How Childhood Maltreatment Contributes to Explaining Depressive Symptoms in Transgender and Gender-Diverse...

Transgender and gender-diverse (TGD) individuals experience disproportionately high rates of childhood trauma and depression; however, the mechanisms linking gender identity and depressive symptoms remain insufficiently understood. This study examines differences in depressive symptoms and childhood trauma between cisgender (CG) and TGD adults. It investigates whether specific subtypes of childhood maltreatment mediate the association between gender identity and depression.

The cross-sectional online study included 249 participants aged 18-72 years (M = 30.85, SD = 12.72), including 144 CG (75 women and 69 men) and 105 TGD individuals (44 transgender and 61 gender diverse individuals). Depression symptoms were assessed using the nine-item Patient Health Questionnaire (PHQ-9), while childhood trauma experiences were measured using the Childhood Trauma Questionnaire-Short Form (CTQ-SF).

The independent-sample Student's t-test showed that TGD participants reported significantly higher levels of depressive symptoms and all forms of childhood trauma than cisgender individuals. Mediation analyses indicated that overall childhood trauma partially mediated the association between gender identity and depression. In parallel mediation models, emotional abuse emerged as the primary statistical mediator, with sexual abuse showing a smaller indirect effect.

The findings extend prior prevalence-focused research by identifying specific childhood trauma pathways associated with depressive symptoms in TGD adults. Experiencing traumatic events during childhood may be a key factor contributing to an increased risk of depression in adulthood, particularly among the TGD population. Therefore, intervention and prevention programs should target TGD individuals and their families to minimize the risk of adverse childhood experiences and mental health disorders. The results underscore the importance of trauma-informed and gender-affirming mental health care and highlight emotional abuse as a particularly salient correlate of depression in this population.