使用自選名字與跨性別青少年較少憂鬱相關——但只有74名青少年，且只在一個時間點測量

使用自選名字與跨性別青少年憂鬱症狀、自殺意念和自殺行為的減少有關

Authors: Stephen T. Russell, Amanda M. Pollitt, Gu Li, Arnold H. Grossman
Journal: Journal of Adolescent Health
Year: 2018
Source: https://doi.org/10.1016/j.jadohealth.2018.02.003

Summary

Researchers used survey answers from 129 trans and gender-nonconforming young people (ages 15 to 21) found through LGBTQ community groups in three US cities. Among the 74 who had picked a new name, those who could use it in more places (home, school, work and with friends) reported less depression and less suicidal thinking and behaviour, even after accounting for social support. The authors concluded that using a chosen name reduces mental health risk. That is plausible, but the study cannot show cause and effect. Everything was measured once, by self-report, in a small community group, and young people with better mental health or more supportive surroundings may simply find it easier to use their chosen name. Hormones and blockers were not measured. The Cass Review's evidence review rated the evidence on social transition, including this study, as low quality.

Key findings

這項分析納入 74 名有自選名字的跨性別年輕人（15 至 21 歲），他們來自一項較大的 LGBTQ 青少年研究中的 129 名跨性別與不符合性別規範者。
他們是在 2011–2012 年透過美國三個城市的 LGBTQ 社群團體和大學團體找到的，並非為了代表所有跨性別青少年而選擇。
可以使用自選名字的場合每多一個，在標準問卷上憂鬱分數就約低 5 分。
在考慮背景和整體社會支持後，每多一個場合，自殺想法約減少 29%，自殺行為約減少 56%。
平均而言，年輕人可以在 4 個場合中的約 3 個使用自選名字；在每個地方都能使用的人，症狀最低。
在考慮親近朋友的支持後，單單與朋友使用該名字，與心理健康並沒有明顯的關聯。
作者將這種關聯描述為因果關係（「降低心理健康風險」），儘管所有東西都是在同一個時間點衡量的。

Abstract

PURPOSE: This study aimed to examine the relation between chosen name use, as a proxy for youths' gender affirmation in various contexts, and mental health among transgender youth. METHODS: Data come from a community cohort sample of 129 transgender and gender nonconforming youth from three U.S. cities. We assessed chosen name use across multiple contexts and examined its association with depression, suicidal ideation, and suicidal behavior. RESULTS: After adjusting for personal characteristics and social support, chosen name use in more contexts was associated with lower depression, suicidal ideation, and suicidal behavior. Depression, suicidal ideation, and suicidal behavior were lowest when chosen names could be used in all four contexts. CONCLUSION: For transgender youth who choose a name different from the one given at birth, use of their chosen name in multiple contexts affirms their gender identity and reduces mental health risks known to be high in this group.

Conclusion

For transgender youth who choose a name different from the one given at birth, use of their chosen name in multiple contexts affirms their gender identity and reduces mental health risks known to be high in this group. The authors argue that schools, workplaces, healthcare providers and other institutions should allow chosen names in records and IDs, and that peers, parents and teachers can support transgender youth's mental health by using their chosen names.

Methodological limitations

Measured once: Although the people came from a larger long-term study, this analysis uses data from one point in time. So it cannot show that name use came first, or caused better mental health.
Cause may run the other way: Young people who are less depressed, more confident or in more accepting settings may find it easier to use a chosen name. The direction of the link cannot be told.
Small group: Only 74 young people were analysed, with 5 to 28 people in many subgroups. Some results were unreliable (for example, impossible-looking results for the six Asian young people).
Not a representative group: People were found through LGBTQ community groups and college groups in three cities, so results may not apply to youth referred to clinics or less connected youth.
All self-reported: Depression, suicidal thoughts and acts, support and name use were all reported by the same person in the same survey, which can make links look stronger than they are.
Rough measure of name use: Name use was a count of yes/no answers to whether they could go by their name in four settings, with nothing on how often, how long or by whom. The average was about 3 of 4, leaving little variation.
Other factors not accounted for: The study accounted for overall support but not parents' acceptance specifically, past mental illness, past therapy, bullying or abuse, or hormones and blockers. A commentary in the same journal noted these could explain the link.
Claims go beyond the data: The summary says chosen name use 'reduces' mental health risk, which a one-time survey showing a link cannot prove.
Old and narrow group: Data were collected in 2011–2012, before the sharp rise in gender clinic referrals and the shift toward mostly teenage girls being referred today.
Rated low quality: The Cass Review's evidence review of social transition (Hall and colleagues, 2024) included this study and judged the evidence limited and low quality, mostly one-time surveys of unrepresentative groups.

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Summary

Key findings

Abstract

Conclusion