Study Examines Relationships between Mental Health, Bullying, and Social Support among Transgender and Gender-Diverse Adolescents
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Poor mental health can have serious effects on all areas of life, ranging from employment and education to symptoms of anxiety, depression, and suicidality. In particular, transgender and gender-diverse (TGD) adolescents are disproportionately affected, with TGD adolescents nearly 5 times more likely to attempt suicide and nearly twice as likely to experience depressive symptoms than their cisgender peers.
However, while an increasing amount of research on mental health and gender-diverse identities among adolescents and young adults exists, there remains a noticeable gap in knowledge of the relationships between mental health outcomes and related risk factors.
A recent study appearing in Discover Mental Health aims to close that gap. Led by Abigail Grimm ’24 as part of her senior honor’s thesis at UMass Amherst (see related story here), and co-authored by Assistant Professor Krystal Kittle and Professor Elizabeth Bertone-Johnson, the study examines the associations between bullying, social support, and mental health among transgender and gender‑diverse adolescents.
“While many studies have addressed mental health, bullying, and social support among LGBTQ+ adolescent populations, few have differentiated the experience of TGD individuals. The differentiation between sexual and gender minorities is critical, particularly as current policy agendas seek to erase the existence and experience of transgender and gender diverse individuals,” notes Grimm, a public health sciences graduate and registered nurse who will enter the nurse practitioner program at the Yale School of Nursing in 2026.
The researchers conducted a cross-sectional analysis of data collected via student health surveys administered by the Communities that Care Coalition of Western Massachusetts in 2023 to more than 1400 high-school students in Franklin County, Massachusetts. Across these youth, 1,240 (89.0%) identified as cisgender and 153 (11.0%) identified as transgender, nonbinary, genderfluid, genderqueer, something else, or were unsure of their gender identity.
When asked about bullying and victimization, 55.6% of TGD respondents reported having been bullied in the last year, including electronically (compared to 34.8% of cisgender peers); 9.2% reported having been physically threatened or injured on school property in the last year (compared to 6.8%), and 14.4% reported missing school due to feeling unsafe in the last year (compared to 6.6%).
In general, TGD respondents reported less social support than their cisgender peers. Among TGD respondents, 49.7% of respondents reported at least one trusted adult at school (compared to 53.3% of cisgender peers); 55.6% reported at least one trusted adult at home (compared to 70.4%), and 69.9% reported the presence of adults in the community that cared about them (compared to 76.0%).
TGD adolescents without a trusted adult at home were 12.4 times more likely than cisgender adolescents with a trusted adult at home to experience at least one poor mental health outcome. This odds ratio was significantly higher than the odds ratio of TGD adolescents with a trusted adult at home (4.8x) and cisgender adolescents without a trusted adult at home (3.5x). This increased risk was consistent across all mental health outcomes.
“Throughout our analysis, TGD respondents reported significantly higher rates of mental health disorders compared with cisgender peers, including depression, anxiety, suicidal ideation, suicide planning, suicide attempts, and non-suicidal self-injury,” the researchers write. “They also reported lower levels of social support and higher rates of bullying and victimization.”
The researchers propose a number of interventions to address victimization and social support may help reduce these outcomes among transgender and gender-diverse youth. They note that school-based interventions such as those designed to combat transphobia and harassment may be effective in addressing high rates of bullying, and thus positively impact the disproportionately high rates of mental health disorders among TGD adolescents. They also recommend providing social support early and often for TGD adolescents, including mental health intervention, and expansion of education curriculums to include transgender and gender diverse characters, stories, and history to reduce transphobia and related stigma. Family-based interventions to support parents and guardians of TGD youth and adolescents may also be successful in increasing social support.
They conclude with a call for additional research to identify interventions that would be successful in reducing victimization and increasing social support among TGD youth and adolescents.