Mental health issues like depression and addiction are more common among young transgender women than the general U.S. population, according to a new study.
While the study can't say why this was true, the researchers say the results highlight the need for culturally competent treatment and care.
"There is a critical need for skilled and well-informed mental health professionals," said Sari Reisner, the study's lead author from Boston Children's Hospital.
The researchers write in JAMA Pediatrics that mental health issues and addiction affect 4 to 26 percent of people in the U.S. Often, those issues emerge during adolescence and young adulthood.
For the new study, the researchers interviewed 300 transgender women in Boston and Chicago between 2012 and 2015. The participants, who ranged in age from 16 to 29, were sexually active and were participating in an HIV prevention study.
Overall, about 42 percent had one or more health or addiction diagnoses. About one in five had two or more diagnoses.
Rates of diagnoses among the participants were about two to four times greater than in the general U.S. population, write the researchers.
About a third of participants had been depressed at some point, and about 15 percent currently had the condition. About one in five participants reported suicidal thoughts within the past 30 days.
Within the last six months, about 8 percent of participants had anxiety and about one in 10 had post-traumatic stress disorder (PTSD).
About 11 percent reported alcohol dependence in the past year. Likewise, about 15 percent reported some other kind of addiction during that time.
The likelihood of mental health and addiction issues appeared to increase with age.
That finding, coupled with a smaller lifetime prevalence of depression than what's been seen in previous studies in older transgender women, suggests there is an opportunity to prevent poor outcomes.
The new results do not show that transgender women are inherently predisposed to mental health issues, Reisner told Reuters Health.
For example, he and his colleagues point out, gender transition and gender affirmation are stressful events. They may affect a transgender and gender-variant person's psychiatric health and well-being during adolescence and young adulthood.
The increased prevalence of mental health and addiction issues likely stems from the intersection of several minority stressors, said Dr. Johanna Olson-Kennedy, who is medical director of the Center for Transyouth Health and Development at Children's Hospital Los Angeles.
The minority stress theory suggests people in minority groups are at a greater risk for health problems due to increased exposures to stressors like prejudice and stigma.
"We can't forget that trans people continue to face an onslaught of microaggressions every single day of their lives," said Olson-Kennedy, who wrote an editorial accompanying the new study.
She told Reuters Health that eliminating stigma goes beyond limited access to healthcare and stretches to all parts of society.
"It's about changing the cultural paradigm so we can do whatever we can to mitigate those challenges," she said.