Table 4.
Association of gender affirmation with mental health symptoms
| Mental health symptom | Primary predictor in separate models | Adjusted odds ratiosa (95% CI) | p value |
|---|---|---|---|
| Depression | Not living full time in affirmed gender | 2.46 (1.21–4.88) | .012b |
| Parental acceptance | 0.91 (0.87–0.96) | .001b | |
| Non-affirmation | 1.08 (1.03–1.13) | .002b | |
| Internalized transphobia | 1.10 (1.07–1.14) | <.001b | |
| Community connectedness | 0.91 (0.91–1.03) | .322 | |
| Lifetime suicidality | Not living full time in affirmed gender | 1.38 (0.66–2.87) | .395 |
| Parental acceptance | 0.96 (0.91–1.01) | .117 | |
| Non-affirmation | 1.10 (1.04–1.15) | <.001b | |
| Internalized transphobia | 1.04 (1.01–1.08) | .009b | |
| Community connectedness | 1.02 (0.96–1.09) | .498 | |
| Anxiety | Not living full time in affirmed gender | 2.23 (1.07–4.63) | .031 |
| Parental acceptance | 0.94 (0.89–0.99) | .022 | |
| Non-affirmation | 1.11 (1.05–1.17) | <.001b | |
| Internalized transphobia | 1.10 (1.06–1.14) | <.001b | |
| Community connectedness | 0.97 (0.91–1.03) | .317 | |
| Interactions terms in separate models with gender affirmation X race/Ethnicity group |
aOR | p value | |
|
| |||
| Depression | Not living full time in affirmed gender x group | 1.43 (0.35–5.87) | .616 |
| Parental acceptance x group | 1.02 (0.92–1.13) | .688 | |
| Non-affirmation x group | 1.04 (0.94–1.14) | .460 | |
| Internalized transphobia x group | 1.05 (0.97–1.13) | .243 | |
| Community connectedness x group | 1.04 (0.91–1.19) | .540 | |
| Lifetime suicidality | Not living full time in affirmed gender x group | 2.22 (0.49–10.0) | .301 |
| Parental acceptance x group | 1.08 (0.97–1.20) | .166 | |
| Non-affirmation x group | 0.94 (0.85–1.04) | .264 | |
| Internalized transphobia x group | 1.00 (0.93–1.07) | .984 | |
| Community connectedness x group | 0.94 (0.82–1.08) | .351 | |
| Anxiety | Not living full time in affirmed gender x group | 0.83 (0.19–3.54) | .798 |
| Parental acceptance x group | 1.00 (0.90–1.11) | .973 | |
| Non-affirmation x group | 1.00 (0.91–1.11) | .886 | |
| Internalized transphobia x group | 1.04 (0.96–1.13) | .308 | |
| Community connectedness x group | 1.04 (0.90–1.20) | .579 | |
aOR = adjusted odds ratio.
a
All models are adjusted for age as a continuous variable and designated sex at birth.
b
Indicates statistical significance at a false discovery rate of 0.05 after Benjamini-Hochberg procedure for multiple comparisons.