medwireNews: Suicidality or self-harm is a frequent cause of hospital admission among gender variant/diverse young people, report researchers.
The study, which is published in The Lancet Child & Adolescent Health, used data from the 2016 and 2019 releases of the US all-payer Kids’ Inpatient Database. Each release provided data from over 3 million children and young people aged 6–20 years, including 1755 in 2016 and 4872 in 2019 who had an International Classification of Diseases (ICD)-10 code related to gender dysphoria.
These figures equated to rates of 0.16% in 2016 and 0.48% in 2019, an increase that Nadir Yehya (Children’s Hospital of Philadelphia, Pennsylvania, USA) and study co-authors say “probably reflect[s] changes in attitudes and approaches to gender diversity in and out of hospital settings.”
And they stress that the actual rates of hospitalised young people who identify as something other than their birth-assigned gender are probably higher than reported, “given that some do not share their gender identity, might not have gender dysphoria, and, among those that do have gender dysphoria, might not be assigned a corresponding administrative code.”
Of note, young people with gender dysphoria-related ICD-10 codes were significantly more likely than those without to be White (71 vs 45% in the 2019 cohort), to have private healthcare insurance (54 vs 41%) and to live in more affluent areas. By contrast, these young people were significantly underrepresented in southern USA states and rural hospitals.
The data imply “inequities in access to gender-affirming care among racial minority and economically disadvantaged young people” and also “raise concerns about discrimination within and outside of health-care settings”, say the researchers.
The prevalence of suicidality ICD-10 codes among study participants with gender dysphoria codes was 36% in 2016 and 55% in 2019, compared with a corresponding 5% and 4% of those without a dysphoria code. These differences equated to significant 5.02- and 4.14-fold increases among gender variant young people in 2016 and 2019, respectively, after accounting for confounders.
Likewise, the presence of a gender dysphoria-linked code was associated with significant 3.64-fold and 3.75-fold increases in self-harm codes in the 2016 and 2019 cohorts, respectively.
“[A]s the present data suggest, a substantial portion of inpatient paediatric encounters with transgender and non-binary young people, particularly those with gender dysphoria, are likely to involve suicidality or self-harm”, conclude Yehya and team.
“Thus, inpatient practitioners are in a unique position to provide appropriate care in an affirming environment, and to provide access to crucial gender-affirming services and treatment.”
By Eleanor McDermid
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