Behavioral Health Diagnoses in Youth With Gender Dysphoria Compared with Controls: A PEDSnet Study.

TitleBehavioral Health Diagnoses in Youth With Gender Dysphoria Compared with Controls: A PEDSnet Study.
Publication TypeJournal Article
Year of Publication2021
AuthorsNunes-Moreno M, Buchanan C, F Cole S, Davis S, Dempsey A, Dowshen N, Furniss A, Kazak AE, Kerlek AJ, Margolis P, Pyle L, Razzaghi H, Reirden DH, Schwartz B, Sequeira GM, Nokoff NJ
JournalJ Pediatr
Date Published2021 Sep 24
ISSN1097-6833
Abstract

OBJECTIVE: To assess the odds of a psychiatric or neurodevelopmental diagnosis among youth with a diagnosis of gender dysphoria compared with matched controls in a large electronic health record dataset from six pediatric health systems, PEDSnet. We hypothesized that youth with gender dysphoria would have higher odds of having psychiatric and neurodevelopmental diagnoses than controls.

STUDY DESIGN: All youth with a diagnosis of gender dysphoria (n=4,173 age at last visit 16.2 + 3.4) and at least one outpatient encounter were extracted from the PEDSnet database and propensity-score matched on 8 variables to controls without gender dysphoria (n=16,648, age at last visit 16.2 + 4.8) using multivariable logistic regression. The odds of having psychiatric and neurodevelopmental diagnoses were examined using generalized estimating equations.

RESULTS: Youth with gender dysphoria had higher odds of psychiatric (OR: 4.0 [95% CI: 3.8, 4.3] P < .0001) and neurodevelopmental diagnoses (1.9 [1.7, 2.0], p<0.0001). Youth with gender dysphoria were more likely to have a diagnosis across all psychiatric disorder sub-categories, with particularly high odds of mood disorder (7.3 [6.8, 7.9], p<0.0001) and anxiety (5.5 [5.1, 5.9], p<0.0001). Youth with gender dysphoria had a greater odds of autism spectrum disorder (2.6, [2.2, 3.0], p<0.0001).

CONCLUSIONS: Youth with gender dysphoria at large pediatric health systems have greater odds of psychiatric and several neurodevelopmental diagnoses compared with youth without gender dysphoria. Further studies are needed to evaluate changes in mental health over time with access to gender affirming care.

DOI10.1016/j.jpeds.2021.09.032
Alternate JournalJ Pediatr
PubMed ID34571022