How Childhood Maltreatment Contributes to Explaining Depressive Symptoms in Transgender and Gender-Diverse Individuals

TL;DR

Transgender and gender-diverse individuals experience more childhood trauma and depression than cisgender people, with emotional abuse being a key factor linking gender identity to depressive symptoms.

Contribution

This study identifies emotional abuse as a primary mediator between gender identity and depression in transgender and gender-diverse individuals.

Findings

TGD individuals reported significantly higher levels of childhood trauma and depression than cisgender individuals.

Emotional abuse was the strongest mediator of the link between gender identity and depressive symptoms.

Trauma-informed and gender-affirming mental health care is essential for TGD populations.

Abstract

What are the main findings?
Transgender and gender-diverse (TGD) individuals scored significantly higher in retrospectively assessed childhood trauma experiences and current depression symptoms than a sample of cisgender participants.Childhood trauma, especially emotional and sexual abuse, mediates the relationship between transgender and gender-diverse individuals and depression symptoms.

Transgender and gender-diverse (TGD) individuals scored significantly higher in retrospectively assessed childhood trauma experiences and current depression symptoms than a sample of cisgender participants.

Childhood trauma, especially emotional and sexual abuse, mediates the relationship between transgender and gender-diverse individuals and depression symptoms.

What are the implications of the main findings?
When diagnosing depression in gender minority populations, it is crucial to consider childhood trauma.Intervention and preventive programs should be designed to improve the well-being of transgender people and those with diverse gender identities, and to support their families.

When diagnosing depression in gender minority populations, it is crucial to consider childhood trauma.

Intervention and preventive programs should be designed to improve the well-being of transgender people and those with diverse gender identities, and to support their families.

Background/Objectives: Transgender and gender-diverse (TGD) individuals experience disproportionately high rates of childhood trauma and depression; however, the mechanisms linking gender identity and depressive symptoms remain insufficiently understood. This study examines differences in depressive symptoms and childhood trauma between cisgender (CG) and TGD adults. It investigates whether specific subtypes of childhood maltreatment mediate the association between gender identity and depression. Methods: The cross-sectional online study included 249 participants aged 18–72 years (M = 30.85, SD = 12.72), including 144 CG (75 women and 69 men) and 105 TGD individuals (44 transgender and 61 gender diverse individuals). Depression symptoms were assessed using the nine-item Patient Health Questionnaire (PHQ-9), while childhood trauma experiences were measured using the Childhood Trauma Questionnaire–Short Form (CTQ-SF). Results: The independent-sample Student’s t-test showed that TGD participants reported significantly higher levels of depressive symptoms and all forms of childhood trauma than cisgender individuals. Mediation analyses indicated that overall childhood trauma partially mediated the association between gender identity and depression. In parallel mediation models, emotional abuse emerged as the primary statistical mediator, with sexual abuse showing a smaller indirect effect. Conclusions: The findings extend prior prevalence-focused research by identifying specific childhood trauma pathways associated with depressive symptoms in TGD adults. Experiencing traumatic events during childhood may be a key factor contributing to an increased risk of depression in adulthood, particularly among the TGD population. Therefore, intervention and prevention programs should target TGD individuals and their families to minimize the risk of adverse childhood experiences and mental health disorders. The results underscore the importance of trauma-informed and gender-affirming mental health care and highlight emotional abuse as a particularly salient correlate of depression in this population.

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