Abstract
Background
Transgender and gender nonconforming (TGNC) youth are at higher risk for anxiety and depression than their peers. The referral rate for those seeking specialty medical care has rapidly increased in recent years. This paper examines the use of brief screening tools with clear cutoffs to assist physicians in rapidly identifying TGNC youth in acute distress.
Methods
A retrospective chart review was conducted for patients aged 11–18 years being treated in a pediatric endocrinology clinic for gender dysphoria. Patient Health Questionnaires for depression (PHQ-9) and Generalized Anxiety Disorder 7-item (GAD-7) were collected for patients attending an initial consultation (n=79) or follow-up appointment (n=115).
Results
Screener data identified high rates of acute distress, including depression (47%), anxiety (61%), and suicidal ideation (30%). Distress was not associated with age or gender identity. More youth endorsed clinically significant anxiety at initial consultation appointments versus follow-up appointments.
Conclusions
The results support the use of the PHQ-9 and GAD-7 as brief, easy-to-use screening measures that can be administered by physicians to rapidly identify acute distress and inform treatment recommendations among TGNC youth seeking medical intervention.
Author contributions: All the authors have accepted responsibility for the entire content of this submitted manuscript and approved submission.
Research funding: None declared.
Employment or leadership: None declared.
Honorarium: None declared.
Competing interests: The funding organization(s) played no role in the study design; in the collection, analysis, and interpretation of data; in the writing of the report; or in the decision to submit the report for publication.
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