Gender identity and mental health inequalities in Australia: Population-level evidence from 22 years of panel data
Melbourne Institute Working Paper No. 06/24
Date: June 2024
Author(s):
Abstract
Background: Evidence exists that trans, nonbinary, and gender diverse (TGD) people experience poorer mental health outcomes relative to cisgender populations. However, a lack of information on gender diversity in longitudinal surveys has hindered efforts to understand how TGD mental health inequalities are changing over time. With newly available information on gender diversity within Australia’s largest national longitudinal study, we aimed to provide the first national estimates of temporal trends in TGD inequalities in self-reported mental health.
Methods: We used the 2001-2022 Household, Income and Labour Dynamics in Australia (HILDA) survey, a large, national probability sample of Australian adults. Using questions about sex at birth and gender identity, asked in the 2022 wave, we compared TGD and cisgender respondents. Mental health was measured using the five-item Mental Health Inventory (MHI). Adjusting for observable characteristics, we then calculated population-weighted estimates of mean MHI scores for TGD and cisgender respondents in each year.
Findings: Across the 22-year sample period, TGD respondents consistently reported poorer mental health than cisgender respondents. Prior to 2009, TGD-cisgender MHI inequalities were more variable but generally TGD respondents had lower MHI scores than cisgender respondents. After 2009 the disparities widened, with TGD-cisgender MHI inequalities ranging from -4.8 (95% CI -7.5;-2.1) to -10.2 (95% CI -13.2;-7.3), which represent clinically relevant differences in mental health.
Interpretation: TGD-cisgender mental health inequalities are increasing in Australia, with inequalities more apparent between 2009 and 2022. These results highlight the urgent need for policy action and greater protections for gender diverse Australians.
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