Mental Health Utilization Among Transgender Veterans
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Le résumé fourni par la source
Importance: Compared with cisgender (CG) individuals, transgender and gender-diverse (TGD) individuals experience substantial social and economic disparities that can result in adverse mental health consequences. It is critical to understand potential barriers to care and to address the causes of the disparities in the future. Objective: To characterize mental health care utilization among TGD veterans with depression. Design, Setting, and Participants: This cohort study used electronic health record data from the US Department of Veterans Affairs (VA) to create a 1:3 age group-matched and VA facility-matched nationwide cohort of TGD and CG veterans with documentation of depression during 2018 to 2020. Data analysis was performed from January to November 2023. Exposure: TGD identity was ascertained by diagnosis of a gender identity disorder. Main Outcomes and Measures: The primary outcome was mental health care utilization, including counts of outpatient (in specialty care and primary care settings), telehealth, emergency department, and inpatient visits in this cohort. Descriptive statistics were used to characterize counts of mental health utilization, and statistically significant differences between TGD and CG veterans were tested using χ2 and Fisher exact tests. Wilcoxon rank-sum tests were used to test for differences in utilization between the 2 groups. Adjusted logistic regression, controlling for age group, administrative sex, race, Charlson Comorbidity Index, and number of mental health medications (eg, antidepressant, antipsychotic, and anxiolytic medications), was also used to compare utilization between TGD and CG veterans. Results: Among 10 564 veterans with depression (mean [SD] age, 46.4 [15.2] years; 8050 male [76.2%]), 2643 TGD veterans were matched with 7921 CG veterans. TGD veterans had 6 more specialty mental health visits per year than CG veterans (mean [SD], 13.93 [20.08] vs 8.46 [14.96] visits a year; median [range], 7.14 [0.00-246.30] vs 3.76 [0.00-202.38] visits per year). In adjusted models, compared with CG veterans, TGD veterans were 2.6 times more likely to have an outpatient mental-health visit (odds ratio, 2.60; 95% CI, 2.16-3.15). Conclusions and Relevance: In this cohort study of veterans with depression, TGD veterans had significantly higher utilization of mental health services compared with CG veterans, even after adjusting for several relevant health factors. Different health system resources may be required to meet the needs of this population. Further studies are needed to understand the determinants of these disparities and subsequently how to address them.
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Le contrôle bibliographique ouvert
DOI retrouvé dans Crossref DOI retrouvé ; titre concordant.
- Titre Crossref
- Mental Health Utilization Among Transgender Veterans
- Date Crossref
- 13/01/2025
- Éditeur
- American Medical Association (AMA)
- Type
- journal-article
Ce recoupement confirme des métadonnées liées au DOI. Il ne confirme ni la méthode ni les conclusions de l’étude, et il ne compte pas comme une seconde source scientifique indépendante.
Où se fait cette recherche
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United States Department of Veterans Affairs pays non établi dans la noticeOrganisme public
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Regenstrief Institute pays non établi dans la noticeOrganisation à but non lucratif
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University of Massachusetts Chan Medical School pays non établi dans la noticeUniversité ou école supérieure
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Veterans Health Administration pays non établi dans la noticeOrganisme public
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Richard L. Roudebush VA Medical Center Health Systems Research CIN 13-416 pays non établi dans la noticeÉtablissement de santé
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Indiana University – Purdue University Indianapolis pays non établi dans la noticeUniversité ou école supérieure
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Indiana University Indianapolis Department of Psychology pays non établi dans la noticeUniversité ou école supérieure
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University of Michigan Department of Internal Medicine pays non établi dans la noticeUniversité ou école supérieure
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VA Ann Arbor Healthcare System pays non établi dans la noticeÉtablissement de santé
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VA Center for Clinical Management Research pays non établi dans la noticeÉtablissement de santé
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Boston University Section of General Internal Medicine pays non établi dans la noticeUniversité ou école supérieure
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Indiana University Bloomington pays non établi dans la noticeUniversité ou école supérieure
United States Department of Veterans Affairs, Regenstrief Institute et University of Massachusetts Chan Medical School, avec 9 autres affiliations.
Une affiliation ne permet pas de déduire la nationalité d’un auteur.