Name: BEATRIZ SOUZA SILVA
Publication date: 28/03/2025
Examining board:
Name |
Role |
|---|---|
| ALEXANDRE CARDOSO DA CUNHA | Examinador Interno |
| JOSE LUIZ MARQUES ROCHA | Presidente |
| LARISSA DE FREITAS BONOMO | Examinador Externo |
| VALDETE REGINA GUANDALINI | Coorientador |
Summary: Introduction: Transgender individuals have some level of gender incongruence,
which in turn is characterized by psychological discomfort caused by the
discrepancy between their gender identity, sex assigned at birth, and/or
physical appearance. Transgender identity is commonly associated with social
stigma, structural vulnerabilities, and increased chances of developing
depressive symptoms. In this sense, this study aimed to analyze the factors
associated with depressive symptoms in transgender individuals and compare
them with those observed in cisgender individuals living in the state of Espírito
Santo. Methods: Observational cross-sectional study, with snowball sampling.
Volunteers were invited to participate in the research through social media,
associations focused on the LGBTQIAPN+ segment (lesbian, gay, bisexual,
transgender, queer, intersex, asexual, pansexual, non-binary and others) and
users treated at a gender diversity outpatient clinic between 2021 and 2024,
with the inclusion criteria being 18 years of age or older; self-identifying as part
of the transgender or cisgender universe and being a resident of the state of
Espírito Santo. The Beck inventory was used to assess depressive symptoms,
and individuals with and without depressive symptoms were classified.
Sociodemographic and health variables were analyzed, including insomnia,
using the PROMIS scale, quality of life using the SF-6D questionnaire,
consumption of alcohol and other substances using the ASSIST screening and
perception of self-image using the Brazilian silhouette scale. Statistical analyses
were performed using SPSS®, version 29.0, and STATA®, version 18. The
Kolmogorov-Smirnov test was used to analyze data normality, Student's t-test
and/or Mann Whitney test to compare independent variables with 2 categories,
ANOVA for variables with 3 or more categories, partitioned chi-square for
categorical variables, and multivariate linear regression to determine the
influence of independent variables. The significance level adopted was 5% for
all tests. Results: The sample included 123 transgender and 79 cisgender
participants with a mean age of 26 (± 7) years, with no difference between the
groups. The transgender group had a higher proportion of depressive
symptoms (11.49% vs 7.80%), presence of comorbidities (29.3% vs 8.9%) and
unemployment (18.7% vs 1.3%) compared to the cisgender group (p <0.05 for
all). On the other hand, they had lower income (65.8% vs 12.3%), education
(79.7% vs 54.4%) and quality of life (score 0.78 vs 0.8) (p <0.05 for all).
Furthermore, transgender participants reported higher consumption of tobacco,
alcohol, marijuana, cocaine, hypnotics and hallucinogens compared to
cisgender participants. Multivariate regression analysis revealed that insomnia,
experience of prejudice and consumption of alcohol, tobacco and hypnotics
remained positively associated with depressive symptoms in the group of
transgender volunteers. However, only insomnia and body dissatisfaction were
positively associated with depressive symptoms in the cisgender group after
adjustment for confounders. Conclusion: Transgender participants had greater
severity and a higher proportion of depressive symptoms, which were
associated with different factors between groups. Furthermore, the strength of
the impact of these factors was greater in the transgender group, suggesting
that this population segment requires specific approaches to meet their unique
demands.
