Depression and anxiety among transgender-identifying adolescents in psychiatric outpatient care

Objectives: We aimed to investigate three key areas: firstly, to determine the prevalence of youth who identify as transgender within the adolescent psychiatric population. Secondly, we sought to examine the prevalence and severity of depression and anxiety disorders among transgender-identifying individuals in comparison to cisgender-identifying individuals. Finally, we explored the potential correlations between perceived gender incongruence and depression and anxiety disorders. Methods: We compared transgender-identifying and cisgender-identifying adolescents in a sample of youth referred to Kuopio University Hospital’s outpatient psychiatric clinic in Finland (total n=746). The data were gathered from self-administered questionnaires and semi-structured diagnostic interviews. Depressive symptoms were measured with the Beck Depression Inventory (BDI-IA) and anxiety levels were measured with the Generalized Anxiety Disorder Assessment (GAD-7). Among other measures the participants were asked if they identified as transgender. Of those who responded in the affirmative to this question, further enquiry was made into the extent to which they perceived incongruence to their body. Results: The prevalence of participants self-identifying as transgender was 11.3 % (n=74). Compared to their cisgender-identifying peers, these individuals exhibited higher mean scores on the BDI and GAD-7 scales, with effect sizes being small. Furthermore, adolescents who identified as transgender did not have a higher rate of anxiety or depressive disorder diagnoses compared to their cisgender peers. A sex difference was observed among cisgender-identifying individuals, with female participants demonstrating higher mean scores on both the BDI and GAD-7 scales. However, no such difference was observed among transgender-identifying participants. No significant correlations were found between levels of perceived gender incongruence and BDI and GAD-7 scales. Conclusions: In adolescent psychiatric patients, depression and anxiety are equally common among transgender and cisgender identifying youth and not related to perceived strength of gender incongruence. Psychiatric treatment must be provided as appropriate regardless of gender identity experience.