Category: Gay / Lesbian / Bisexual / Transgender Issues
Gender-diverse adolescents, including those who are transgender, are at substantially higher risk for depression and anxiety as compared with cisgender youth. Cognitive-behavioral theory posits that depressive and anxiety symptoms may be exacerbated, in part, by maladaptive thinking patterns, including those related to the self and the future. Gender-diverse adolescents may experience low gender identity congruence (GIC)—the feeling that one’s outward appearance accurately reflects their gender identity—but its impact on mental health has not been empirically examined. Using self-report data from a clinical sample of gender-diverse youth aged 12-22, the present study examined the ability of gender identity congruence (GIC) and gender-related negative future expectations (NFE) to predict levels of depressive and anxiety symptoms. The sample (N=93), gathered from a pediatric transgender health clinic in the Midwest, had a mean age of 15.75 years (SD=1.78) and was 69.9% European American and 71% assigned female at birth. Analyses revealed significant positive correlations between NFE and negative correlations between GIC and the outcomes of interest; although NFE and GIC scores were more strongly associated with depressive than anxiety symptoms. Standard multiple regression analyses performed separately for depression and anxiety outcomes indicated that those with higher levels of GIC and lower levels of NFE were less likely to report depressive symptoms: F (2,91) = 9.44, p .01, R2= .17. In terms of anxiety, NFE was a non-significant predictor; however, those with higher levels of GIC were less likely to report anxiety symptoms: F (2,91) = 5.06, p < .01, R2=.10. These results suggest that cognitive-behavioral interventions, such as cognitive restructuring, focused on decreasing NFE and improving GIC may help alleviate depressive symptoms. In addition, mindfulness interventions may help alleviate distress associated with low GIC and, in turn, anxiety. Apart from these interventions, gender-affirmative approaches that may reduce NFE (e.g., mentoring programs with gender-diverse adults) and increase GIC (e.g., social gender transition, gender-affirming medical interventions) may decrease both depressive and anxiety symptoms in gender-diverse adolescents.