Trans Students Are Found Far More Likely Than Others to Suffer From a Host of Psychological Problems

Transgender, gender-nonconforming, and gender-nonbinary college students suffer two to four times more than their cisgender classmates from mental-health problems, including depression, anxiety, eating disorders, self-injury, and suicidality, according to a new study that is the largest of its kind.

Previous research has shown that this population experiences pervasive mistreatment, harassment, discrimination, and violence. The new study shows the alarming scale of the mental-health toll on trans and other gender-minority college students in particular, says the lead author, Sarah Ketchen Lipson, an assistant professor of health law, policy, and management at Boston University.

“I’m hoping,” she says, “that the magnitude of these disparities will create a sense of urgency” among college leaders in instituting trans-friendly policies like access to gender-neutral bathrooms and housing, and allowing students to change their name in campus records.

The paper, published on Friday in the American Journal of Preventive Medicine, was also written by Julia Raifman, an assistant professor of health law, policy, and management at Boston University’s School of Public Health; Sari L. Reisner, of Harvard Medical School and the Fenway Institute; and Sara Abelson, of the University of Michigan School of Public Health.

In the largest mental-health survey of college students ever undertaken in the United States, data were collected from 2015 through the spring of 2017 from the Healthy Minds Study, which Lipson leads with Daniel Eisenberg of the University of Michigan. The sample included 65,213 students, mostly undergraduates, at 71 colleges and universities, with 98 percent identifying as cisgender, and 2 percent as gender-minority.

Among the key findings:

• Seventy-eight percent of transgender, gender-nonconforming, and gender-nonbinary students — 4.3 times more than their cisgender classmates — met the criteria for one or more mental-health problems.
• Fifty-eight percent of those gender-minority students screened positive for depression in the previous two weeks, and 52 percent reported non-suicidal self-injury in the past year.
• More than one-third of them reported seriously thinking about suicide in the past year.

Also key are mental-health concerns the researchers found among specific gender-minority populations: transgender, genderqueer, and self-identified gender, with trans subcategories female at birth and male at birth.

For instance, the authors found that trans-masculine students (male students who had been identified as female at birth) were 2.9 times likelier, and trans-feminine students (female students who had been identified as male at birth) were 1.6 times likelier, to have inflicted non-suicidal self-injury than did their cisgender peers within the past year. And in that same period, trans-masculine students were 2.6 times likelier, and trans-feminine students were 1.8 times likelier, to have had suicidal ideation.

Lipson says the next steps will involve longitudinal studies tracking how policies affirming gender-minority identities affect mental health. She hopes colleges will act fast, bettering, and perhaps saving, lives.

Alexander C. Kafka is a Chronicle senior editor. Follow him on Twitter @AlexanderKafka, or email him at alexander.kafka@chronicle.com.