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State-level gender-affirming healthcare policy and depressive symptoms among LGBTQ+ youth

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  • Houghtaling, Laura M.
  • Eisenberg, Marla E.
  • Henning-Smith, Carrie
  • Nelson, Toben
  • Osypuk, Theresa L.

Abstract

U.S. states vary in their level of support and protection for transgender and gender diverse youth. Few studies have examined associations between state-level policy affecting access to gender-affirming healthcare (GAC) and mental health among these youth. This study examines the association between the GAC Index, a composite index that includes four state-level policies affecting access to GAC, and individual-level depressive symptoms in a national sample of LGBTQ + adolescents (N = 10,513) cross-sectionally in 2017. Multilevel linear regression models adjusted for individual and state-level demographic and socioeconomic covariates suggest that better access to gender-affirming healthcare (a higher score on the GAC Index) is associated with a lower frequency of depressive symptoms among gender diverse youth but not transgender youth or cisgender LGBQ+ youth. This research contributes to the understanding of the association between state policy environment and mental health for transgender and gender diverse youth.

Suggested Citation

  • Houghtaling, Laura M. & Eisenberg, Marla E. & Henning-Smith, Carrie & Nelson, Toben & Osypuk, Theresa L., 2025. "State-level gender-affirming healthcare policy and depressive symptoms among LGBTQ+ youth," Social Science & Medicine, Elsevier, vol. 364(C).
    • Handle: RePEc:eee:socmed:v:364:y:2025:i:c:s0277953624009870
    DOI: 10.1016/j.socscimed.2024.117533
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    References listed on IDEAS

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    1. White Hughto, Jaclyn M. & Reisner, Sari L. & Pachankis, John E., 2015. "Transgender stigma and health: A critical review of stigma determinants, mechanisms, and interventions," Social Science & Medicine, Elsevier, vol. 147(C), pages 222-231.
    2. Cruz, Taylor M., 2014. "Assessing access to care for transgender and gender nonconforming people: A consideration of diversity in combating discrimination," Social Science & Medicine, Elsevier, vol. 110(C), pages 65-73.
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