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Exploring Psychiatric Disorders Among Transgender Individuals – A Danish Nationwide Population Study
19 Pages Posted: 1 May 2023
More...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: Suggested Citation