Gender Identity and Expression Congruence in Gender Diverse Youth

Abstract

Transgender and gender diverse youth face disparities in adverse mental health outcomes including depression, anxiety, and suicidality. Little has been researched about the congruence between gender identity and expression (as continuous variables) in relation to mental health outcomes in gender diverse youth. The present study seeks to investigate if congruence, as measured on sliders, is associated with decreased levels of depression and anxiety, and whether the congruence improves over time seen in a multidisciplinary gender clinic. Data was collected from gender diverse patients from the Seattle Children’s Gender Clinic. Fixed-effects modeling was used to examine the effect of congruence difference on depression and anxiety scores. Paired t-tests compared the mean congruence differences between baseline and measures at 3 months, 6 months, and 12 months. No effect was demonstrated between congruence and depression/anxiety scores. The mean congruence difference was only significantly lower at 6-month follow-up (p=0.02). The findings highlight the need to address limitations of this study and implications for future research to investigate the relationship between gender identity and expression congruence with adverse mental health outcomes for gender diverse youth.