Transgender people who give birth are likelier than mothers who identify with their biological sex to have chronic health problems like anxiety and depression, a new study found.
Seven researchers published the study Thursday in the Journal of the American Medical Association, examining the records of 256 trans people and 1,255,942 cisgender women in the Medicaid database who delivered a child between 2014 and 2018. They also looked at the commercial insurance records of 1,651 trans people and 1,465,565 cisgender women over the same period.
The study found that patients coded for gender dysphoria — the international medical designation used for women who identify as transgender men, nonbinary or gender fluid — were likelier than others in both databases to report respiratory illness, anxiety or depression at the time they gave birth.
Additionally, publicly insured trans patients were likelier than women who identified with their birth sex to report alcoholism, drug abuse and “any chronic health issue” such as HIV or liver disease.
The study addresses an absence of research on childbirth outcomes among transgender people, who generally “have worse health outcomes than cisgender individuals,” the researchers noted.
Their study also found that transgender people had similar rates of severe parental morbidity and preterm birth — and lower rates of cesarean delivery – compared with cisgender women.
“Difference in cesarean birth rates may result from differences in birth care clinicians or interventions,” the researchers wrote. “The similar outcomes occurred despite trans people having higher overall prevalence of chronic conditions.”
The study found that trans people receiving public insurance through Medicaid were younger (averaging 23 years old) than cisgender people (average age 26), less likely to be White (33.6% compared with 49.8%) and likelier to have a chronic condition (22.7% versus 14.9%) like anxiety, depression, respiratory illness and substance abuse.
Privately insured trans people had higher rates of anxiety or depression (5.5% versus 3.4%) and respiratory illness (3.7% versus 2.9%) than mothers who identified with their biological sex. They were about the same average age (30) as other moms, but commercial insurance records did not disclose their race.
Limitations of the study included the likelihood that some patients did not disclose their transgender status to doctors, the researchers noted. Other limitations were the failure of the study to measure the impact of testosterone use on trans parents trying to become male and the inability of researchers to measure differences in rare cases of severe parental morbidity.
