Academic Publications

Academic Publications

Schwartz C, Barican J, White O, Tang J, Catherine N, Thomson K, & Waddell C. (2024). Mental Health of Transgender and Nonbinary Children and Youth: Informing Service Needs. Vancouver, BC: Children’s Health Policy Centre, Faculty of Health Sciences, Simon Fraser University.

Executive Summary

Many transgender and nonbinary children and youth face added challenges compared with their cisgender counterparts, including more frequent adverse experiences, peer victimization and harassment. These avoidable hardships cause harm in and of themselves and also raise risks for secondary mental health problems. Knowing the prevalence of mental health concerns for transgender and nonbinary young people is therefore crucial as the numbers of those in need can and should inform service planning to ensure both adequate mental healthcare and greater equity. 

To provide the most accurate estimate, we conducted a systematic review of studies on the prevalence of mental disorders in transgender and nonbinary young people. The two studies that met inclusion criteria, were both conducted in the United States (US). The first study assessed overall prevalence, finding that 56.6% of transgender young people had experienced at least one mental disorder in the previous six months — a proportion between 5.9 and 13.0 times higher than cisgender counterparts. As well, for individual disorders as well as disorder groups, prevalence was higher for transgender children and youth compared with cisgender counterparts. The second study focused exclusively on eating disorders, finding that 4.2% of transgender youth had this diagnosis — a proportion approximately 200% higher than expected according to studies in general populations of young people.

We also identified two studies that assessed suicidal ideation and self-harm including one of the previously cited American studies. This US study found that 3.2% of transgender youth experienced a self-inflicted injury in the previous six months according to health records — a rate at least 17 times higher than cisgender counterparts. As well, health records noted suicidal ideation for 6.3% of transgender youth — a rate approximately 24 times higher than cisgender counterparts. A Canadian study found even higher rates according to an anonymous survey. Researchers found that nearly 80% of transgender and nonbinary youth reported engaging in self-harm in the past year, approximately five times the rate for cisgender peers. As well, 65.2% of transgender and nonbinary youth reported suicidal ideation in the past year, five times the rate for cisgendered peers.

The high prevalence of mental health concerns for transgender and nonbinary young people underscores the need for easily accessible and effective mental health treatments with these populations. It is also imperative that public mental health services be provided with intensity that is proportionate to the needs, and be delivered by practitioners within settings and systems that are sensitive to the experiences of these young people. This approach aligns with the World Health Organization’s recognition of mental health as a basic human right. It is equally crucial to address the unacceptable and preventable adverse experiences that many transgender and nonbinary young people face and that can contribute to the development of mental health conditions.  Ensuring mental wellbeing for these young people also requires adequate monitoring of service use in relation to the needs, as well as monitoring of social determinants including preventable adversities. Such monitoring plays a vital role because “what gets counted counts.” In other words, comprehensive collective efforts encompassing mental healthcare, prevention and monitoring are needed to bring about mental health equity for transgender and nonbinary young people in BC.

Read the full report here. 

Catherine, N.L.A., MacMillan, H., Cullen, A., Zheng, Y., Xie, H., Boyle, M., Sheehan, D., Lever, R., Jack, S. M., Gonzalez, A., Gafni, A., Tonmyr, L., Barr, R., Marcellus, L., Varcoe, C., & Waddell, C. (2023). Effectiveness of nurse-home visiting in improving child and maternal outcomes prenatally to age two years: A randomised controlled trial (British Columbia Healthy Connections Project). Journal of Child Psychology and Psychiatry. https://doi.org/10.1111/jcpp.13846 Read More »

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