use across all ages, with wider disparities among those 17-18+. With regard to bias-based bullying (see Figure 2), transgender youth had substantially higher rates of LGB- and gender-based bullying relative to non-transgender youth. These disparities were fairly consistent for LGB-based bullying across youth aged 13-18+, but were larger among older students for gender-based bullying (22% among 13-year-olds vs. 29% among 18+-year-old transgender students).

Discussion. Results suggest that experiences with depressive symptomology, substance use, and biased-based bullying vary by age and gender identity. Importantly, gender identity disparities in mental health, substance use, and victimization were already present by age 12, suggesting the need for early prevention and intervention. Implications for research and application will be discussed.

Authors

• Jessica Fish, University of Maryland - College Park
  Presenting Author

• Meg Bishop, University of Maryland - College Park
  Non-Presenting Author

• Stephen T Russell, University of Texas at Austin
  Non-Presenting Author