• Sarah Ketchen Lipson, Julia Raifman, Sara Abelson, and Sari L Reisner.
• Department of Health Law Policy and Management, Boston University School of Public Health, Boston, Massachusetts. Electronic address: sklipson@bu.edu.
• Am J Prev Med. 2019 Sep 1; 57 (3): 293-301.

IntroductionThe purpose of this study was to examine mental health status by gender identity among undergraduate and graduate students.MethodsData came from the 2015-2017 Healthy Minds Study, a mobile survey of randomly selected students (N=65,213 at 71 U.S. campuses, including 1,237 gender minority [GM] students); data were analyzed in 2018. Outcomes were symptoms of depression, anxiety, eating disorders, self-injury, and suicidality based on widely used, clinically validated screening instruments. Bivariable and multivariable analyses explored differences between GM and cisgender (non-GM) students as well as by assigned sex at birth.ResultsAcross mental health measures, a significantly higher prevalence of symptoms was observed in GM students than cisgender students. Compared with 45% of cisgender students, 78% of GM students met the criteria for 1 or more of the aforementioned mental health outcomes. GM status was associated with 4.3 times higher odds of having at least 1 mental health problem (95% CI=3.61, 5.12).ConclusionsFindings from this largest campus-based study of its kind using representative data with both gender identity and mental health measures underscore the importance of recognizing and addressing GM mental health burdens, such as by screening for mental health and providing gender-affirming services. There is broad urgency to identify protective factors and reduce mental health inequities for this vulnerable population.Copyright © 2019 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.

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