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UBC Theses and Dissertations

Examining mental health disparities among transgender and/or gender nonconforming young people : a mixed-methods approach Pattison, Rachal


Introduction: Transgender and gender nonconforming (TGNC) young people are vulnerable to a range of negative health outcomes (Reisner, Vetters, et al., 2015; Rider et al, 2018). Additionally, our health systems are recognized as contributing to gendered health inequities (Payne, 2009). It is important that we understand the health outcomes and needs of TGNC young people, if we are to ensure delivery of effective integrated youth mental health services to this vulnerable population. Objectives: The study compared rates of mental health distress between TGNC and cisgender youth and sought to understand how TGNC youth experience mental health services. Methods: Adopting an intersectional framework, I used a mixed-methods, sequential explanatory approach. I conducted a secondary analysis of data of youth accessing a network of BC community health centers. I analyzed the difference in rates of mental health distress between TGNC and cisgender youth using a two-sample t-test. Next, I used stratified simple linear regression to test the association of race with TGNC identity and mental health distress. Finally, I conducted interviews with a purposive sample of TGNC young people to understand their experiences using mental health services. Qualitative data were analysed using qualitative description with overtones of constructivist grounded theory. Results: The quantitative sample (n=727) had a mean age of 21 years (SD=2), 48% were non-white, 51% were white and 77% were from Metro Vancouver. Compared to cisgender youth, TGNC youth reported significantly higher levels of mental health distress. TGNC youth were more distressed than cisgender youth across both race strata but non-white TGNC youth were not more distressed than white TGNC youth. From the qualitative sample (n=5), TGNC participants revealed themes of upsetting interactions with health providers, barriers and facilitators to services, and their experiences of the gender binary as a form of tyranny. They provided simple, practical advice on how to better support and affirm TGNC young people accessing care. Conclusions: The findings from this study emphasize the need for increased education and understanding of TGNC concepts and health concerns as well as on promoting intersectoral collaboration of social service organizations beyond simply health care.

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