The Impact of Interruptions in Gender-Affirming Medical Care during COVID-19 on Anxiety and Depression among Trans and Non-binary People in Canada: A Longitudinal Study
Abstract
Background. Transgender and non-binary (TGNB) populations experience disproportionally high levels of anxiety and depression; it is imperative we investigate how the COVID-19 pandemic may have impacted the mental health of TGNB communities. Methods. Among a Canadian sample of TGNB persons aged >=15 years, we used multiple linear regression to examine whether interruptions in gender-affirming care were associated with anxiety and depression, and whether that effect was modified by pre-pandemic mental health. Results. Anxiety and depression levels were high both pre-pandemic and during the pandemic. Approximately a quarter of TGNB persons experienced interruptions in hormonal care. After adjusting for confounders, there was no association between interruptions in gender-affirming care and anxiety. However, interruptions in hormonal care was associated with increased depressive symptoms during the pandemic, and this effect was modified by pre-pandemic depression. Conclusion. Interruptions in hormonal care may have increased depressive symptoms in an already highly-depressed group of TGNB persons.