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Gender Minority Mental Health in the U.S.: Results of a National Survey on College Campuses

  • Sarah Ketchen Lipson
    Correspondence
    Address correspondence to: Sarah Ketchen Lipson, PhD, 715 Albany Street, Boston University School of Public Health, Department of Health Law Policy and Management, Talbot Hall, Room 264W, Boston MA 02118.
    Affiliations
    Department of Health Law Policy and Management, Boston University School of Public Health, Boston, Massachusetts
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  • Julia Raifman
    Affiliations
    Department of Health Law Policy and Management, Boston University School of Public Health, Boston, Massachusetts
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  • Sara Abelson
    Affiliations
    Department of Health Behavior and Health Education, University of Michigan School of Public Health, Ann Arbor, Michigan
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  • Sari L. Reisner
    Affiliations
    Department of Pediatrics, Harvard Medical School, Boston, Massachusetts

    Department of Pediatrics, Boston Children's Hospital, Boston, Massachusetts

    Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts

    The Fenway Institute, Boston, Massachusetts
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      Introduction

      The purpose of this study was to examine mental health status by gender identity among undergraduate and graduate students.

      Methods

      Data came from the 2015–2017 Healthy Minds Study, a mobile survey of randomly selected students (N=65,213 at 71 U.S. campuses, including 1,237 gender minority [GM] students); data were analyzed in 2018. Outcomes were symptoms of depression, anxiety, eating disorders, self-injury, and suicidality based on widely used, clinically validated screening instruments. Bivariable and multivariable analyses explored differences between GM and cisgender (non-GM) students as well as by assigned sex at birth.

      Results

      Across mental health measures, a significantly higher prevalence of symptoms was observed in GM students than cisgender students. Compared with 45% of cisgender students, 78% of GM students met the criteria for 1 or more of the aforementioned mental health outcomes. GM status was associated with 4.3 times higher odds of having at least 1 mental health problem (95% CI=3.61, 5.12).

      Conclusions

      Findings from this largest campus-based study of its kind using representative data with both gender identity and mental health measures underscore the importance of recognizing and addressing GM mental health burdens, such as by screening for mental health and providing gender-affirming services. There is broad urgency to identify protective factors and reduce mental health inequities for this vulnerable population.
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