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Journal of Gay & Lesbian Mental Health Volume 21, 2017 - Issue 1
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Original Articles

Perception of community tolerance and prevalence of depression among transgender persons

Ashli A. Owen-SmithDepartment of Health Management and Policy, School of Public Health, Georgia State University, Atlanta, Georgia, USACorrespondence[email protected]
, PhD, SM,
Craig SineathDepartment of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, Georgia, USA
, MPH,
Travis SanchezDepartment of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, Georgia, USA
, DVM, MPH,
Robin DeaThe Permanente Medical Group (Retired), Redwood City, California, USA
, MD,
Shawn GiammatteiThe Rockway Institute, Alliant International University, San Francisco, California, USA
, PhD,
Theresa GillespieDepartment of Surgery, School of Medicine, Emory University, Atlanta, Georgia, USA
, PhD,
Monica F. HelmsDepartment of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, Georgia, USA
,
Enid M. HunkelerDivision of Research, Kaiser Permanente Northern California, Oakland, California, USA
, MA, FAHA,
Virginia P. QuinnDepartment of Research and Evaluation, Kaiser Permanente Southern California, Pasadena, California, USA
, PhD,
Douglas RoblinDepartment of Health Management and Policy, School of Public Health, Georgia State University, Atlanta, Georgia, USA
, PhD,
Jennifer SlovisDivision of Research, Kaiser Permanente Northern California, Oakland, California, USA
, MD,
Robert StephensonDepartment of Health Behavior and Biological Sciences, School of Nursing, University of Michigan, Ann Arbor, Michigan, USA
, PhD,
Patrick S. SullivanDepartment of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, Georgia, USA
, DVM, PhD,
Vin TangprichaDepartment of Endocrinology, School of Medicine, Emory University, Atlanta, Georgia, USA
, MD, PhD,
Cory WoodyattDepartment of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, Georgia, USA
&
Michael GoodmanDepartment of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, Georgia, USA
, MD, MPH show all
Pages 64-76 | Received 20 Apr 2016, Accepted 22 Aug 2016, Published online: 21 Oct 2016
 
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ABSTRACT

The goal of the study was to examine the association between depression and perceived community tolerance after controlling for various demographic and personal characteristics, treatment receipt, and past experiences with abuse or discrimination. An online survey assessed depressive symptoms among transgender and gender nonconforming individuals. Depression was assessed using the 7-item Beck Depression Inventory for Primary Care (BDI-PC) and the 10-item Center for Epidemiologic Studies Depression (CESD-10) scale. The prevalence ratios (95% confidence intervals) comparing depression in persons who did and did not perceive their area as tolerant were 0.33 (0.20–0.54) for BD-PC and 0.66 (0.49–0.89) for CESD-10. Other factors associated with depression were experience with abuse or discrimination, lower education, and unfulfilled desire to receive hormonal therapy. Depression was common in this sample of transgender and gender nonconforming individuals and was strongly and consistently associated with participants’ perceptions of community tolerance, even after adjusting for possible confounding. The association between desire to receive hormonal therapy and depression is a finding that warrants further exploration. Future research should also assess depression and changes in perception of community tolerance in transgender individuals before and after initiation of gender confirmation treatment.

Funding

This research was supported by Contract AD-12-11-4532 from the Patient Centered Outcome Research Institute and by Grant R21HD076387 from the Eunice Kennedy Shriver National Institute of Child Health and Human Development. The work was facilitated by the Center for AIDS Research at Emory University (P30AI050409) and by the National Center for Advancing Translational Sciences of the National Institutes of Health (UL1TR000454).

Disclosure

No competing financial interests exist.

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