Mental Health Utilization Among Transgender Veterans.

Area of Science:

• Health Services Research
• Mental Health
• Health Disparities

Background:

• Transgender and gender-diverse (TGD) individuals face significant social and economic disparities, often leading to adverse mental health outcomes.
• Understanding barriers to care and the causes of these disparities is crucial for improving future healthcare.
• Veterans represent a unique population within the TGD community, potentially facing distinct challenges in accessing care.

Purpose of the Study:

• To characterize and compare mental health care utilization between TGD and cisgender (CG) veterans diagnosed with depression.
• To identify differences in the frequency and type of mental health services accessed by TGD veterans compared to their CG counterparts.

Main Methods:

• A nationwide cohort study utilizing electronic health records from the US Department of Veterans Affairs (VA) from 2018 to 2020.
• A 1:3 age and VA facility-matched cohort of TGD and CG veterans with depression was created.
• Mental health care utilization (outpatient, telehealth, emergency, inpatient visits) was analyzed using descriptive statistics and adjusted logistic regression.

Main Results:

• The study included 10,564 veterans with depression, with 2,643 TGD veterans matched with 7,921 CG veterans.
• TGD veterans had significantly more specialty mental health visits per year (mean 13.93 vs 8.46).
• TGD veterans were 2.6 times more likely to have an outpatient mental health visit compared to CG veterans, even after adjusting for covariates.

Conclusions:

• TGD veterans with depression demonstrate significantly higher utilization of mental health services compared to CG veterans.
• These findings suggest that different health system resources may be necessary to adequately address the mental health needs of TGD veterans.
• Further research is essential to understand the determinants of these utilization differences and to develop targeted interventions.