Clinical trial NCT02119377: First Australian National Trans Mental Health Study
Official title: A Mixed-Methods Study of Mental Health and Associated Factors in Transgender and Transsexual (Trans) People
Study type: OBSERVATIONAL
Overall status: COMPLETED
Conditions: Transsexualism
Keywords: trans
transsexual
transgender
sistergirl
brotherboy
androgynous
genderqueer
Lead sponsor: Curtin University
Sponsor class: OTHER
Collaborators: name: Beyondblue (The National Depression Initiative)
First posted: 2014-04-21
Enrollment: 946
Sex: ALL
Minimum age (years): 18
Standard ages: ADULT
OLDER_ADULT
Accepts healthy volunteers: yes
Observational model: CASE_ONLY
Time perspective: CROSS_SECTIONAL
Sampling method: NON_PROBABILITY_SAMPLE
Study population: This is a study of trans people living in Australia aged 18 years or older. The investigators used the term trans in an inclusive way, and included people who use (or used) words like transsexual, transgender, sistergirl, brotherboy, androgynous, or genderqueer to describe themselves. All trans people, including those who just describe themselves as men or women were encouraged to participate.

Brief summary: This is an Internet-based survey of transgender and transsexual (trans) people aged 18 years and older living in Australia. This population has received limited attention from public health researchers, planners, and practitioners. However, a growing body of evidence suggests that trans people experience disparities in several important areas of health compared with the population generally. In particular, trans people are more likely to experience mental health problems (notably depression and anxiety disorders), use alcohol, tobacco, and illicit drugs, and think about or attempt suicide. Additionally, trans people commonly report that their physical and mental health needs are not met, and underutilise preventive health care.

Participants were recruited using several non-probability sampling techniques, (including purposive sampling and snowball sampling), because random sampling is not possible with this population. Medical, social, support, and advocacy networks used by trans people were used to promote the study. A mixed quantitative and qualitative methodology was used. Validated quantitative instruments were used to obtain measures of health and well-being, which will be compared against population norms. Qualitative items complement these measures, providing rich experiential data.

The investigators hypothesised that:

* the prevalence of depressive and anxiety disorders will be higher than for the population generally, and that these conditions will commonly be undiagnosed and untreated;
* depressive and anxiety disorders will be associated with risky behaviours, such as tobacco, alcohol, and illicit drug use; and,
* trans people will report poor relationships with medical practitioners.

The investigators hypothesised that poor mental health is a consequence of several interrelated factors: body dysphoria (as a consequence of experiencing difficulty accessing medical treatment to alter sexual characteristics); societal discrimination and stigma (including harassment and violence); institutionalised discrimination (including difficulty changing identifying documents, and exclusion of surgical procedures and related treatments from public and private health systems); social isolation; and the belief held by many clinicians that transsexualism is a mental disorder (which may be a barrier to trans people forming trusting relationships with medical practitioners).


Eligibility criteria: Inclusion Criteria:

* Live in Australia
* Self-identify as trans

Exclusion Criteria:

* Aged less than 18 years

Primary outcomes:
measure: Prevalence of depressive and anxiety disorders
timeFrame: At time of entry into study (cross-sectional)
measure: Perceived physical and mental health status
timeFrame: At time of entry into study (cross-sectional)
Secondary outcomes:
measure: Use of alcohol, tobacco, and illicit drugs
timeFrame: At time of entry into study (cross-sectional)
measure: Patient-doctor relationship between trans people and their general practitioners, and doctors generally
timeFrame: At time of entry into study (cross-sectional)
measure: Body image
timeFrame: At time of entry into study (cross-sectional)
measure: Factors that encourage and discourage trans people from accessing health care
timeFrame: At time of entry into study (cross-sectional)
measure: Factors that protect and promote mental health in trans people
timeFrame: At time of entry into study (cross-sectional)
measure: Use of hormone therapy and desire for, and uptake of transition-related surgery
timeFrame: At time of entry into study (cross-sectional)
measure: Experiences of discrimination and harassment
timeFrame: At time of entry into study (cross-sectional)
measure: Desire to, and success changing identifying documentation
timeFrame: At time of entry into study (cross-sectional)
Other outcomes:
Locations:
city: Perth
country: Australia
facility: Curtin University
state: Western Australia
Study officials:
affiliation: Curtin University
name: Zoë Hyde, MPH PhD
role: PRINCIPAL_INVESTIGATOR
affiliation: Curtin University
name: Maryanne Doherty, MSc PhD
role: PRINCIPAL_INVESTIGATOR
affiliation: Curtin University
name: Peter Tilley, MPsych
role: PRINCIPAL_INVESTIGATOR
affiliation: The University of Western Australia
name: Kieran A. McCaul, MPH PhD
role: PRINCIPAL_INVESTIGATOR
affiliation: Curtin University
name: Rosanna Rooney, MPsych PhD
role: PRINCIPAL_INVESTIGATOR
affiliation: Curtin University
name: Jonine Jancey, PhD
role: PRINCIPAL_INVESTIGATOR
References: