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RESEARCH WEEKLY: June Research Roundup, LGBTQIA+ Pride Month
By Hope Parker
(June 30, 2023) Research Roundup is a monthly public service of the Office of Research and Public Affairs. Each edition describes a striking new data point about severe mental illness and summarizes recently published research reports or developments.
This month’s roundup is in honor of LGBTQIA+ Pride Month and highlights the experiences of LGBTQ people whose lives are impacted by severe mental illness.
Datapoint of the month
75% past-year prevalence rate for at least one MDPS mental health disorder in transgender and gender diverse adults
The Mental and Substance Use Disorders Prevalence Study, published earlier this week, examined the prevalence of mental and substance use disorders among 5,679 adults in the United States ages 18-65. This study found that transgender and gender diverse adults were significantly more likely to have one of the seven mental health disorders evaluated by the MDPS compared to cisgender individuals (individuals who identify with their sex at birth). Nearly one-third (30%) of transgender and gender diverse adults had two or more MDPS mental disorders, and 46% of transgender and gender diverse adults met criteria for past-year generalized anxiety disorder.
This finding highlights the need for more medical and behavioral health professionals to be aware of the mental health needs of transgender and gender diverse individuals.
Ringeisen, H. et al. (June 2023). Mental and Substance Use Disorders Prevalence Study: Findings report. RTI International.
Research of the month
Higher rates of serious mental illnesses and treatment for legal-involved lesbian, gay, and bisexual individuals
A recent study from “Psychiatric Services” used data from the 2015-2019 National Survey on Drug Use and Health to compare mental illness, substance use disorders, and access to treatment between gay, lesbian, and bisexual adults and heterosexual adults involved in the criminal legal system. The study found that LBG individuals were overrepresented in the criminal legal system; 9% of respondents involved with the criminal legal system identified as members of the LBG community, while only 4-5% of the general population identifies as lesbian, gay, or bisexual.
Lesbian, gay, and bisexual individuals with criminal legal system involvement had over twice the rate of serious mental illness (22%) as heterosexual individuals in the criminal legal system (10%). Individuals with criminal legal system involvement who identified as being LBG also had higher rates of depressive thoughts, suicidal ideation, suicide plans, and a history of at least one suicide attempt. Substance use was also more prevalent in people who identified as LBG as compared to their heterosexual peers.
The results of this study highlight the need for culturally competent mental health and substance use treatment within correctional facilities that address the specific needs of the LGBTQ+ population. Further research should include analysis of prevalence rates of substance use, mental health, and treatment utilization within subgroups of the LGBTQ+ population.
Ramakrishnan, A. & Gonzales, G. (August 2022). Sexual Orientation, Mental Illness, and Substance Use Disorders Among Criminal Legal System-Involved Individuals. Psychiatric Services.
Research on schizophrenia in transgender and gender non-conforming individuals needs improvement
Despite high prevalence rates of mental health disorders in transgender and gender non-conforming populations, very little research in this area addresses the effect of gender and often only includes “men” and “women” as gender options.
To address this research gap, authors from a study published in “Biological Psychiatry” suggest several solutions, such as:
- Including transgender and gender non-conforming individuals in research to ensure appropriate questions are asked and analysis remains free of bias.
- Training medical professionals on developing relationship building skills and using gender-inclusive practices with transgender and gender non-conforming individuals.
- Including specific subgroups within the transgender and gender non-conforming community (e.g. transgender women, transgender men, nonbinary people) instead of grouping all transgender and gender non-conforming people together in results. This allows groups of transgender and gender nonconforming people to be compared against each other, as well as against cisgender individuals.
- Using respondent-driven sampling to get a more representative sample of participants. Often in transgender and gender non-conforming research, samples are taken from gender clinics, which creates study samples with an overrepresentation of white and affluent individuals. Snowball sampling, which allows survey participants to refer other individuals they know to the study, may help create results that better reflect the diversity of the transgender and gender non-conforming community.
- Addressing implicit bias against transgender and gender non-conforming individuals with psychiatric disorders. In one study, nearly four in ten trans men reported delaying preventative care due to discrimination. Because transgender and gender non-conforming people are most likely to be recruited from medical locations, this negatively affects study recruitment.
- Recognizing the intersectionality within the transgender community and different levels of discrimination individuals may face based on race, ethnicity, and nationality.
- Disseminating reported findings through methods like E-bulletins so research findings can be easily accessed by other researchers and clinicians.
It is important to note that the researchers do not believe that belonging to the transgender and gender non-conforming community inherently makes an individual more likely to have a mental illness. “Minority stress theory” proposes that the higher rate of psychiatric disorders in transgender individuals may be due to the stressful experiences of stigma, discrimination, and prejudice.
Nolan, C.J., et al. (March 2023). Beyond the Binary: Gender Inclusivity in Schizophrenia Research. Biological Psychiatry.
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