title: Gender abuse and major depression among transgender women: a prospective study of vulnerability and resilience.
abstract: OBJECTIVE
  We examined the social and interpersonal context of gender abuse and its effects on Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition major depression among transgender women.
  
  
  METHODS
  We conducted a 3-year prospective study (2004-2007) among 230 transgender women aged 19 to 59 years from the New York City Metropolitan Area. Statistical techniques included generalized estimating equations (logistic regression).
  
  
  RESULTS
  We observed significant associations of psychological and physical gender abuse with major depression during follow-up. New or persistent experiences of both types of abuse were associated with 4- to 7-fold increases in the likelihood of incident major depression. Employment, transgender presentation, sex work, and hormone therapy correlated across time with psychological abuse; the latter 2 variables correlated with physical abuse. The association of psychological abuse with depression was stronger among younger than among older transgender women.
  
  
  CONCLUSIONS
  Psychological and physical gender abuse is endemic in this population and may result from occupational success and attempts to affirm gender identity. Both types of abuse have serious mental health consequences in the form of major depression. Older transgender women have apparently developed some degree of resilience to psychological gender abuse.
authors: At the time of this research, Larry Nuttbrock, Andrew Rosenblum, Sel Hwahng, Mona Mason, Monica Macri, and Jeffrey Becker were with the National Development and Research Institutes, New York, NY. Walter Bockting was with the Division of Gender, Sexuality and Health, New York State Psychiatric Institute, Columbia University, New York, NY.
authors: Larry
authors: L
authors: Nuttbrock
authors: Walter
authors: W
authors: Bockting
authors: Andrew
authors: A
authors: Rosenblum
authors: Sel
authors: S
authors: Hwahng
authors: Mona
authors: M
authors: Mason
authors: Monica
authors: M
authors: Macri
authors: Jeffrey
authors: J
authors: Becker
mesh_terms: D000328:Adult; D003865:Major Depressive Disorder / Q000453:epidemiology* / Q000209:etiology; D005260:Female; D006801:Humans; D016014:Linear Models; D016015:Logistic Models; D008875:Middle Aged; D009519:New York City / Q000453:epidemiology; D015995:Prevalence; D011446:Prospective Studies; D055500:Resilience, Psychological; D013179:Spouse Abuse / Q000523:psychology* / Q000706:statistics & numerical data; D019966:Substance-Related Disorders / Q000453:epidemiology; D063106:Transgender Persons / Q000523:psychology* / Q000706:statistics & numerical data; D055815:Young Adult; D008297:Male