Depression and anxiety in transgender and non-binary adolescents: prevalence and associations between adolescent and caregiver reports

Authors

Sophia M. Liles, The Abigail Wexner Research Institute at Nationwide Children's Hospital, 431 S 18th St,, Columbus, OH, 43205, USA.
Anna L. Olsavsky, The Abigail Wexner Research Institute at Nationwide Children's Hospital, 431 S 18th St,, Columbus, OH, 43205, USA.
Diane Chen, Ann and Robert H. Lurie Children's Hospital, Northwestern University Feinberg School of Medicine, Chicago, IL, USA.
Connor Grannis, The Abigail Wexner Research Institute at Nationwide Children's Hospital, 431 S 18th St,, Columbus, OH, 43205, USA.
Kristen R. Hoskinson, The Abigail Wexner Research Institute at Nationwide Children's Hospital, 431 S 18th St,, Columbus, OH, 43205, USA.
Scott F. Leibowitz, The Ohio State University College of Medicine, Columbus, OH, USA.
Eric E. Nelson, The Abigail Wexner Research Institute at Nationwide Children's Hospital, 431 S 18th St,, Columbus, OH, 43205, USA.
Charis J. Stanek, The Abigail Wexner Research Institute at Nationwide Children's Hospital, 431 S 18th St,, Columbus, OH, 43205, USA.
John F. Strang, Center for Neuroscience, Children's National Research Institute, Children's National Hospital, Washington, DC, USA.
Leena Nahata, The Abigail Wexner Research Institute at Nationwide Children's Hospital, 431 S 18th St,, Columbus, OH, 43205, USA. leena.nahata@nationwidechildrens.org.

Document Type

Journal Article

Publication Date

8-28-2024

Journal

European journal of pediatrics

DOI

10.1007/s00431-024-05723-z

Keywords

Caregiver awareness; Mental health symptoms; Transgender

Abstract

UNLABELLED: Transgender/non-binary (TNB) adolescents are at increased risk for mental health concerns, and caregiver awareness is important to facilitate access to care. Yet, limited research has examined caregiver awareness of TNB mental health. Thus, we examined (1) the prevalence of internalizing symptoms (depression, generalized anxiety, separation anxiety, social anxiety) among TNB adolescents and (2) associations between adolescent and caregiver reports of adolescent mental health symptoms. TNB adolescents (N = 75) aged 12-18 and a caregiver were recruited from a multidisciplinary gender clinic in Ohio. Adolescents self-reported their mental health symptoms via the CDI and SCARED. Caregivers reported their perceptions of the adolescent's mental health symptoms via the CASI-5. Descriptive statistics assessed participant characteristics, adolescent self-reported mental health symptoms, and caregiver proxy reports of adolescent mental health symptoms. Pearson's correlations and scatterplots were used to compare adolescent and caregiver reports and McNemar tests assessed if the differences were statistically significant. Most TNB adolescents reported elevated symptoms of depression (59%), generalized anxiety (75%), separation anxiety (52%), and social anxiety (78%). Caregiver and adolescent reports were significantly correlated for depression (r = .36, p = .002), separation anxiety (r = .39, p < .001), and social anxiety (r = .47, p < .001). Caregiver and adolescent reports of generalized anxiety were not significantly correlated (r = .21, p = .08). McNemar tests were significant (all p < .001), such that adolescents' reports met clinical cutoffs far more than their caregivers' reports. CONCLUSIONS: Though adolescent and caregiver reports were low to moderately correlated, youth reports were consistently higher, suggesting the importance of interventions to increase caregiver understanding of TNB adolescent mental health. WHAT IS KNOWN: • Transgender/non-binary adolescents are at high risk for mental health concerns and caregivers are essential to coordinate care. WHAT IS NEW: • This study expands the diagnostic mental health sub-categories examined in transgender/non-binary adolescents, noting elevated symptoms of separation and social anxiety. • Transgender/non-binary adolescents reported more symptoms of depression, generalized anxiety, separation anxiety, and social anxiety than caregivers.

APA Citation

Liles, Sophia M.; Olsavsky, Anna L.; Chen, Diane; Grannis, Connor; Hoskinson, Kristen R.; Leibowitz, Scott F.; Nelson, Eric E.; Stanek, Charis J.; Strang, John F.; and Nahata, Leena, "Depression and anxiety in transgender and non-binary adolescents: prevalence and associations between adolescent and caregiver reports" (2024). GW Authored Works. Paper 5423.
https://hsrc.himmelfarb.gwu.edu/gwhpubs/5423

Department

Medicine