Non-binary and binary transgender youth:Comparison of mental health, self-harm, suicidality, substance use and victimization experiences

Background: Little research has compared the mental health and victimisation experiences of nonbinary youth depending on their sex assigned at birth (SAAB), or compared these two groups with binary transgender youth.Aims: To compare mental health, self-harm and suicidality, substance use and victimisation experiences between nonbinary and binary transgender young adults, both male assigned at birth (MAAB) and female assigned at birth (FAAB). Methods: Online survey data from 677 participants from the ‘Youth Chances’ community study of 16 to 25 year-olds in the United Kingdom was analysed, comparing across binary participants (transgender females (n=105) and transgender males (n=210)) and nonbinary participants (MAAB (n=93) and FAAB (n=269)).Results: Female SAAB participants (binary and nonbinary) were more likely to report a current mental health condition and history of self-harm than male SAAB participants (binary and nonbinary). Similarly, female SAAB participants (binary and nonbinary) were more likely to report childhood sexual abuse than male SAAB participants (binary and nonbinary); the reverse pattern was found for lifetime physical assault relating to being LGBTQ. Nonbinary MAAB participants were less likely than the other groups to report past suicide attempts and previous help-seeking for depression / anxiety. Binary participants reported lower life satisfaction than nonbinary participants. For all four groups, mental health problems, self-harm, suicidality, alcohol use and victimisation experiences were generally higher than that of youth in general population studies.Conclusions: These findings highlight the importance of considering both nonbinary versus binary gender identity and sex assigned at birth in relation to mental health problems, self-harm, suicidality and substance use in transgender youth. The roles of sexual abuse, other abuse and discrimination in contributing to increased rates of mental illness and self-harm in nonbinary and binary transgender individuals, particularly those who were assigned female at birth, relative to those assigned male, require investigation