Gender Abuse and Major Depression Among Transgender Women: A Prospective Study of Vulnerability and Resilience
Gender Abuse and Major Depression Among Transgender Women: A Prospective Study of Vulnerability and Resilience
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DOI：
10.2105/ajph.2013.301545
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发表时间：
2014-11-01
影响因子：
12.7
通讯作者：
Becker, Jeffrey
中科院分区：
文献类型：
--
作者：
Nuttbrock, Larry;Bockting, Walter;Becker, Jeffrey
目标。我们研究了性别虐待的社会和人际背景及其对《精神疾病诊断和统计手册》第四版跨性别女性重度抑郁症的影响。方法。我们对纽约市都会区 230 名年龄在 19 岁至 59 岁之间的跨性别女性进行了一项为期 3 年的前瞻性研究（2004 年至 2007 年）。统计技术包括广义估计方程（逻辑回归）。结果。在随访过程中，我们观察到心理和身体性别虐待与重度抑郁症之间存在显着关联。新的或持续的这两种类型的虐待经历与发生重度抑郁症的可能性增加 4 至 7 倍相关。就业、变性表现、性工作和激素治疗随时间的推移与心理虐待相关；后两个变量与身体虐待相关。心理虐待与抑郁症的关联在年轻跨性别女性中比在年长跨性别女性中更强。结论。心理和身体上的性别虐待在这一人群中很普遍，可能是由于职业成功和试图肯定性别认同而造成的。这两种类型的虐待都会以重度抑郁症的形式产生严重的心理健康后果。老年跨性别女性显然已经对心理性别虐待产生了一定程度的适应能力。
Objectives. We examined the social and interpersonal context of gender abuse and its effects on Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition major depression among transgender women.Methods. We conducted a 3-year prospective study (2004-2007) among 230 transgender women aged 19 to 59 years from the New York City Metropolitan Area. Statistical techniques included generalized estimating equations (logistic regression).Results. We observed significant associations of psychological and physical gender abuse with major depression during follow-up. New or persistent experiences of both types of abuse were associated with 4- to 7-fold increases in the likelihood of incident major depression. Employment, transgender presentation, sex work, and hormone therapy correlated across time with psychological abuse; the latter 2 variables correlated with physical abuse. The association of psychological abuse with depression was stronger among younger than among older transgender women.Conclusions. Psychological and physical gender abuse is endemic in this population and may result from occupational success and attempts to affirm gender identity. Both types of abuse have serious mental health consequences in the form of major depression. Older transgender women have apparently developed some degree of resilience to psychological gender abuse.