Psychiatric diagnoses in nonbinary compared to binary transgender adults: a retrospective analysis of medical records at an urban health system

Abstract

Transgender and Non-Binary (TGNB) people across the lifespan have increased risk of mood and anxiety disorders compared to cisgender (non-transgender) people; previous research has typically grouped non-binary and binary transgender adults as one, despite recorded differences in experience between the two populations. We used a retrospective cohort study design to analyze de-identified summary-level data taken from electronic medical records of a TGNB adult patient sample. Our aim was to compare the odds of mood disorder diagnosis in non-binary versus binary transgender adults, and to see whether these odds differed when each group is stratified across the demographic variables of age, sex assigned at birth, race, and insurance payer. Non-binary patients had significantly higher odds of a mood disorder diagnosis when stratified across almost all demographic variables. This study provides emerging evidence for key differences in prevalence of psychopathology in non-binary compared to binary transgender adults, which can inform changes to medical practice as well as the need for disaggregation of this population within future research.