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New Study Finds Dramatically Worsening Mental Health and Health Disparities Among Transgender and Gender -Diverse Adults in the US

Young sad trans teenager boy suffering from depression feeling sad and desperate. Depressed transgender teen in distress In Mental health, Depression and gender identity and human rights concept.

BOSTON, June 24, 2024 — A Research Letter published online today in JAMA Internal Medicine highlights significant and growing health disparities between transgender and gender -diverse (TGD) adults and their cisgender peers across the United States. Findings from “Health Status and Mental Health of Transgender and Gender-Diverse Adults” suggest that the surge in anti-transgender legislation and public policies restricting access to gender-affirming care over the past decade has likely contributed to these disparities.


“Our study reveals a burgeoning mental health crisis among transgender and gender-diverse people, with more than half reporting a diagnosis of depressive disorders,” said Michael Liu, MPhil, lead author of the study. “There is an urgent need for the health care sector to adhere to established, evidence-based standards of care and advocate for policies that protect the health and fundamental rights of these vulnerable populations.”


“Health Status and Mental Health of Transgender and Gender-Diverse Adults” analyzed data from the Behavioral Risk Factor Surveillance System between 2014 and 2022. Researchers utilized statistical models to calculate and compare representative state-level trends in health outcomes between TGD and non-TGD adults. Despite some limitations, such as potential recall and response biases and variation in data collection across states, findings from this study provide important insight into the unprecedented health challenges faced by TGD adults.


Key findings include:

Poor or Fair Health Status: The prevalence of poor or fair health status among TGD adults increased from 26.6% in 2014 to 35.1% in 2022. In contrast, this metric slightly decreased among cisgender adults during the same period.

Frequent Mental Distress: The percentage of TGD adults experiencing frequent mental distress (defined as 14 or more poor mental health days in the past month) rose dramatically from 18.8% to 38.9%. For cisgender adults, the increase was more modest, from 11.2% to 15.5%.

Depression: The prevalence of depression among TGD adults more than doubled, from 19.7% in 2014 to 51.3% in 2022. Among cisgender adults, the increase was significantly smaller from 18.6% to 21.1%.


“It is deeply concerning that mental health disparities among TGD adults have worsened over the last decade, despite our increasing understanding of the harm caused by multi-level stigma and discrimination,” said study senior author Dr. Alex S. Keuroghlian, who directs the National LGBTQIA+ Health Education Center at The Fenway Institute and the Massachusetts General Hospital Psychiatry Gender Identity Program. “The damage from these new laws that restrict access to life-saving care as well as the toxic rhetoric promulgated by these legislative campaigns is incalculable. It is imperative that clinicians understand established, evidence-based standards of care, and that they follow them when caring for TGD people.”


Findings from “Health Status and Mental Health of Transgender and Gender-Diverse Adults” build upon those of other recent work published by the same authors examining the impact of public policies on the health and well-being of TGD people.


A Perspective published by the New England Journal of Medicine provided guidance on how the health care sector can improve the health of sexual and gender minorities amid the recently enacted and proposed legislation that restrict the rights and protections of these populations. “Achieving the Triple Aim for Sexual and Gender Minorities” was published on July 23, 2022 in the New England Journal of Medicine and is available here:


A Viewpoint published in JAMA Pediatrics found that the numerous bills filed in 2021 and 2022 seeking to block access to gender-affirming care for TGD adolescents have far-reaching repercussions for clinicians who provide gender-affirming care and for the broader medical community. “Clinician-Level Implications of Bans on Gender-Affirming Medical Care for Youth in the US” was published online by JAMA Pediatrics on August 8, 2022. It is available here:


A commentary published by Nature Medicine asserted that the viability of gender-affirming health care is inextricably linked with governmental policies, institutions, and structures that protect and support the rights, dignity, inclusion and belonging of all transgender and gender-diverse people. “The context, science and practice of gender-affirming care” was published online in Nature Medicine on December 15, 2022 and is available here:


“Health Status and Mental Health of Transgender-Diverse Adults,” is available online here:




About Fenway Health & The Fenway Institute Founded in 1971, Fenway Health advocates for and delivers innovative, equitable, accessible health care, supportive services, and transformative research and education. We center LGBTQIA+ people, BIPOC individuals, and other underserved communities to enable our local, national, and global neighbors to flourish. The Fenway Institute at Fenway Health is an interdisciplinary center for research, training, education and policy development focusing on national and international health issues.

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