There is a higher prevalence of mental disorders and suicidal behavior among transgender and gender-diverse (TGD) people versus the cisgender population, according to a research letter published online Oct. 2 in JAMA Network Open.

Heidi Eccles, from the University of Ottawa in Ontario, Canada, and colleagues investigated the prevalence and risk for mental disorders, substance use disorders, and suicidal behaviors (both past 12 months and lifetime) among a population-representative sample of 9,861 TGD and cisgender Canadians participating in the Mental Health and Access to Care Survey.

The researchers found that 0.53 percent of participants identified as TGD. Compared with cisgender respondents, past 12-month and lifetime major depressive episode, generalized anxiety disorder, bipolar disorder, social phobia, substance use disorder, suicide ideation, suicide plan, and suicide attempts were higher in TGD respondents.

For example, lifetime prevalence of depression among cisgender participants was 13.7 versus 63.7 percent among TGD respondents (adjusted rate ratio, 2.78). In an adjusted analysis, the risk for all 12-month and past-year mental disorders, substance use disorder, and suicide ideation remained higher in TGD respondents than cisgender participants.

TGD respondents also had a significantly higher risk for lifetime suicide plan and attempts. However, neither past 12 months nor lifetime alcohol use disorder differed between the groups.

“This disparity may be explained by minority stress theory, which posits that the experience of prejudice and negative social experiences by members of historically stigmatized groups can have substantial impacts on both physical and mental health,” the authors write.

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