Association of Exposure to Online Harassment and Stigma With Mental Health Among Transgender and Nonbinary Young Adults in the United States.

PURPOSE: Transgender and nonbinary young adults (TNB YA) in the United States (U.S.) have higher risk of adverse mental health outcomes than cisgender YA, due in part by exposure to social stressors such as online harassment.

METHODS

We analyzed cross-sectional data from an online survey of U.S. TNB YA ages 18-25 years (n = 152). We assessed lifetime experiences of online harassment in six domains (e.g., physical threat); participants reported whether the harassment was based on a stigmatized social status (e.g., gender, weight). Logistic models assessed associations between online harassment and prevalence of three mental health indicators: eating disorders (ED), anxiety, and depressive symptoms. Among those reporting any online harassment, we examined associations between harassment based on gender, race/ethnicity, or weight and each mental health indicator.

RESULTS

Three in four participants (78%) had experienced any form of online harassment. Those who experienced online harassment had higher prevalence of all three mental health indicators relative to those who had not experienced online harassment (e.g., ED symptoms, adjusted prevalence ratio [aPR] = 1.92; 95% confidence interval [CI] = 1.09, 3.37). Among the subset who experienced online harassment, 89% reported gender-based, 36% reported race-based, and 33% reported weight-based harassment. Weight-based harassment was significantly associated with ED (aPR = 1.90; 95% CI = 1.27, 2.84) and depressive symptoms (aPR = 1.41; 95% CI = 1.00, 1.97) after adjustment.

DISCUSSION: Exposure to online social stressors was common and associated with mental distress in a sample of TNB YA. Research and advocacy are needed to develop clinical and policy interventions to help protect TNB YA from harassment online.