There is a paucity of research on transgender and gender nonconforming (TGNC) students who present to university counseling centers (UCCs). Using national-level data from the Center for Collegiate Mental Health (2012 to 2015), the current findings indicate that TGNC students seeking services at UCCs are presenting with high acuity and more severe concerns than their cisgender peers. This severity is in nearly every clinical domain including suicidality, history of hospitalization, trauma history, mood disorders, and family distress. Comparing the transgender and gender nonconforming (GNC) collegiate clients, GNC clients have the highest levels of distress and clinical symptoms on nearly every indicator. Overall, these findings for both transgender and GNC clients provide important information for UCCs about treatment and outreach to these high-risk populations. Our findings also mirror the mental health disparities seen in noncollegiate community TGNC samples. We discuss treatment implications, limitations, and suggestions for future research.
American Psychological Association. (2015). Guidelines for psychological practice with transgender and gender nonconforming people. American Psychologist, 70, 832–864. doi:10.1037/a0039906
2.
BeemynB. G. (2003). Serving the needs of transgender college students. Journal of Gay & Lesbian Issues in Education, 1, 33–50. doi:10.1300/J367v01n01_03
3.
BeemynB. G. (2005). Making campuses more inclusive of transgender students. Journal of Gay & Lesbian Issues In Education, 3, 77–87. doi:10.1300/J367v03n01_08
4.
BeemynB.CurtisB.DavisM.TubbsN. J. (2005). Transgender issues on college campuses. In SanloR. (Ed.), Gender identity and sexual orientation: Research, policy, and personal (New Directions for Student Services, No. 111, pp. 49–60). San Francisco, CA: Jossey-Bass.
5.
BeemynG.RankinS. (2011). The lives of transgender people. New York, NY: Columbia University Press.
6.
CarmelT. C.Erickson-SchrothL. (2016). Mental health and the transgender population. Psychiatric Annals, 46, 346–349. doi:10.3928/00485713-20160419-02
7.
CastonguayL. G.LockeB. D.HayesJ. A. (2011). The Center for Collegiate Mental Health: An example of a practice-research network in university counseling centers. Journal of College Student Psychotherapy, 25, 105–119.
Clements-NolleK.MarxR.GuzmanR.KatzM. (2001). HIV prevalence, risk behaviors, health care use, and mental health status of transgender persons: Implications for public health intervention. American Journal of Public Health, 91, 915–921. doi:10.2105/ajph.91.6.915
11.
Clements-NolleK.MarxR.KatzM. (2006). Attempted suicide among transgender persons: The influence of gender-based discrimination and victimization. Journal of Homosexuality, 51, 53–69. doi:10.1300/J082v51n03_04
12.
ColemanE.BocktingW.BotzerM.Cohen-KettenisP.DeCuypereG.FeldmanJ.. . . MonstreyS. (2012). Standards of care for the health of transsexual, transgender, and gender-nonconforming people, version 7. International Journal of Transgenderism, 13, 165–232. doi:10.1080/15532739.2011.700873
13.
ConronK. J.ScottG.StowellG. S.LandersS. J. (2012). Transgender health in Massachusetts: Results from a household probability sample of adults. American Journal of Public Health, 102, 118–122. doi:10.2105/AJPH.2011.300315
14.
dickeyl.m.SinghA.ChangS.C.RehrigM. (2017). Advocacy and social justice: The next generation of counseling and psychological practice with transgender and gender nonconforming clients. In SinghA.dickeyl. (Eds.), Affirmative counseling and psychological practice with transgender and gender nonconforming clients. Washington, DC: American Psychological Association.
15.
DonatoneB.RachlinK. (2013). An intake template for transgender, transsexual, genderqueer, gender nonconforming, and gender variant college students seeking mental health services. Journal of College Student Psychotherapy, 27, 200–211. doi:10.1080/87568225.2013.798221
16.
DuganJ. P.KuselM. L.SimounetD. M. (2012). Transgender college students: An exploratory study of perceptions, engagement, and educational outcomes. Journal of College Student Development, 53, 719–736. doi:10.1353/csd.2012.0067
17.
EffrigJ. C.BieschkeK. J.LockeB. D. (2011). Examining victimization and psychological distress in transgender college students. Journal of College Counseling, 14, 143–157. doi:10.1002/j.2161-1882.2011.tb00269.x
18.
Erickson-SchrothL. (2014). Trans bodies, trans selves: A resource for the transgender community. Oxford University Press.
19.
GarveyJ. C.RankinS. R. (2015). The influence of campus experiences on the level of outness among trans-spectrum and queer-spectrum students. Journal of Homosexuality, 62, 374–393. doi:10.1080/00918369.2014.977113
20.
GrantJ. M.MottetL. A.TanisJ.HarrisonJ.HermanJ. L.KeislingM. (2011). Injustice at every turn: A report of the National Transgender Discrimination Survey. Washington, DC: National Center for Transgender Equality.
21.
GrossmanA. H.D’augelliA. R. (2007). Transgender youth and life-threatening behaviors. Suicide and Life-Threatening Behavior, 37, 527–537. doi:10.1521/suli.2007.37.5.527
22.
HarrisonJ.GrantJ.HermanJ. L. (2012). A gender not listed here: Genderqueers, gender rebels, and otherwise in the National Transgender Discrimination Survey. LGBTQ Public Policy Journal at the Harvard Kennedy School, 2, 13–24.
23.
HendricksM. L.TestaR. J. (2012). A conceptual framework for clinical work with transgender and gender nonconforming clients: An adaptation of the Minority Stress Model. Professional Psychology: Research and Practice, 43, 460. doi:10.1037/a0029597
24.
KenagyG. P. (2005). Transgender health: Findings from two needs assessment studies in Philadelphia. Health & Social Work, 30, 19–26. doi:10.1093/hsw/30.1.19
25.
LevA. I. (2004). Transgender emergence. New York, NY: Haworth Clinical Practice Press.
26.
LockeB. D.BieschkeK. J.CastonguayL. G.HayesJ. A. (2012). The Center for Collegiate Mental Health (CCMH): Studying college student mental health through an innovative research infrastructure that brings science and practice together. Harvard Review of Psychiatry, 20, 233–245.
27.
LockeB. D.Soet BuzolitzJ.LeiP. W.BoswellJ. F.McAleaveyA. A.SevigT. D.. . . HayesJ. A. (2011). Development of the Counseling Center Assessment of Psychological Symptoms-62 (CCAPS-62). Journal of Counseling Psychology, 58, 97–109. doi:10.1037/a0021282
28.
MaguenS.ShipherdJ. C. (2010). Suicide risk among transgender individuals. Psychology & Sexuality, 1, 34–43. doi:10.1080/19419891003634430
29.
McAleaveyA. A.LockardA. J.CastonguayL. G.HayesJ. A.LockeB. D. (2015). Building a practice research network: Obstacles faced and lessons learned at the Center for Collegiate Mental Health. Psychotherapy Research, 25, 134–151. doi:10.1080/10503307.2014.883652
30.
McKinneyJ. S. (2005). On the margins: A study of the experiences of transgender college students. Journal of Gay & Lesbian Issues in Education, 3, 63–76. doi:10.1300/J367v03n01_07
31.
MeyerI. H. (2003). Prejudice, social stress, and mental health in lesbian, gay, and bisexual populations: Conceptual issues and research evidence. Psychological Bulletin, 129, 674–697. doi:10.1037/0033-2909.129.5.674
32.
MilletN.LongworthJ.ArcelusJ. (2017). Prevalence of anxiety symptoms and disorders in the transgender population: A systematic review of the literature. International Journal of Transgenderism, 18, 27–38. doi:10.1080/15532739.2016.1258353
33.
MizockL.LundquistC. (2016). Missteps in psychotherapy with transgender clients: Promoting gender sensitivity in counseling and psychological practice. Psychology of Sexual Orientation and Gender Diversity, 3, 148–155. doi:10.1037/sgd0000177
34.
MoradiB.TebbeE. A.BrewsterM. E.BudgeS. L.LenzenA.EgeE.. . . FloresM. J. (2016). A content analysis of literature on trans people and issues: 2002–2012. The Counseling Psychologist, 44, 960–995. doi:10.1177/0011000015609044
35.
NuttbrockL.HwahngS.BocktingW.RosenblumA.MasonM.MacriM.BeckerJ. (2010). Psychiatric impact of gender-related abuse across the life course of male-to-female transgender persons. Journal of Sex Research, 47, 12–23. doi:10.1080/00224490903062258
36.
ParentM. C. (2013). Handling item-level missing data: Simpler is just as good. The Counseling Psychologist, 41, 568–600. doi:10.1177/0011000012445176
37.
Perez-BrumerA.HatzenbuehlerM. L.OldenburgC. E.BocktingW. (2015). Individual-and structural-level risk factors for suicide attempts among transgender adults. Behavioral Medicine, 41, 164–171. doi:10.1080/08964289.2015.1028322
38.
PryorJ. T. (2015). Out in the classroom: Transgender student experiences at a large public university. Journal of College Student Development, 56, 440–455. doi:10.1353/csd.2015.0044
39.
RadloffL. S. (1977). The CES-D scale: A self-report depression scale for research in the general population. Applied Psychological Measurement, 1, 385–401. doi:10.1177/014662167700100306
40.
RankinS. R. (2003). Campus climate for gay, lesbian, bisexual and transgender people: A national perspective. Washington DC: National Gay and Lesbian Task Force Policy Institute.
41.
RichardsC.BoumanW. P.SealL.BarkerM. J.NiederT. O.T’SjoenG. (2016). Non-binary or genderqueer genders. International Review of Psychiatry, 28, 95–102. doi:10.3109/09540261.2015.1106446
42.
SaferJ. D.ColmanE.FeldmanJ.GarofaloR.HembreeW.RadixA.SeveliusJ. (2016). Barriers to health care for transgender individuals. Current Opinions in Endocrinology, Diabetes, and Obesity, 23, 168–171. doi:10.1097/MED.0000000000000227
43.
SeelmanK. L. (2016). Transgender adults’ access to college bathrooms and housing and the relationship to suicidality. Journal of Homosexuality, 63, 1378–1399. doi:10.1080/00918369.2016.1157998
44.
SinghA. A.dickeyl. m. (2016). Implementing the APA guidelines on psychological practice with transgender and gender nonconforming people: A call to action to the field of psychology. Psychology of Sexual Orientation and Gender Diversity, 3, 195–200. doi:10.1037/sgd0000179
45.
SinghA.dickeyl. m. (Eds.). (2017). Perspectives on sexual orientation and diversity. Affirmative counseling and psychological practice with transgender and gender nonconforming clients. Washington, DC: American Psychological Association. doi:10.1037/14957-000
46.
SinghA. A.MengS.HansenA. (2013). “It’s already hard enough being a student”: Developing affirming college environments for trans youth. Journal of LGBT Youth, 10, 208–223. doi:10.1080/19361653.2013.800770
47.
SlinkerB.K.GlantzS.A. (1988). Multiple linear regression is a useful alternative to traditional analysis of variance. American Journal of Physiology, 255, 353–367. doi:10.1152/ajpregu.1988.255.3.R353
48.
SnelgroveJ. W.JasudavisiusA. M.RoweB. W.HeadE. M.BauerG. R. (2012). “Completely out-at-sea” with “two-gender medicine”: A qualitative analysis of physician-side barriers to providing healthcare for transgender patients. BMC Health Service Research, 12, 1–13. doi:10.1186/1472-6963-12-110
49.
TebbeE. A.MoradiB.BudgeS. L. (2016). Enhancing scholarship focused on trans people and issues. The Counseling Psychologist, 44, 950–959. doi:10.1177/0011000015608950
50.
TestaR. J.SciaccaL. M.WangF.HendricksM. L.GoldblumP.BradfordJ.BongarB. (2012). Effects of violence on transgender people. Professional Psychology: Research and Practice, 43, 452–459.
51.
ToomeyR. B.CardN. A.CasperD. M. (2014). Peers’ perceptions of gender nonconformity: Associations with overt and relational peer victimization and aggression in early adolescence. The Journal of Early Adolescence, 34, 463–485. doi:10.1177/0272431613495446
52.
WhiteI. R.RoystonP.WoodA. M (2011). Multiple imputation using chained equations: Issues and guidance for practice. Statistics in Medicine, 30, 377–399. doi:10.1002/sim.4067
53.
XavierJ. M.BobbinM.SingerB.BuddE. (2005). A needs assessment of transgendered people of color living in Washington, DC. International Journal of Transgenderism, 8, 31–47. doi:10.1300/J485v08n02_04
54.
XavierJ.HonnoldJ. A.BradfordJ. (2007). The health, health-related needs, and lifecourse experiences of transgender Virginians. Virginia: Virginia HIV Community Planning Committee and Virginia Department of Health.
Supplementary Material
Please find the following supplemental material available below.
For Open Access articles published under a Creative Commons License, all supplemental material carries the same license as the article it is associated with.
For non-Open Access articles published, all supplemental material carries a non-exclusive license, and permission requests for re-use of supplemental material or any part of supplemental material shall be sent directly to the copyright owner as specified in the copyright notice associated with the article.
