Survey finds high rates of childhood abuse among transgender adolescents

1. Transgender adolescents were more likely to report experiencing psychological, physical and sexual abuse as compared to cisgender adolescents.

2. Transgender males and nonbinary adolescents assigned female at birth experienced higher rates of psychological abuse as compared to cisgender adolescents.

Evidence Rating Level: 3 (Average)

Study Rundown: Transgender adolescents, or adolescents whose gender identity does not align with the sex assigned at birth, experience higher rates of mental illness when compared to cisgender adolescents, or those whose gender identity aligns with the sex assigned at birth. Although these health disparities have been widely reported, psychosocial contributors to them have yet to be investigated. This study investigated childhood abuse as a potential psychosocial contributor to mental health difficulties for transgender adolescents as compared to cisgender adolescents, across multiple subgroups of gender identity. Rates of psychological, physical and sexual abuse were higher among transgender adolescents, and psychological abuse was higher among transgender males and nonbinary adolescents assigned female at birth as compared to cisgender adolescents. This study indicates childhood abuse may contribute to the mental health disparities seen among transgender adolescents and should be screened for by healthcare providers in this population.

Click to read the study in PEDIATRICS

Click to read an accompanying editorial in PEDIATRICS

Relevant Reading: Understanding factors associated with suicidality among transgender and gender-diverse identified youth

In-Depth [survey]: In total, 1836 adolescents aged 14-18 across the United States completed an online survey in 2018 assessing childhood abuse using the Adverse Childhood Experiences questionnaire. Of the total participants, 1055 were transgender adolescents, and 773 were cisgender adolescents (further divided into 340 heterosexual and 433 sexual minority cisgender adolescents). Overall, 73% of transgender adolescents reported psychological abuse, 39% reported physical abuse, and 19% reported sexual abuse. When compared to cisgender adolescents, the adjusted odds ratio of abuse was higher for transgender adolescents for psychological (OR = 1.84), physical (OR = 1.61), and sexual (OR = 2.04) abuse. When comparing subgroups, transgender males and nonbinary adolescents had an increased odds ratio of psychological abuse compared to cisgender adolescents.

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