Abstract
Purpose
Recently, there has been an increase in awareness of social stigma and mental health issues experienced by transgender individuals in South Korea. To provide quantitative evidence, we conducted a nationwide cohort study of transgender adults, first of its kind in Asia. The aim of the study is to assess the prevalence of depressive and anxiety symptoms and examine their associations with discrimination experiences among transgender adults.
Methods
We conducted a two-wave longitudinal survey of 269 Korean transgender adults, where the baseline was collected in October 2020 and the follow-up in October 2021. Experiences of discrimination in the past 12 months at follow-up were categorized accordingly: those who experienced (1) none, (2) only anti-transgender discrimination, (3) only other types of discrimination, and (4) both anti-transgender and other types of discrimination. Depressive symptoms were measured using the Center for Epidemiologic Studies Depression scale at both waves and anxiety symptoms were measured using the Generalized Anxiety Disorder 7 only at follow-up. We used modified Poisson regression to examine the association between experiences of discrimination and mental health outcomes at follow-up and adjusted for sociodemographic characteristics and baseline depressive symptoms.
Results
A total of 63.9% had depressive symptoms and 47.2% had anxiety symptoms. Participants who experienced both anti-transgender and other types of discrimination had 1.38-times (95% CI 1.06–1.81) and 1.77-times (95% CI 1.16–2.70) higher prevalence of depressive and anxiety symptoms, respectively, compared to those without any experiences of discrimination.
Conclusions
Interventions to lessen discrimination towards transgender individuals are needed for the promotion of mental health among transgender individuals.
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Acknowledgements
The authors would like to thank research participants and the community experts of Rainbow Connection Project III—Korean Transgender Adult’s Health Panel Study for their contributions to the study.
Funding
Research reported in this publication was funded by the National Human Rights Council of Republic of Korea and the National Research Foundation of Republic of Korea, under project BK21 FOUR operated by the Center for Teaching and Learning of Korea University. The funders held no role in the development of this manuscript. The data of the study are not available.
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SC: funding acquisition, survey development, data curation, conceptualization, methodology, formal analysis, and writing—original draft. RYK: funding acquisition, survey development, and writing—review and editing. HL: funding acquisition, survey development, and writing—review and editing. HY: funding acquisition, survey development, and writing—review and editing. YJE: survey development and writing—review and editing. RK: writing—review and editing. SSK: funding acquisition, survey development, conceptualization, supervision, and writing—review and editing.
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Ethical approval
Korea University Institutional Review Board reviewed and approved study procedures, which were performed in accordance with ethical standards of the 1964 Helsinki Declaration and its later amendments. All participants provided informed consent for participation and academic use of their responses via online.
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Choo, S., Kim, R., Lee, H. et al. Associations between discrimination experiences and symptoms of depression and anxiety among transgender adults: a nationwide cohort study of 269 transgender adults in South Korea. Soc Psychiatry Psychiatr Epidemiol 59, 859–869 (2024). https://doi.org/10.1007/s00127-023-02554-5
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DOI: https://doi.org/10.1007/s00127-023-02554-5