Impact of Bathroom Discrimination on Mental Health Among Transgender and Nonbinary Youth

Purpose: Nascent research has found that transgender and/or nonbinary (TGNB) youths experience higher rates of poor mental health outcomes than cisgender youths. The minority stress model highlights experiences of rejection and discrimination on mental health disparities for TGNB individuals. Methods: Using data from a quantitative cross-sectional survey of TGNB youth aged 13-24 years, we examined the association between experiencing bathroom discrimination and depressive mood, seriously considering suicide, and attempting suicide. Results: Overall, 58% of TGNB youths in this sample reported being prevented or discouraged from using a bathroom that corresponds to their gender identity. Among the TGNB youth who experienced bathroom discrimination, 85% reported depressive mood and 60% seriously considered suicide. Furthermore, 1 in three TGNB youths who experienced bathroom discrimination reported a past-year suicide attempt, with 1 in five reporting multiple suicide attempts. After adjusting for demographic variables and general discrimination due to one's gender identity, bathroom discrimination significantly increased the odds of reporting depressive mood (adjusted odds ratio [aOR] = 1.34), seriously considering suicide (aOR = 1.40), a suicide attempt (aOR = 1.66), and multiple suicide attempts (aOR = 1.71). Conclusions: These findings suggest that preventing TGNB youths from accessing appropriate bathrooms is associated with harmful mental health indicators. Addressing the suicide disparities for TGNB youths requires structural change. Policies and procedures need to be in place to ensure that all youths have equal access to appropriate bathrooms. (C) 2020 Society for Adolescent Health and Medicine. All rights reserved.