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Exploring Psychiatric Disorders Among Transgender Individuals – A Danish Nationwide Population Study

19 Pages Posted: 1 May 2023

See all articles by Ali Xapana

Ali Xapana

University of Copenhagen - Institute for Biological Psychiatry

Klaus Damgaard Jakobsen

University of Copenhagen - Institute for Biological Psychiatry

Basim Reza

University of Copenhagen - Institute for Biological Psychiatry

Lea Arregui Nordahl Christoffersen

University of Copenhagen - Institute for Biological Psychiatry

Dorte Helenius

University of Copenhagen - Institute for Biological Psychiatry

Thomas Werge

University of Copenhagen - Institute for Biological Psychiatry

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Abstract

Background: Several studies have shown increased prevalence of psychiatric diagnoses among transgender individuals. However, unbiased population-valid risk-estimates of psychiatric diagnoses for transgender individuals to guide healthcare provision are missing.

Methods: For the analyses in this study transgender status was defined as having received a diagnosis of the following diagnostic ICD10 codes F64.0, F64.2, F64.8 or F64.9 (N = 929). The prevalence and lifetime risk of receiving a psychiatric diagnosis were estimated for all individuals born in Denmark from 1968 thru 2017 (N = 4,348,985) and compared between transgender individuals and non-transgender individuals using time-to-event (COX) analyses.

Findings: Transgender individuals have an eight-fold increased hazard ratio (HR) relative to non-transgender individuals of receiving a psychiatric diagnosis during an in- or out-patient hospital admission (HR = 8·62 [95% CI: 7·95 – 9·36]). This reflects significantly increased risk for all examined diagnoses, lowest for diagnoses of eating disorders: (HR = 4·99 [95% CI: 3·49 – 7·14]) and highest for diagnoses of personality disorders: (HR = 14·19 [95% CI: 11·98 – 16·80]). Sensitivity analyses verified that individuals without psychiatric diagnoses at the time of receiving a transgender diagnosis also had a significantly increased risk of being diagnosed with all included diagnoses, lowest for eating disorder (HR = 2·15 [95% CI: 1·08 – 4·30]) and highest for personality disorder (HR = 7·86 [95% CI: 6·29 – 9·83].I

nterpretation: The highly significant risk of psychiatric disorders among transgender individuals underscores the importance of early, systematic, and targeted assessment alongside careful consideration of appropriate means to improve mental health.
Trial Registration:

Funding: AX acknowledges a Lundbeck Foundation Scholarship.

Declaration of Interest: None to declare.

Ethical Approval: The Danish Health Data Authority and the Danish Data Protection Agency approved this study (project no. FSEID-00003339). According to Danish law, written informed consent and evaluation by a Scientific Ethics Committee is not required for register-based studies. All personal data identifiers were anonymized.

Keywords: Transgender, Psychiatry, mental health, LGBTQ+, Nationwide study

Suggested Citation

Xapana, Ali and Jakobsen, Klaus Damgaard and Reza, Basim and Christoffersen, Lea Arregui Nordahl and Helenius, Dorte and Werge, Thomas, Exploring Psychiatric Disorders Among Transgender Individuals – A Danish Nationwide Population Study. Available at SSRN: https://ssrn.com/abstract=4430754 or http://dx.doi.org/10.2139/ssrn.4430754

Ali Xapana (Contact Author)

University of Copenhagen - Institute for Biological Psychiatry ( email )

Klaus Damgaard Jakobsen

University of Copenhagen - Institute for Biological Psychiatry ( email )

Basim Reza

University of Copenhagen - Institute for Biological Psychiatry ( email )

Lea Arregui Nordahl Christoffersen

University of Copenhagen - Institute for Biological Psychiatry ( email )

Dorte Helenius

University of Copenhagen - Institute for Biological Psychiatry ( email )

Thomas Werge

University of Copenhagen - Institute for Biological Psychiatry ( email )

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