Levels of depression in transgender people and its predictors

Results of a large matched control study with transgender people accessing clinical services

Gemma L Witcomb, Walter Pierre Bouman, Laurence Claes, Nicola Brewin, John R Crawford, Jon Arcelus

Research output: Contribution to journalArticle

14 Citations (Scopus)

Abstract

BACKGROUND: Depression is a serious disorder which significantly impacts wellbeing and quality of life. Studies exploring mental wellbeing in the transgender population are mostly limited by small, non-homogenous samples and lack of matched controls. This study aimed to address these limitations and explore depression rates in a large sample of transgender people, compared with matched controls from the general population, as well as factors predicting depression in those taking cross-sex hormone treatment (CHT) compared to those not.

METHODS: Transgender individuals (n = 913) completed a measure of depression, measures which predict psychopathology (self-esteem, victimization, social support, interpersonal problems), and information regarding CHT use. Participants were matched by age and experienced gender with adults from the general population who had completed the measure of depression.

RESULTS: Individuals were categorized as having no, possible or probable depressive disorder. Transgender individuals not on CHT had a nearly four-fold increased risk of probable depressive disorder, compared to controls. Older age, lower self-esteem, poorer interpersonal function and less social support predicted depressive disorder. Use of CHT was associated with less depression.

LIMITATIONS: Participants were attending a national gender identity service and therefore represent only a sub-group of transgender people. Due to the cross-sectional design, longitudinal research is required to fully confirm the finding that CHT use reduces depression.

CONCLUSION: This study confirms that non-treated transgender individuals have an increased risk of a depressive disorder. Interventions offered alongside gender affirming treatment to develop interpersonal skills, increase self-esteem and improve social support may reduce depression and prepare individuals for a more successful transition.

Original languageEnglish
Pages (from-to)308-315
Number of pages8
JournalJournal of Affective Disorders
Volume235
Early online date17 Feb 2018
DOIs
Publication statusPublished - 31 Aug 2018

Fingerprint

Transgender Persons
Depression
Gonadal Steroid Hormones
Depressive Disorder
Self Concept
Social Support
Therapeutics
Population
Crime Victims
Psychopathology
Research Design
Quality of Life

Keywords

  • Transgender
  • depression
  • self-esteem
  • social support
  • interpersonal function
  • cross-sex hormone treatment

Cite this

Levels of depression in transgender people and its predictors : Results of a large matched control study with transgender people accessing clinical services. / Witcomb, Gemma L; Bouman, Walter Pierre; Claes, Laurence; Brewin, Nicola; Crawford, John R; Arcelus, Jon.

In: Journal of Affective Disorders, Vol. 235, 31.08.2018, p. 308-315.

Research output: Contribution to journalArticle

@article{4859a133bb354fc89823acfb14f5519d,
title = "Levels of depression in transgender people and its predictors: Results of a large matched control study with transgender people accessing clinical services",
abstract = "BACKGROUND: Depression is a serious disorder which significantly impacts wellbeing and quality of life. Studies exploring mental wellbeing in the transgender population are mostly limited by small, non-homogenous samples and lack of matched controls. This study aimed to address these limitations and explore depression rates in a large sample of transgender people, compared with matched controls from the general population, as well as factors predicting depression in those taking cross-sex hormone treatment (CHT) compared to those not.METHODS: Transgender individuals (n = 913) completed a measure of depression, measures which predict psychopathology (self-esteem, victimization, social support, interpersonal problems), and information regarding CHT use. Participants were matched by age and experienced gender with adults from the general population who had completed the measure of depression.RESULTS: Individuals were categorized as having no, possible or probable depressive disorder. Transgender individuals not on CHT had a nearly four-fold increased risk of probable depressive disorder, compared to controls. Older age, lower self-esteem, poorer interpersonal function and less social support predicted depressive disorder. Use of CHT was associated with less depression.LIMITATIONS: Participants were attending a national gender identity service and therefore represent only a sub-group of transgender people. Due to the cross-sectional design, longitudinal research is required to fully confirm the finding that CHT use reduces depression.CONCLUSION: This study confirms that non-treated transgender individuals have an increased risk of a depressive disorder. Interventions offered alongside gender affirming treatment to develop interpersonal skills, increase self-esteem and improve social support may reduce depression and prepare individuals for a more successful transition.",
keywords = "Transgender, depression, self-esteem, social support, interpersonal function, cross-sex hormone treatment",
author = "Witcomb, {Gemma L} and Bouman, {Walter Pierre} and Laurence Claes and Nicola Brewin and Crawford, {John R} and Jon Arcelus",
note = "We would like to thank all of the participants for taking part in this study and support staff at the Nottingham Centre for Transgender Health.",
year = "2018",
month = "8",
day = "31",
doi = "10.1016/j.jad.2018.02.051",
language = "English",
volume = "235",
pages = "308--315",
journal = "Journal of Affective Disorders",
issn = "0165-0327",
publisher = "Elsevier",

}

TY - JOUR

T1 - Levels of depression in transgender people and its predictors

T2 - Results of a large matched control study with transgender people accessing clinical services

AU - Witcomb, Gemma L

AU - Bouman, Walter Pierre

AU - Claes, Laurence

AU - Brewin, Nicola

AU - Crawford, John R

AU - Arcelus, Jon

N1 - We would like to thank all of the participants for taking part in this study and support staff at the Nottingham Centre for Transgender Health.

PY - 2018/8/31

Y1 - 2018/8/31

N2 - BACKGROUND: Depression is a serious disorder which significantly impacts wellbeing and quality of life. Studies exploring mental wellbeing in the transgender population are mostly limited by small, non-homogenous samples and lack of matched controls. This study aimed to address these limitations and explore depression rates in a large sample of transgender people, compared with matched controls from the general population, as well as factors predicting depression in those taking cross-sex hormone treatment (CHT) compared to those not.METHODS: Transgender individuals (n = 913) completed a measure of depression, measures which predict psychopathology (self-esteem, victimization, social support, interpersonal problems), and information regarding CHT use. Participants were matched by age and experienced gender with adults from the general population who had completed the measure of depression.RESULTS: Individuals were categorized as having no, possible or probable depressive disorder. Transgender individuals not on CHT had a nearly four-fold increased risk of probable depressive disorder, compared to controls. Older age, lower self-esteem, poorer interpersonal function and less social support predicted depressive disorder. Use of CHT was associated with less depression.LIMITATIONS: Participants were attending a national gender identity service and therefore represent only a sub-group of transgender people. Due to the cross-sectional design, longitudinal research is required to fully confirm the finding that CHT use reduces depression.CONCLUSION: This study confirms that non-treated transgender individuals have an increased risk of a depressive disorder. Interventions offered alongside gender affirming treatment to develop interpersonal skills, increase self-esteem and improve social support may reduce depression and prepare individuals for a more successful transition.

AB - BACKGROUND: Depression is a serious disorder which significantly impacts wellbeing and quality of life. Studies exploring mental wellbeing in the transgender population are mostly limited by small, non-homogenous samples and lack of matched controls. This study aimed to address these limitations and explore depression rates in a large sample of transgender people, compared with matched controls from the general population, as well as factors predicting depression in those taking cross-sex hormone treatment (CHT) compared to those not.METHODS: Transgender individuals (n = 913) completed a measure of depression, measures which predict psychopathology (self-esteem, victimization, social support, interpersonal problems), and information regarding CHT use. Participants were matched by age and experienced gender with adults from the general population who had completed the measure of depression.RESULTS: Individuals were categorized as having no, possible or probable depressive disorder. Transgender individuals not on CHT had a nearly four-fold increased risk of probable depressive disorder, compared to controls. Older age, lower self-esteem, poorer interpersonal function and less social support predicted depressive disorder. Use of CHT was associated with less depression.LIMITATIONS: Participants were attending a national gender identity service and therefore represent only a sub-group of transgender people. Due to the cross-sectional design, longitudinal research is required to fully confirm the finding that CHT use reduces depression.CONCLUSION: This study confirms that non-treated transgender individuals have an increased risk of a depressive disorder. Interventions offered alongside gender affirming treatment to develop interpersonal skills, increase self-esteem and improve social support may reduce depression and prepare individuals for a more successful transition.

KW - Transgender

KW - depression

KW - self-esteem

KW - social support

KW - interpersonal function

KW - cross-sex hormone treatment

U2 - 10.1016/j.jad.2018.02.051

DO - 10.1016/j.jad.2018.02.051

M3 - Article

VL - 235

SP - 308

EP - 315

JO - Journal of Affective Disorders

JF - Journal of Affective Disorders

SN - 0165-0327

ER -