Neuropsychiatric Disorders Among Individuals Seeking Transgender Care in the Texas Panhandle: A Cross-Sectional Study

Abstract

Abstract

Background:  Psychiatric disorders are commonly encountered among individuals with gender dysphoria.  Transgender patients are a historically marginalized population and knowledge about neuropsychiatric morbidity in rural populations of transgender individuals is limited.

Objective: Identify neuropsychiatric diagnoses and use of psychotropic medications among transgender individuals referred to a university-based transgender

care clinic serving a largely rural population.

Methods:  A retrospective cross-sectional chart review was performed on transgender patients presenting for endocrine therapy at a single academic institution between 2009 and 2023.  A total of 102 charts were included.  Data pertaining to neuropsychiatric diagnoses and treatments form mental health professionals, primary care physicians, and medical specialists were recorded and analyzed.  This is a sub-study from a broader analysis.

Findings: Neuropsychiatric conditions were found in 60.8% of the transgender population and use of psychotropic medication utilization was 56.9%.  A total of 35.3% received more than one medication.  Psychiatric conditions in this transgender population exceeded general population estimates in the US by over two-fold.  No differences were found between transmen and transwomen.

Conclusions:  Mental health disorders and use of prescription psychotropic medications are frequently encountered among the transgender population in the Texas Panhandle and closely approximates levels described in the international literature.  Mental health practitioners and primary physicians should be aware of higher incidence of neuropsychiatric conditions in rural transgender populations.

Abbreviations:  Transgender (TG), gender dysphoria (GD), Texas Tech University Health Sciences Center School of Medicine at Amarillo, Texas (TTUHSC-Amarillo), World Professional Association of Transgender Health (WPATH), American Society for Reproductive Medicine (ASRM), Diagnostic and Statistical Manual of Mental Disorders V-Text Revision (DSM-V-TR), major depressive disorder (MDD), post-traumatic stress disorder (PTSD), generalized anxiety disorder (GAD).