Work

Gender minority stress and resilience factors associated with persistent depressive symptoms among transgender and gender diverse adolescents and young adults accessing gender-affirming medical care.

Year: 2026

Type: article

Abstract: While many transgender and gender diverse (TGD) youth experience improved mental health after initiating gender-affirming hormone therapy (GAHT), some continue to experience persistent depressive (PD) symptoms. We examined associations of risk factors (e.g., negative expectations for the future, internalized transphobia) and protective factors (e.g. self-efficacy) for PD among TGD youth accessing GAHT. We used data from the Trans Youth Care U.S. Study, a national longitudinal prospective cohort study of TGD youth ages 12-20 years (N=315 at baseline). Experiencing PD, gender minority stress, resilience, and other factors were assessed at four timepoints (baseline, 6, 12, 18, and 24-months). After identifying two groups based on reported PD, we estimated differences at baseline and change over time of risk and protective factors using linear mixed-effects models. We also examined the association between these rates and experiencing PD using logistic regression. Two groups of PD youth (n=62) and non-PD youth (non-PD; n=253) were identified. Greater negative expectation at baseline was associated with increased odds of PD, while the opposite was observed for greater self-efficacy. Increased rate of change in body esteem was associated with decreased odds of PD. There was an interaction effect between negative expectation and self-efficacy. While self-efficacy was a protective factor, this effect lost its strength as perceived negative expectation increased. These findings identify important areas of assessment and intervention for TGD youth who experience PD despite accessing GAHT. Addressing these factors in treatment appears vital to ensuring adequate treatment for PD.

Source: Psychology of Sexual Orientation and Gender Diversity

DOI: 10.1037/sgd0000965