Transgender people are more likely to experience discrimination, isolation and lack of social support. This, coupled with negative psychosocial challenges like being denied access to gender-neutral restrooms, combined with being a college student, and you have what associate professor of neurology Shelley Hershner MD calls “a perfect storm” that can contribute to sleep. disorders and other mental health problems.
Hershner, who directs the University of Michigan Collegiate Sleep Disorders Clinic, studies sleep among college students, and now she and her colleagues are filling a research gap on the association of transgender people with sleep disorders. and mood. Her 2021 study found that transgender college students have significantly higher odds of being diagnosed with insomnia, sleep and mood disorders, and suicidal behavior, compared to their cisgender peers (who have a gender identity that aligns with the sex a person was assigned at birth).
The study was published in Nature and science of sleep, where Hershner et al 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 student data on health, health behaviors, and perceptions.
Of the 221,549 participants, 3,471 students reported identifying as transgender in the US and 717 in Canada. The study showed that compared to cisgender students, transgender college students were: 35% more likely to not get enough sleep; 51% more likely to have difficulty falling asleep; 41% more likely to feel sleepy during the day; and 245% more likely to be diagnosed or treated for a sleep disorder.
Sleep quality can affect mood, academic performance, quality of life, GPA and school retention, Hershner explained.
College 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 worsens your risk of succeeding at a vulnerable time in your life.”
Shelley Hershner MD, Associate Professor of Neurology, University of Michigan
The researchers also found that the odds of depression and anxiety among transgender students compared to their cisgender peers were also significant. According to their study, transgender people are 295% more likely to have a diagnosis of depression and 253% more likely to have a diagnosis of anxiety.
Hershner’s research also confirmed previous studies showing that transgender students are more likely to attempt suicide and have suicidal thoughts compared to cisgender students. Hershner reported that transgender college students are 345% more likely to consider suicide and 421% more likely to attempt it.
For Hershner, the next steps include finding solutions and interventions to improve sleep among transgender college students. Future research is also needed on whether gender-affirming therapy can improve mood and sleep disorders.
Just as important for further investigation?-; Advocacy.
Hershner wants to use this additional information and 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 Equity Index, a national LGBTQ+ benchmarking tool developed by the Human Rights Campaign that assesses the practices and policies of health care systems. for LGBTQ+ patients, visitors and employees. .
Hershner commends the rating along with the Advisory Committee for the Advancement of LGBTQ Health at Michigan Medicine, designed to help care for and support LGBTQIA+ patients, families and visitors. But her research indicates that more universities and institutions need to act to help transgender people.
“Students should be able to use the name they chose; they should be able to declare their pronouns in health systems to avoid gender confusion. There should also be gender-inclusive bathrooms and gender-inclusive housing so roommates aren’t just chosen for legal sex.”Nondiscrimination policies are crucial, and each state will have to decide where things go from the legislature’s standpoint,” Hershner said.
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Magazine reference:
Hershner, S. et al. (2022). Associations between transgender identity, sleep, mental health, and suicide among a North American cohort of college students. Nature and science of sleep. doi.org/10.2147/NSS.S286131.
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