Mental health and wellbeing outcomes associated with social, medical, and legal gender affirmation among trans young people in Australia

Figures & data

Table 1. Sample characteristics (n = 1697).

	n	%
Age group
14-17	945	55.7
18-21	752	44.3
Sexual orientation
Lesbian	148	8.7
Gay	151	8.9
Bisexual	365	21.5
Pansexual	332	19.6
Queer	261	15.4
Asexual	113	6.7
Something else	326	19.2
Gender
Trans woman	75	4.4
Trans man	406	23.9
Non-binary	1216	71.7
Education level
Secondary school (high school)	929	58.9
University	375	23.8
TAFE	151	9.6
Other	121	7.7
Country of birth
Australia	1535	90.6
Other English-speaking country	97	5.7
Non-English-speaking country	62	3.7
Residential location
Capital city, inner suburban	99	5.8
Capital city, outer suburban	916	54.1
Regional city or town	474	28
Rural/remote	205	12.1

Table 2. : Frequencies of hoping to and actively affirming gender medically, legally, or socially.

	Trans woman		Trans man		Non-binary		Total
	n	%	n	%	n	%	n	%	Χ^2
Medical affirmation
Hoped to affirm	71	98.6	393	98.0	558	59.5** ^a	1022	72.4	234.7**
Actively affirmed	34	47.9	177	44.1	90	9.7** ^b	301	21.5	227.0**
Legal affirmation
Hoped to affirm	68	94.4	394	98.3	602	64.2** ^c	1064	75.4	190.7**
Actively affirmed	19	26.8	132	32.9	89	9.6** ^d	240	17.2	111.7**
Social affirmation
Hoped to affirm	71	98.6	401	100.0	904	96.4** ^e	1376	97.5	15.6**
Actively affirmed	53	74.6	369	92.0** ^f	609	65.8** ^g	1031	73.7	99.6**

** <0.001;

^adiffers to trans women (Χ² = 43.6) and trans men (Χ² = 202.5);

^bdiffers to trans women (Χ² = 88.2) and trans men (Χ² = 206.3);

^cdiffers to trans women (Χ² = 27.4) and trans men (Χ² = 171.2);

^ddiffers to trans women (Χ² = 20.08) and trans men (Χ² = 109.5);

^ediffers to trans men (Χ² = 14.9);

^fdiffers to trans women (Χ² = 19.2);

^gdiffers to trans men (Χ² = 99.5);

Table 3. Associations between access to medical, legal or social gender affirmation and health and wellbeing outcomes.

	Recent suicidal ideation				Recent suicide attempt				Recent self-harm
	n	%	AOR(95% CI)	p	n	%	AOR(95% CI)	p	n	%	AOR(95% CI)	p
Affirmed medically
No	791	75.0	REF	–	145	14.4	–	–	592	54.8	–	–
Yes	212	72.6	0.8 (0.54 − 1.19)	0.275	50	17.8	1.06 (0.64 − 1.74)	0.821	154	51.3	0.89 (0.62 − 1.28)	0.529
Affirmed legally
No	842	75.4	REF	–	157	14.7	–	–	628	55.0	–	–
Yes	161	70.0	0.59 (0.39 − 0.89)	0.012	38	17.3	0.99 (0.59 − 1.66)	0.980	118	49.4	0.79 (0.54 − 1.14)	0.204
Affirmed socially
No	263	74.1	REF	–	41	12.2	–	–	187	51.7	–	–
Yes	740	74.6	0.79 (0.55 − 1.13)	0.198	154	16.2	1.15 (0.71 − 1.87)	0.558	559	54.9	1.07 (0.79 − 1.44)	0.665
	Psychological distress				Anxiety				Happiness
			β(95% CI)	p			β(95% CI)	p			β(95% CI)	P
Affirmed medically
No	–	–	REF	–	–	–	–	–	–	–	–	–
Yes	–	–	−1.63 (−2.99 – −0.27)	0.019	–	–	−1.01 (−1.96 – −0.06)	0.038	–	–	0.03 (−0.21 − 0.28)	0.805
Affirmed legally
No	–	–	REF	–	–	–	–	–	–	–	–	–
Yes	–	–	−2.68 (−4.05 – −1.31)	0.000	–	–	−1.39 (−2.37– −0.4)	0.006	–	–	0.32 (0.07 − 0.56)	0.011
Affirmed socially
No	–	–	REF	–	–	–	–	–	–	–	–	–
Yes	–	–	−1.05 (−2.22 − 0.11)	0.077	–	–	−0.43 (−1.23 − 0.37)	0.289	–	–	0.17 (−0.03 − 0.36)	0.090
	Drug use						Homelessness				Verbal harassment
	n	%	AOR(95% CI)	p	n	%	AOR(95% CI)	p	n	%	AOR(95% CI)	p
Affirmed medically
No	301	30.2	REF	–	349	32.1	–	–	607	57.0	–	–
Yes	128	46.9	1.75 (1.17 − 2.6)	0.006	120	40.4	1.04 (0.7 − 1.53)	0.856	177	60.4	1.22 (0.82 − 1.83)	0.324
Affirmed legally
No	330	31.5	REF	–	383	33.3	–	–	645	57.3	–	–
Yes	99	44.6	1.57 (1.06 − 2.33)	0.025	86	36.8	0.91 (0.61 − 1.36)	0.653	139	59.7	1.21 (0.8 − 1.82)	0.368
Affirmed socially
No	87	26.3	REF	–	85	23.4	–	–	187	53.1	–	–
Yes	342	36.4	1.52 (1.04 − 2.21)	0.030	384	37.6	1.53 (1.06 − 2.21)	0.022	597	59.3	1.85 (1.37 − 2.5)	0.000

NOTE: n’s and %’s reflect the frequency and proportion of participants who had experienced the outcomes. This only applies to dichotomized outcomes used in the logistic regression analyses.