Table 3.
Multivariable Models with Mental Health Outcomes as a Function of Lifetime Changes in Attractions and Social Determinants in Transgender Individuals (N = 452)
| Self-Harm | Suicide Attempts | Depression Diagnosis | Depressive Distress | |
|---|---|---|---|---|
| Primary Predictor | RR (95% CI) | RR (95% CI) | RR (95% CI) | RR (95% CI) |
| Lifetime changes in attractions |
||||
| No | Ref | Ref | Ref | Ref |
| Yes | 1.93 (1.59, 2.33) | 1.48 (1.21, 1.81) | 1.39 (1.16, 1.67) | 1.44 (1.16, 1.78) |
| General Social Determinants | ||||
| Age (years) | 0.97 (0.96, 0.98) | 1.02 (1.01, 1.03) | 1.01 (1.00, 1.02) | 1.00 (0.99, 1.01) |
| Race/ethnicity | ||||
| White non-Hispanic | Ref | Ref | Ref | Ref |
| Black non-Hispanic | 0.40 (0.22, 0.73) | 0.95 (0.55, 1.67) | 0.96 (0.56, 1.63) | 1.91 (1.08, 3.38) |
| Hispanic/Latino | 0.87 (0.62, 1.21) | 1.06 (0.75, 1.49) | 1.60 (1.16, 2.19) | 1.95 (1.37, 2.78) |
| Other non-Hispanic | 0.37 (0.20, 0.69) | 1.01 (0.57, 1.78) | 0.60 (0.34, 1.07) | 1.23 (0.67, 2.26) |
| Multiracial non-Hispanic | 1.20 (0.80, 1.81) | 1.66 (1.11, 2.46) | 2.03 (1.36, 3.04) | 2.63 (1.75, 3.96) |
| Gender identity | ||||
| Male-to-female/trans feminine | Ref | Ref | Ref | Ref |
| Female-to-male/trans masculine | 2.34 (1.85, 2.97) | 1.69 (1.32, 2.16) | 2.02 (1.61, 2.54) | 1.00 (0.78, 1.29) |
| SES | ||||
| Income (range:0–3) | 0.83 (0.73, 0.95) | 0.74 (0.65, 0.85) | 0.86 (0.76, 0.98) | 0.85 (0.73, 0.98) |
| Education (range:1–4) | 0.81 (0.67, 1.13) | 0.69 (0.62, 0.77) | 0.80 (0.72, 0.89) | 0.73 (0.65, 0.82) |
| Sexual orientation identity | ||||
| Straight | Ref | Ref | Ref | Ref |
| Gay/lesbian | 1.12 (0.75, 1.66) | 0.55 (0.37, 0.80) | 2.12 (1.47, 3.08) | 1.05 (0.68, 1.61) |
| Bisexual | 1.21 (0.85, 1.73) | 0.37 (0.26, 0.53) | 1.18 (0.84, 1.65) | 1.21 (0.83, 1.76) |
| Queer | 0.83 (0.60, 1.16) | 0.39 (0.28, 0.55) | 0.94 (0.69, 1.28) | 0.71 (0.49, 1.02) |
| Other/non-binary | 1.50 (1.06, 2.13) | 0.49 (0.35, 0.69) | 1.06 (0.77, 1.47) | 0.99 (0.68, 1.43) |
| Transgender-Specific Social Determinants |
||||
| Age of transgender realization (years) | 0.98 (0.97, 0.99) | 0.98 (0.97, 0.99) | 1.00 (0.99, 1.01) | 0.98 (0.97, 0.99) |
| Social gender transition | ||||
| No | Ref | Ref | Ref | Ref |
| Yes | 0.78 (0.61, 0.99) | 0.82 (0.64, 1.05) | 0.71 (0.57, 0.90) | 0.42 (0.33, 0.54) |
| Medical gender transition | ||||
| No | Ref | Ref | Ref | Ref |
| Yes | 1.32 (1.04, 1.66) | 1.17 (0.93, 1.48) | 2.09 (0.88, 2.36) | 0.90 (0.70, 1.14) |
| Visual gender nonconformity | ||||
| High | Ref | Ref | Ref | Ref |
| Moderate | 0.87 (0.67, 1.13) | 1.44 (1.09, 1.89) | 0.76 (0.59, 0.97) | 0.64 (0.48, 0.86) |
| Low | 0.64 (0.50, 0.82) | 0.94 (0.73, 1.23) | 0.62 (0.49, 0.79) | 0.71 (0.54, 0.93) |
| Non-binary identification | ||||
| No | Ref | Ref | Ref | Ref |
| Yes | 0.88 (0.70, 1.10) | 1.36 (1.08, 1.72) | 0.81 (0.66, 1.01) | 1.31 (1.03, 1.67) |
Note. RR = Risk Ratio. 95% CI = 95% Confidence Interval. Models adjusted for survey mode (online/in-person). Significant effects are bolded, p < .05. Male-to-female/trans feminine = individuals assigned male sex at birth who now identify somewhere along the feminine gender spectrum. Female-to-male/trans masculine= individuals assigned female sex at birth who now identify somewhere along the masculine gender spectrum.