Mental Health Utilization Among Transgender Veterans

Published in the journal JAMA Network Open. Here is a link to the article.

Regenstrief Institute authors: Jennifer Carnahan, M.D., MPH and Michael Weiner, M.D., MPH

This cohort study examined mental health care utilization among transgender and gender-diverse (TGD) veterans with depression, compared to cisgender (CG) veterans. Using U.S. Department of Veterans Affairs electronic health records from 2018 to 2020, researchers matched 2,643 TGD veterans with 7,921 CG veterans by age group and VA facility. TGD identity was determined by a gender identity disorder diagnosis. The study measured mental health care utilization, including outpatient, telehealth, emergency department, and inpatient visits. TGD veterans had significantly more specialty mental health visits than CG veterans—averaging 13.93 visits per year versus 8.46. Adjusted logistic regression showed that TGD veterans were 2.6 times more likely to have an outpatient mental health visit. These findings suggest that TGD veterans with depression use mental health services more frequently than their CG counterparts, indicating that different or expanded health system resources may be needed to address the needs of TGD individuals. Further research is needed to understand and address the causes of these disparities.

Authors

Joy L. Lee, PhD, M.S. ^1,2,3,4; Adam Hirsh, PhD ⁵; Archana Radhakrishnan, M.D., MHS ^6,7; Guneet K. Jasuja, PhD, MPH ^2,8,9; Stanley Taylor, M.A. ¹; Stephanie Dickinson, M.S. ¹⁰; Jocelyn Mineo, M.S. ¹⁰; Jennifer Carnahan, M.D., MPH ^1,4,11; Michael Weiner, M.D., MPH ^1,4,11

Author Affiliations

¹VA Center for Health Information and Communication, US Department of Veterans Affairs, Veterans Health Administration, Health Systems Research CIN 13-416, Richard L. Roudebush VA Medical Center, Indianapolis, Indiana

²VA Center for Healthcare Optimization and Implementation Research, US Department of Veterans Affairs, Veterans Health Administration, VA Bedford Healthcare System, Bedford, Massachusetts

³Department of Population and Quantitative Health Sciences, UMass Chan Medical School, Worcester, Massachusetts

⁴The Regenstrief Institute, Inc, Indianapolis, Indiana

⁵Department of Psychology, Indiana University Indianapolis, Indianapolis

⁶Department of Internal Medicine, University of Michigan, Ann Arbor

⁷VA Center for Clinical Management Research, VA Ann Arbor Healthcare System, Ann Arbor, Michigan

⁸Section of General Internal Medicine, Boston University Chobanian and Avedisian School of Medicine, Boston, Massachusetts

⁹Department of Health Law, Policy and Management, School of Public Health, Boston University, Boston, Massachusetts

¹⁰Department of Epidemiology and Biostatistics, School of Public Health, Indiana University Bloomington, Bloomington

¹¹Department of Medicine, Indiana University School of Medicine, Indianapolis