Trajectories of antidepressant dispensing among privately insured transgender people in the United States.

Psychiatric medication utilization studies rarely identify transgender and gender diverse (TGD) people, masking TGD health inequities. This study assessed antidepressant prescription fill patterns and their predictors among a privately insured TGD sample with newly dispensed anti-depressants after a recent depression or anxiety diagnosis from Merative MarketScan commercial insurance claims from 2007 to 2021. We measured trajectories of antidepressants utilization over 6-months using group-based trajectory modeling (GBTM), then identified demographic and clinical predictors of medication utilization group membership. Among 2499 TGD people with depression or anxiety, we found three anti-depressant dispensing trajectory groups (short-term [21.1%], decreasing [32.3%], and long-term [46.6%]). TGD people with previous chronic co-morbidities or emergency department visits had an increased probability of shorter-term antidepressant dispensing compared to long-term dispensing. TGD people under the age of 25 and those with previous psychotherapy treatment were less likely to have shorter-term anti-depressant dispensing than those with older ages (25-64) and those without prior psychotherapy. This study provides real-world evidence of distinct anti-depressant dispensing patterns and predictive factors associated with shorter-term dispensing among TGD people. Policymakers, providers, and advocacy groups can utilize findings to inform tailored strategies to improve sustained antidepressant use among TGD people living with mental health conditions.