Mental health outcomes and loneliness in older transgender individuals receiving long-term gender-affirming hormone therapy compared with older cisgender individuals.
Jason O van Heesewijk, Inge L de Groot, Koen M A Dreijerink, Chantal M Wiepjes, Almar A L Kok, Natasja M van Schoor, Martijn Huisman, Martin den Heijer, Baudewijntje P C Kreukels
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引用次数: 0
Abstract
Objectives: Many older adults experience mental health challenges and loneliness which negatively affect other health aspects. This data is largely lacking in older transgender adults. This study aimed to determine differences in depressive symptoms, anxiety and loneliness between older transgender individuals receiving gender-affirming hormone therapy (GHT), and cisgender (non-transgender) individuals, and to assess the contribution of financial, psychological, somatic, and social-contact related factors.
Design: Cross-sectional.
Setting: Gender identity clinic; general population.
Participants: Seventy-two transgender women and 39 transgender men (56-84 y) receiving GHT for ≥ 10 y, age-matched 1:3 with cisgender women and men from the general population.
Measurements: Depressive symptoms, anxiety and loneliness were assessed with questionnaires. Differences were compared using linear regression analyses with log-transformed variables, and back-transformed for presentation. Additionally, models were adjusted for financial, psychological, somatic and social-contact related factors.
Results: Transgender women scored higher than cisgender women and cisgender men, respectively, on depressive symptoms (1.92, 95 % confidence interval (CI) 1.52-2.42; 2.66, CI 2.11-3.37), anxiety (1.43, CI 1.17-1.75; 1.89, CI 1.54-2.32) and loneliness (2.42, CI 1.96-2.97; 2.32, CI 1.92-2.82). Transgender men scored higher than cisgender men on depressive symptoms (2.10, CI 1.50-2.94), anxiety (1.67, CI 1.27-2.19) and loneliness (1.50, CI 1.16-1.93), and higher than cisgender women on loneliness (1.57, CI 1.20-2.05). These differences were largely explained by differences in financial, psychological, somatic and social-contact related factors.
Conclusions: Mental health outcomes and loneliness are compromised in older transgender individuals compared to cisgender individuals, particularly in transgender women. The socio-economic, psychological and somatic risk factors identified warrant further research and awareness.
目的：许多老年人经历心理健康挑战和孤独，这对其他健康方面产生负面影响。这方面的数据在老年变性人中基本缺乏。本研究旨在确定接受性别确认激素治疗（GHT）的老年跨性别者与顺性别（非跨性别）者在抑郁症状、焦虑和孤独感方面的差异，并评估经济、心理、身体和社会接触相关因素的影响。设计:横断面。地点：性别认同诊所；一般人群。参与者：接受GHT≥10年的72名跨性别女性和39名跨性别男性（56-84岁），与普通人群中的顺性别女性和男性年龄匹配1:3。测量方法：用问卷对抑郁症状、焦虑和孤独感进行评估。差异比较使用线性回归分析与对数转换变量，并反向转换为表示。此外，对模型进行了财务、心理、身体和社会接触相关因素的调整。结果：跨性别女性的抑郁症状得分分别高于顺性女性和顺性男性(1.92,95%可信区间（CI） 1.52-2.42；2.66, CI 2.11-3.37)，焦虑(1.43,CI 1.17-1.75；1.89, CI 1.54-2.32)和孤独(2.42,CI 1.96-2.97；2.32, ci 1.92-2.82)。变性男性在抑郁症状（2.10,CI 1.50-2.94）、焦虑（1.67,CI 1.27-2.19）和孤独感（1.50,CI 1.16-1.93）上得分高于顺性男性，在孤独感（1.57,CI 1.20-2.05）上得分高于顺性女性。这些差异在很大程度上可以用经济、心理、身体和社会接触相关因素的差异来解释。结论：与顺性人相比，老年变性人的心理健康结果和孤独感受到损害，尤其是变性女性。已确定的社会经济、心理和身体风险因素值得进一步研究和认识。
期刊介绍：
A highly respected, multidisciplinary journal, International Psychogeriatrics publishes high quality original research papers in the field of psychogeriatrics. The journal aims to be the leading peer reviewed journal dealing with all aspects of the mental health of older people throughout the world. Circulated to over 1,000 members of the International Psychogeriatric Association, International Psychogeriatrics also features important editorials, provocative debates, literature reviews, book reviews and letters to the editor.
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