Transgender people are more likely to experience discrimination, isolation and a lack of social support. This, along with negative psychosocial challenges, such as being denied access to gender-neutral restrooms, combined with being a student, and you have what associate professor of neurology Shelley Hershner MD calls “a storm perfect” which can contribute to sleep disorders and other mental health problems.
Hershner, who directs the University of Michigan Collegiate Sleep Disorders Clinic, studies sleep in college students, and now she and her colleagues are filling a gap in research on transgender people’s association with sleep and mood disorders. Their 2021 study found that transgender students significantly a higher likelihood of being diagnosed with insomnia, sleep and mood disorders, and suicidal behavior, compared to their cisgender – having a gender identity that matches the sex assigned to a person at birth – their peers.
The study was published in Nature and science of sleep, where Hershner and fellow authors analyzed self-reported data from 221,549 North American college students from The American College Health Association-National College Health Assessment II survey. This survey collects data on students’ health, behaviors and perceptions of health.
Of the 221,549 participants, 3,471 students identified as transgender in the United States and 717 in Canada. The study showed that, compared to cisgender students, transgender students were: 35% more likely to have insufficient sleep; 51% more likely to have trouble falling asleep; 41% more likely to feel sleepy during the day; and 245% more likely to be diagnosed or receive treatment for a sleep disorder.
Sleep quality can impact mood, school performance, quality of life, GPA and school retention, Hershner explained.
Students are already at significant risk for sleep and mood problems, and when you add the additional stress of being transgender, marginalization, discrimination, and exclusion, it compounds their risk. to succeed at a vulnerable time in their lives.”
Shelley Hershner MD, Associate Professor of Neurology, University of Michigan
The researchers also found that the risks of depression and anxiety among transgender students compared to cisgender peers were also significant. According to their study, transgender people are 295% more likely to be diagnosed with depression and 253% more likely to be diagnosed with anxiety.
Hershner’s research also confirmed previous studies that show transgender students have higher risks of suicide attempts and suicidal thoughts compared to cisgender students. Hershner reported that transgender students are 345% more likely to consider suicide and 421% more likely to attempt suicide.
For Hershner, the next steps are to find solutions and interventions to improve the sleep of transgender students. Future research is also needed to find out if gender-affirming therapy can improve mood and sleep disorders.
Just as important for further research? -; Advocacy.
Hershner wants to use this information and additional resources to advocate for gender-inclusive policies on college campuses.
Earlier this year, Michigan Medicine received a full score (100 points out of 100) on the Health Care Equality Index, a national LGBTQ+ benchmarking tool developed by the Human Rights Campaign that assesses practices and health system policies for LGBTQ+ patients, visitors and employees. .
Hershner praises the note as well as Michigan Medicine’s LGBTQ Health Advancement Advisory Committee, designed to help care for and provide support to LGBTQIA+ patients, families, and visitors. But her research indicates that more colleges and institutions need to act to help support transgender people.
“Students must be able to use the name they have chosen; they must be able to declare their pronouns in health systems to avoid gender errors. “Non-discrimination policies are critical, and each state is going to have to decide where things go from a legislative standpoint,” Hershner said.
Michigan Medicine – University of Michigan
Hershner, S. et al. (2022) Associations between transgender identity, sleep, mental health, and suicidality among a North American cohort of college students. Nature and science of sleep. doi.org/10.2147/NSS.S286131.