Transgender children who have socially transitioned, that is, who identify as the gender “opposite” their natal sex and are supported to live openly as that gender, are increasingly visible in society, yet we know nothing about their mental health. Previous work with children with gender identity disorder (GID; now termed gender dysphoria) has found remarkably high rates of anxiety and depression in these children. Here we examine, for the first time, mental health in a sample of socially transitioned transgender children.
A community-based national sample of transgender, prepubescent children (n = 73, aged 3–12 years), along with control groups of nontransgender children in the same age range (n = 73 age- and gender-matched community controls; n = 49 sibling of transgender participants), were recruited as part of the TransYouth Project. Parents completed anxiety and depression measures.
Transgender children showed no elevations in depression and slightly elevated anxiety relative to population averages. They did not differ from the control groups on depression symptoms and had only marginally higher anxiety symptoms.
Socially transitioned transgender children who are supported in their gender identity have developmentally normative levels of depression and only minimal elevations in anxiety, suggesting that psychopathology is not inevitable within this group. Especially striking is the comparison with reports of children with GID; socially transitioned transgender children have notably lower rates of internalizing psychopathology than previously reported among children with GID living as their natal sex.
Comments
RE: Standard Deviations for table 3
Dear Dr. Schumm, As we discussed over email, the SDs for Table 3 means are:
Anxiety: SD for controls 7.0, SD for trans 8.8,
SD for sibs 9.1; Depression: SD for controls is 7.3,
SD for trans is 7.4, SD for sibs is 7.7 . The SD mentioned previously is the SD of the normed PROMIS scale.
RE: Standard deviations
In Table 3, you presented the mean T scores without standard deviations. Your response would seem to suggest that the standard deviation for each mean score in Table 3 was 10. However, in your article "Mental health and self-worth in socially transitioned transgender youth" in the Journal of the American Academy of Child and Adolescent Psychiatry (Volume 56, February 2017) your table 3 also lists means scores (T) and standard deviations for the same measures of depression and anxiety, none of which equals 10, using many of the same participants. Please advise if all of the SDs for your table 3 were 10 or what they were, if not 10. Thanks!
RE:
Thanks for your questions. Yes, the F-test should say F(2,189) not F(2189)-that was a typo. As indicated on page 4 of the manuscript, a standard deviation for these scores is 10. The low end of the range for all groups for anxiety was 34.5 and for depression was 36.2. The high end of the range for anxiety for controls was 65.6 and it was 66.8 for depression. The high end of the range for transgender participants was 72.2 for anxiety and 69.2 for depression. For siblings the high end of the range was 76.1 for anxiety and 68.4 for depression.
Next we provide the number and percentage of scores above 60 and above 63. These values correspond to what should be the top 16% and top 10% of a typical sample. For controls on anxiety, 7 (9.6%) scores were 60 or above, of which 1 (1.4%) score was above 63. For controls on depression, 4 (5.5%) scored above 60 of which 2 (2.7%) scores above 63. For transgender children on anxiety, 19 (26%) scores were above 60 of which 11 (15%) were above 63. For transgender children on depression, 8 (11%) scores were above 60, of which 4 (5.5%) were above 63. For siblings on anxiety, 9 (18.4%) scores were above 60 of which 6 were above 63 (12.2%). For siblings on depression, 6 (12.2%) scores were above 60, of which 2 (4.1%) were above 63. As one can see here, the ranges and the percentages of participants in each group closely mirror the story of the means in the main paper—transgender children, if anything, show a slightly elevated anxiety level, but look fairly typical on depression. We present similar values as well as transgender children’s own self-reports of anxiety and depression more in a follow-up paper with a similar sample: Durwood, McLaughlin, Olson (2017) in JAACAP.