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Transgender college students are four times as likely to experience mental health problems compared with their peers.

The largest mental health survey of US college students to date found that students who identified as gender non-conforming, transgender, nonbinary or genderqueer experience significantly higher rates of mental health problems when compared with their peers.

Researchers from Boston Univerity, Harvard, The Fenway Institute and The University of Michigan examined a sample of more than 1200 gender minority students across 71 colleges.  

“The magnitude of the mental health inequities faced by gender minority students is heart-breaking,” Sara Ableson, MPH, Co-Investigator and Lead for Diversity, Equity and Inclusion Projects with the Healthy Minds Network at the University of Michigan told Theravive.

“I’ve been working with colleges and universities for over a decade to help them better address student mental health and identify and act on opportunities to advance health equity. I was inspired to conduct this research having a sense that trans, genderqueer, and gender non-conforming students likely face some of the most significant mental health inequities on campus and that institutions of higher education are in a powerful position to help reduce the mental health burdens faced by these students.” 

Of the sample the researchers examined, 78 per cent of the gender minority students had one or more mental health problems. 60 per cent of them had clinically significant depression. Comparatively, students who are cisgender (whose assigned sex at birth matches their current gender identity) screened positive for clinically significant depression in just 28 per cent of cases.

“We conducted the study because we had a sense there may be disparities, but we were really struck by the magnitude of disparities across several mental health conditions,” Julia Raifman, co-author of the study and Assistant Professor of

Health Law, Policy and Management at the Boston University School of Public Health told Theravive. 

“We were particularly struck that transgender students were more than four times more likely to report suicidal ideation relative to cisgender students.” 

This latest research reinforces findings of previous studies that showed significant obstacles for gender minority college students. Past research has highlighted that those who identify as transgender have a higher college dropout rate, and experience greater levels of discrimination or harassment. Prior studies suggest that transgender students are at greater risk of attempting suicide if they are denied access to gender-appropriate housing or bathrooms on campus.

The researchers found that certain subgroups were particularly vulnerable to mental health challenges.

“We found that trans masculine students, those assigned a female sex at birth, are especially vulnerable to the mental health outcomes explored in this study. Genderqueer students had higher rates of depression, anxiety, eating disorders, non-suicidal self-injury, and suicidal ideation relative to transgender students and those with another self-identified gender,” Ableson said.  

Raifman says that the challenges facing transgender students aren’t isolated to college campuses, but can be seen across the United States.

“We know that these disparities occur in a context in which transgender people have unequal rights to employment, housing, and public accommodations,” she said.

“The United States has been rolling back equal rights for transgender people, including protections from discrimination in health care, employment, housing, and participation in the military. I think it’s important to realize that the administration is targeting a population that already experiences a vastly disproportionate burden of poor mental health, and to recognize that these policies may further exacerbate existing disparities.”

Ableson, who has spent the past ten years working with schools to support student mental health, says she isn’t surprised by the disparity.

“Our transphobic society systematically enforces the gender binary and renders transgender and other gender diverse young people vulnerable to significant mental health burdens. Gender minority youth face appalling levels of discrimination, victimization and bullying,” she told Theravive.

She says trans-inclusive policies across college campuses will assist in making transgender students feel a sense of belonging.

‘We know that trans and gender-nonconforming students value gender-inclusive restrooms, non-discrimination policies that are inclusive of gender identity, and the ability to change one’s name on campus records without legal name change. The known presence of trans-inclusive policies is associated with a greater sense of belonging and more positive perceptions of the campus climate for these students,” she said.

Raifman notes that it is also important for college campuses to have mental-health providers who are trained in gender-affirming care.

“As national and state policymakers consider policies that either protect or dismantle equal rights for transgender people, it is important to keep in mind that transgender people face high levels of suicidality and depression that may be affected by such policies. It is also important that college and university administrators take these disparities into account and consider steps that they can take to support transgender students through policies pertaining to names and pronouns, restrooms and dorms, and mental health care provider training,” she said.