Psychological distress, self-harm and suicide attempts in gender minority compared with cisgender adolescents in the UK

White, James ORCID: https://orcid.org/0000-0001-8371-8453, Trinh, Mai-Han and Reynolds, Colleen 2023. Psychological distress, self-harm and suicide attempts in gender minority compared with cisgender adolescents in the UK. The British Journal of Psychiatry 9 (5) , e138. 10.1192/bjo.2023.534

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Abstract

Background Few population-based studies have compared the mental health of gender minority and cisgender adolescents. Aims To compare reports of psychological distress, behavioural and emotional difficulties, self-harm and suicide attempts between gender minority and cisgender adolescents. Method Data came from the Millennium Cohort Study (n = 10 247), a large nationally representative birth cohort in the UK. At a 17-year follow-up, we assessed gender identity, psychological distress (Kessler K6 scale), behavioural and emotional difficulties (parent and child reports on the Strengths and Difficulties Questionnaire), self-harm in the previous year, suicide attempts, substance use, and victimisation including harassment and physical and sexual assaults. Multivariable modified Poisson and linear regression models were used. Attenuation after the inclusion of victimisation and substance use was used to explore mediation. Results Of the 10 247 participants, 113 (1.1%) reported that they were a gender minority. Gender minority participants reported more psychological distress (coefficient 5.81, 95% CI 4.87–6.74), behavioural and emotional difficulties (child report: coefficient 5.60; 95% CI 4.54–6.67; parent/carer report: coefficient 2.60; 95% CI 1.47–3.73), self-harm including cutting or stabbing (relative risk (RR) 4.38; 95% CI 3.55–5.40), burning (RR 3.81; 95% CI 2.49–5.82), taking an overdose (RR 5.25; 95% CI 3.35–8.23) and suicide attempts (RR 3.42; 95% CI 2.45–4.78) than cisgender youth. These associations were partially explained by differences in exposure to victimisation. Conclusions Gender minority adolescents experience a disproportionate burden of mental health problems. Policies are needed to reduce victimisation and services should be adapted to better support the mental health of gender minority adolescents.

Item Type:	Article
Date Type:	Publication
Status:	Published
Schools:	Medicine Centre for Trials Research (CNTRR)
Publisher:	Cambridge University Press
ISSN:	0007-1250
Funders:	MRC
Date of First Compliant Deposit:	7 July 2023
Date of Acceptance:	22 June 2023
Last Modified:	11 Oct 2023 21:42
URI:	https://orca.cardiff.ac.uk/id/eprint/160858

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