Risk and protective factors for mental health morbidity in a community sample of female-to-male trans-masculine adults
Risk and protective factors for mental health morbidity in a community sample of female-to-male trans-masculine adults
复制标题
DOI：
10.1186/s12888-018-2008-0
复制
发表时间：
2019-01-09
期刊：
影响因子：
4.4
通讯作者：
Reisner, Sari L.
中科院分区：
文献类型：
--
作者：
McDowell, Michal J.;Hughto, Jaclyn M. White;Reisner, Sari L.
跨男性（TM）个体在出生时被指定为女性，并按照男性性别谱进行识别，与顺性人相比，他们面临着心理健康差异。有限的研究试图探索与TM人群心理健康发病率相关的多层次风险和保护因素。方法2015年8月至2016年9月，150名TM成人参加了一项一次性生物行为健康研究。一项调查评估了社会人口统计、过去12个月的日常歧视、终生亲密伴侣暴力（IPV）、恢复力（使用简短恢复力量表）和其他因素。双变量和多变量logistic回归分析检验了参与者特征与四种心理健康状态之间的关联：创伤后应激障碍（PTSD）、抑郁、焦虑和非自杀性自伤（NSSI）。结果该样本（76.7%为男性或跨性别男性二元性别认同，74.7%为白人，70.0%年龄在30岁以下），42.2%为过去30天症状的PTSD；过去7天有抑郁症状的占25.7%；31.1%的患者过去7天有焦虑症状；31.3%在过去12个月内曾有过自伤行为。多变量模型结果表明：1)失业、终身IPV和过去12个月的歧视均与PTSD发病几率增加相关，而有伴侣与PTSD发病几率降低相关。2)抑郁：受教育程度较低和过去12个月受歧视均与抑郁几率增加相关，而适应能力较强与抑郁几率降低相关。3)焦虑：家庭年收入低、过去12个月受歧视均与焦虑发生率增加相关，而心理韧性与焦虑发生率降低相关。4)自伤：过去12个月的歧视与过去12个月自伤的几率增加有关，而年龄越大，恢复能力越强与自伤的几率降低有关（均p值）
BackgroundTrans-masculine (TM) individuals, who are assigned female sex at birth and identify along the masculine gender spectrum, face mental health disparities relative to cisgender people. Limited research has sought to explore the multi-level risk and protective factors associated with mental health morbidity for TM populations.MethodsBetween August 2015-September 2016, 150 TM adults were enrolled in a one-time biobehavioral health study. A survey assessed socio-demographics, past 12-month everyday discrimination, lifetime intimate partner violence (IPV), resilience (using the Brief Resilience Scale), and other factors. Bivariate and multivariable logistic regression analyses examined associations between participant characteristics and four mental health statuses: post-traumatic stress disorder (PTSD), depression, anxiety, and non-suicidal self-injury (NSSI).ResultsIn this sample (76.7% had a binary gender identity, i.e., man or transgender man; 74.7% were white, 70.0% were under age 30years), 42.2% had PTSD based on past 30-day symptoms; 25.7% had depression based on past 7-day symptoms; 31.1% had anxiety based on past 7-day symptoms; and 31.3% had engaged in NSSI within the past 12-months. Results from multivariable models: 1) PTSD: unemployment, lifetime IPV and past 12-month discrimination were each associated with increased odds of PTSD, while having a partner was associated with the reduced odds of PTSD. 2) Depression: lower educational attainment and past 12-month discrimination were each associated with the increased odds of depression, while greater resilience was associated with the reduced odds of depression. 3) Anxiety: low annual household income and past 12-month discrimination were each associated with the increased odds of anxiety, while resilience was associated with the reduced odds of anxiety. 4) NSSI: past 12-month discrimination was associated with the increased odds of past 12-month NSSI, while higher age and greater resilience was associated with the reduced odds of NSSI (all p-values