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Mental Health and Protective Factors for Transgender and Gender-Diverse Youths Who Trade Sex: A Minnesota Statewide
G Nic Rider1, Barbara J McMorris1, Camille Brown1
1G. Nic Rider (they/them) is with the Institute for Sexual and Gender Health, Department of Family Medicine and Community Health, University of Minnesota Medical School, Minneapolis. Barbara J. McMorris (she/her), Camille Brown (she/her), Montana Filoteo (they/them), Emily Singerhouse (she/her), and Lauren Martin (she/her) are with the School of Nursing, University of Minnesota, Minneapolis. Marla E. Eisenberg (she/her) and Amy L. Gower (she/her) are with the Division of General Pediatrics and Adolescent Health, Department of Pediatrics, University of Minnesota, Minneapolis. Katie Johnston-Goodstar (she/they) is with the School of Social Work, University of Minnesota, St. Paul.
Abstract:
Objectives. To describe the prevalence of sex trading by gender and by associations with mental health concerns and protective factors. Methods. We used data from 9th and 11th graders who completed the 2019 Minnesota Student Survey. The analytic sample (n = 67 806) included transgender and gender-diverse (TGD) youths and cisgender youths who reported trading sex. Data on 7 mental health measures and 4 school-related and health care-related protective factors were collected. Results. The prevalence of sex trading (5.9%) was 5 times higher among TGD students than cisgender students (1.2%). In addition, the prevalence of all mental health concerns was high among TGD students who traded sex (e.g., 75.9% reported a lifetime suicide attempt, as compared with 45.9% of cisgender students who traded sex). Fewer statistical differences were found across protective factors. When TGD students who traded sex were compared according to sex assigned at birth, no statistically significant differences were found. Conclusions. Our findings support strong calls for increased competence regarding gender and sex trading or exploitation in clinical and school-based settings to decrease health disparities among TGD youths. Public Health Implications. In this study, we have presented unique prevalence estimates of mental health disparities among TGD students in the United States who trade sex. Our results indicate that TGD students who trade sex are at risk for mental health symptoms and that sensitivity to both gender and sex trading or exploitation will be critical to meeting the needs of this group in clinical as well as school-based settings.
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